Qualitative study investigating the perceptions of parents of children who failed vision screening at the age of 4-5 years

Objective: To explore in depth parents’ experiences and understanding of their children’s eye care in order to better comprehend why there is relatively low uptake of services and variable adherence to treatment. Design: Semi-structured interviews, informed by the Health Belief framework, were conducted with parents of children who had failed vision screening at age 4-5 years. Four were parents of children who never attended follow-up, 11 had children who attended but did not adhere to spectacle wear and 5 parents of children who had attended and adhered. Interviews were recorded and transcribed verbatim, thematic analysis based on the constant comparative method was undertaken. Results: Parents beliefs led to uncertainty about the benefit of treatment, with parents testing their children to confirm the presence of a vision deficit and seeking advice from other family and community members. The stigma of spectacle wear explained the resistance of some to their child’s treatment with the maintenance of ‘normality’ often more important than clinical advice. The combination of parents own health beliefs, stigma and the practicalities of attending appointments together influenced parental decisions. Attendance following vision screening and the decision to adhere to spectacle wear were primarily based on the perceived severity of the visual reduction with the perceived benefit of spectacle wear outweighing any negative consequences. Conclusions: Health care professionals require a greater understanding of parents’ decision making processes in order to provide personalised information. Knowledge of thecues to attendance and adherence provides policy makers a framework with which to review the barriers, develop strategies and redesign children’s eye care pathways