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Abstract：
OBJECTIVE: This study aims to determine the factors influencing eye care service utilisation and compliance with spectacles wear among school students.
METHODS: Mixed-methods study.
METHODS: 27 community schools from 6 districts of Bagmati province of Nepal.
METHODS: Adolescents with mild vision impairment who were screened at schools by their trained peers for visual acuity measurement and subsequently received subsidised spectacles for refractive error correction. For the quantitative study, 317 students from 21 schools completed the survey. For qualitative study, 62 students from 6 schools participated in 6 focus group discussions.
METHODS: Utilisation of eye care services and compliance with spectacles wear.
RESULTS: Among 317 students, 53.31% were aged 15-19, and 35.96% were male. More than half (52.68%, n=167) did not use eye health services. Among students who did not go, 51.50% reported eye health facilities being far away. Thematic analysis showed that distance, COVID-19 and awareness were influential in the utilisation of eye care. The multivariate analysis showed urban residents were likelier (adjusted OR (AOR) 4.347, 95% CI 2.399 to 7.877, p<0.001) to use eye care services. During an unannounced visit to schools after 3-4 months of spectacles distribution, 188 (59.31%) students were wearing spectacles. 20.16% of students not wearing spectacles reported they did not feel the need. Thematic analysis showed the influence of family and peers, affordability, aesthetic appearance, comfortability and symptomatic relief in spectacles compliance. The multivariate analysis showed that urban residents (AOR 2.552, 95% CI 1.469 to 4.433, p<0.001), older adolescents (AOR 1.758, 95% CI 1.086 to 2.848, p=0.022), mothers with paid jobs (AOR 2.440, 95% CI 1.162 to 5.125, p=0.018) and students visiting eye care centres (AOR 1.662, 95% CI 1.006 to 2.746, p=0.047) were more likely to be compliant with spectacles wear.
CONCLUSIONS: There are multiple barriers for students to use eye care services and stay compliant with spectacles wear. Eye health programmes should include eye health promotion and be accessible, affordable and equitable.
METHODS: Mixed-methods study.
METHODS: 27 community schools from 6 districts of Bagmati province of Nepal.
METHODS: Adolescents with mild vision impairment who were screened at schools by their trained peers for visual acuity measurement and subsequently received subsidised spectacles for refractive error correction. For the quantitative study, 317 students from 21 schools completed the survey. For qualitative study, 62 students from 6 schools participated in 6 focus group discussions.
METHODS: Utilisation of eye care services and compliance with spectacles wear.
RESULTS: Among 317 students, 53.31% were aged 15-19, and 35.96% were male. More than half (52.68%, n=167) did not use eye health services. Among students who did not go, 51.50% reported eye health facilities being far away. Thematic analysis showed that distance, COVID-19 and awareness were influential in the utilisation of eye care. The multivariate analysis showed urban residents were likelier (adjusted OR (AOR) 4.347, 95% CI 2.399 to 7.877, p<0.001) to use eye care services. During an unannounced visit to schools after 3-4 months of spectacles distribution, 188 (59.31%) students were wearing spectacles. 20.16% of students not wearing spectacles reported they did not feel the need. Thematic analysis showed the influence of family and peers, affordability, aesthetic appearance, comfortability and symptomatic relief in spectacles compliance. The multivariate analysis showed that urban residents (AOR 2.552, 95% CI 1.469 to 4.433, p<0.001), older adolescents (AOR 1.758, 95% CI 1.086 to 2.848, p=0.022), mothers with paid jobs (AOR 2.440, 95% CI 1.162 to 5.125, p=0.018) and students visiting eye care centres (AOR 1.662, 95% CI 1.006 to 2.746, p=0.047) were more likely to be compliant with spectacles wear.
CONCLUSIONS: There are multiple barriers for students to use eye care services and stay compliant with spectacles wear. Eye health programmes should include eye health promotion and be accessible, affordable and equitable.
摘要：
目的：本研究旨在确定影响学生眼部护理服务利用率和眼镜佩戴依从性的因素。
方法：混合方法研究。
方法：来自尼泊尔巴格马蒂省6个地区的27所社区学校。
方法：患有轻度视力障碍的青少年在学校接受了受过训练的同龄人进行视力测量的筛查，随后接受了矫正屈光不正的补贴眼镜。对于定量研究，来自21所学校的317名学生完成了调查。对于定性研究，来自6所学校的62名学生参加了6次焦点小组讨论。
方法：使用眼部护理服务并遵守眼镜佩戴。
结果：在317名学生中，15-19岁占53.31%，男性占35.96%。超过一半（52.68%，n=167）没有使用眼保健服务。在没有去的学生中，51.50％的人报告说，眼保健设施很远。主题分析表明，距离，COVID-19和意识对眼部护理的利用有影响。多变量分析显示，城市居民更有可能使用眼部护理服务（校正OR（AOR）4.347，95％CI2.399至7.877，p<0.001）。在经过3-4个月的眼镜分发后对学校的暗访中，188名（59.31%）学生戴眼镜。20.16％的学生没有戴眼镜，他们认为没有必要。主题分析表明，家庭和同龄人的影响，负担能力，美观的外观，眼镜依从性的舒适性和症状缓解。多因素分析显示,城镇居民(AOR2.552,95%CI1.469~4.433,p<0.001),年龄较大的青少年（AOR1.758，95%CI1.086至2.848，p=0.022），有带薪工作的母亲(AOR2.440,95%CI1.162至5.125,p=0.018)和参观眼部护理中心的学生(AOR1.662,95%CI1.006至2.746,p=0.047)更有可能符合眼镜佩戴要求。
结论：学生在使用眼部护理服务和遵守眼镜佩戴方面存在多种障碍。眼睛健康计划应包括促进眼睛健康，并易于获得，负担得起和公平。
方法：混合方法研究。
方法：来自尼泊尔巴格马蒂省6个地区的27所社区学校。
方法：患有轻度视力障碍的青少年在学校接受了受过训练的同龄人进行视力测量的筛查，随后接受了矫正屈光不正的补贴眼镜。对于定量研究，来自21所学校的317名学生完成了调查。对于定性研究，来自6所学校的62名学生参加了6次焦点小组讨论。
方法：使用眼部护理服务并遵守眼镜佩戴。
结果：在317名学生中，15-19岁占53.31%，男性占35.96%。超过一半（52.68%，n=167）没有使用眼保健服务。在没有去的学生中，51.50％的人报告说，眼保健设施很远。主题分析表明，距离，COVID-19和意识对眼部护理的利用有影响。多变量分析显示，城市居民更有可能使用眼部护理服务（校正OR（AOR）4.347，95％CI2.399至7.877，p<0.001）。在经过3-4个月的眼镜分发后对学校的暗访中，188名（59.31%）学生戴眼镜。20.16％的学生没有戴眼镜，他们认为没有必要。主题分析表明，家庭和同龄人的影响，负担能力，美观的外观，眼镜依从性的舒适性和症状缓解。多因素分析显示,城镇居民(AOR2.552,95%CI1.469~4.433,p<0.001),年龄较大的青少年（AOR1.758，95%CI1.086至2.848，p=0.022），有带薪工作的母亲(AOR2.440,95%CI1.162至5.125,p=0.018)和参观眼部护理中心的学生(AOR1.662,95%CI1.006至2.746,p=0.047)更有可能符合眼镜佩戴要求。
结论：学生在使用眼部护理服务和遵守眼镜佩戴方面存在多种障碍。眼睛健康计划应包括促进眼睛健康，并易于获得，负担得起和公平。
