A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study
Abstract
:1. Introduction
2. Methods
2.1. Study Goal
2.2. Study Design
2.3. Participants
2.4. Measurement
2.4.1. Feasibility and Usability Assessment
2.4.2. Primary Outcome
2.4.3. Secondary Outcome
2.5. Statistical Analysis
3. Results
3.1. Development of the Compliance App
3.1.1. End-User
3.1.2. Managers
3.2. Developer and Cloud Computing
3.3. End-User Testing, Usability, and Feedback
3.3.1. System Usability Scale (SUS) Scores
3.3.2. Qualitative Feedback and Satisfaction with the App
3.4. Preliminary Outcomes
4. Discussion
Principal Findings
5. Conclusions
6. Limitations and Future Directions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
OK | Orthokeratology |
SUS | System Usability Scale |
ECPs | Eye care professionals |
SER | Spherical equivalent refraction |
D | Diopter |
AL | Axial length |
VA | Visual acuity |
CVI | Content validity index |
Appendix A
- How do you manage children wearing orthokeratology lenses?
- What are the factors that make young children to adhere to care orthokeratology lenses successfully?
- What kind of knowledge and assistance should parents who care for children with orthokeratology lenses provided by ECPs?
References
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Steps | Step 1 | Step 2 | Step 3 | Step 4 |
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Time | 2019.8–2019.12 | 2020.3–2020.6 | 2020.3–2020.7 | 2021.8–2021.12 |
Method | Qualitative | Qualitative | Quantitative | Qualitative |
Sampling |
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Purpose |
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Steps | 1 | 2 | 3 | 4 |
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Participants | 16 mothers/3 fathers | 827 posts from 2018 to 2021 had been analyzed | 253 parents | 2 optometrists, 2 ophthalmologists, and 1 nurse |
Main themes | ||||
Wear and Care |
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Intensive Care |
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Ocular Symptom |
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Control Indicator |
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Follow-Up Visit |
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Application Design |
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Variable | N | % |
---|---|---|
Parents | ||
Fathers | 3 | 10.0 |
Mothers | 27 | 90.0 |
Educational level | ||
College | 4 | 13.3 |
University and above | 26 | 86.7 |
Myopia | ||
No | 2 | 6.7 |
Yes | 28 | 93.3 |
Spherical equivalent refraction (SE) of right eye (diopters, D) (range, −0.50 to −16.00 D) | ||
≤−5.00 | 4 | 14.2 |
>−5.00 | 24 | 85.8 |
Variable | N | % |
---|---|---|
Child age (range, 6 to 13 years) | Mean = 11.1 | SD = 1.33 |
<10 years old | 3 | 10.0 |
≥10 years old | 27 | 90.0 |
Onset age (range, 6 to 12 years) | Mean = 8.35 | SD = 1.50 |
<10 years old | 21 | 70 |
≥10 years old | 9 | 30 |
Spherical equivalent refraction (SER) of right eye (diopters, D) (range, 0 to −7.50 D) | Mean = −2.39 | SD = −1.32 |
>−2.00D | 1 | 3.3 |
−2.00 to −3.00 | 9 | 30.0 |
−3.00 to −4.00 | 18 | 60.0 |
−4.00 to −5.00 | 2 | 6.7 |
Period of wear (months) | Median = 9 | |
≥1~6 | 6 | 20.0 |
≥6~12 | 16 | 53.3 |
≥12 | 8 | 26.7 |
Domain | ECPs | Parents | ||
---|---|---|---|---|
Mean | SD | Mean | SD | |
Total SUS score | ||||
First month | 73.5 | 11.2 | 73.4 | 9.3 |
Third month | 83.6 | 6.3 | 82.5 | 7.2 |
Wilcoxon signed rank test | 3.84 * | 3.84 * |
Domain | Functions/Features | Suggestions | Satisfaction |
---|---|---|---|
User Interface | Login/Register | ||
1. Basic information input | E: Fill in the time for next lens replacement P: Cannot remember the degree of myopia | Mean = 3.98 (P) Mean = 4.00 (E) | |
2. Reminder | P: The icon is too small and unclear | Mean = 4.10 (P) Mean = 4.80 (E) | |
3. Compliance—care and wear | E: Should indicate the solution required for each step P: Too many items in the questionnaire | Mean = 3.76 (P) Mean = 4.00 (E) | |
4. Compliance—intensive care | P: Some tasks are completed by the child | Mean = 3.76 (P) Mean = 4.00 (E) | |
5. Ocular symptom record | P: Need to record the date | Mean = 4.00 (P) Mean = 4.00 (E) | |
6. Axial length record | E: Add multi-period query | Mean = 4.27 (P) Mean = 4.8 (E) | |
7. Health Education | Nil | Mean = 4.00 (P) Mean = 4.27 (E) | |
8. Questions and Answers | Nil | Mean = 3.76 (P) Mean = 4.00 (E) | |
9. Incentive system | Nil | Mean = 3.90 (P) Mean = 3.80 (E) | |
Administrator Interface | 10. Date for the next follow-up visit | Mean = 4.8 (E) | |
11. Axial length recorded in the current visit | Nil | Mean = 3.80 (E) | |
12. Health education information | Nil | Mean = 4.00 (E) | |
13. Broadcasts | E: Add individualized notifications | Mean = 4.00 (E) | |
Cloud Computing | 14. Axial length change | P: Serves as a reminder | Mean = 4.8 (E) |
15. Degree of compliance behaviors | P: Not very helpful | Mean = 4.0 (E) | |
16. Broadcasts—follow-ups/health education | Nil | Mean = 4.0 (E) |
Variable | Baseline | 3-Month | χ2/z |
---|---|---|---|
Full compliance | 82% | 85% | 1.62 |
Wear and wash | 90% | 92% | 1.17 |
Intensive care | 72% | 88% | 1.92 |
Regular follow-up visits | 78% | 100% | 4.25 * |
Ocular symptom—itchy eyes | 3 | 2 | 0.08 |
Ocular symptom—redness | 2 | 1 | 0.06 |
Ocular symptom—foreign body sensation | 2 | 1 | 0.06 |
Axial length growth | 24.21 | 24.25 | 0.76 |
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Sun, C.-C.; Liao, G.-Y.; Liao, L.-L.; Chang, L.-C. A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study. Int. J. Environ. Res. Public Health 2021, 18, 10316. https://doi.org/10.3390/ijerph181910316
Sun C-C, Liao G-Y, Liao L-L, Chang L-C. A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study. International Journal of Environmental Research and Public Health. 2021; 18(19):10316. https://doi.org/10.3390/ijerph181910316
Chicago/Turabian StyleSun, Chi-Chin, Gen-Yih Liao, Li-Ling Liao, and Li-Chun Chang. 2021. "A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study" International Journal of Environmental Research and Public Health 18, no. 19: 10316. https://doi.org/10.3390/ijerph181910316