الفهرس 
Visual impairment among primary school studentsOnly 14 pages are availabe for public view
 |  | from | 277 |  |  |
| | | from | 277 | | |
Abstract
Childhood visual impairment has been a priority area for Vision 2020: the right to sight initiative of the World Health Organization. Childhood visual impairment is important not only because these children have a lifetime of visual impairment ahead but also because it has profound psychological, educational, and economic effects on the individual and the community. Furthermore, many of the causes of visual impairment in children are either preventable or treatable (Gyawali et al., 2017).
Based on the causes of visual impairment are important for proper allocation of resources to appropriate preventive and curative services. Some of the causes may require primary-level public health interventions such as immunization and nutrition for corneal scarring, whereas others will need tertiary-level interventions such as surgery and low-vision services for conditions such as cataracts, retinopathy of prematurity, and glaucoma (Gyawali & Moodley., 2017).
Aim of the study:
This study aimed to assess quality of life for primary school students with visual impairment, through:
1- Assessing parent’s knowledge regarding visual impairment.
2- Assessing the impact of visual impairment on the quality of life for students with visual impairment.
3- Assessing the interfering of visual impairment with school performance for students with visual impairment.
4- Assessing the school environment for students with visual impairment.
Research Questions:
1- Is there a relationship between socio-demographic characteristics and quality of life for primary school students with visual impairment?
2- What are the factors that affect quality of life of the primary school students with visual impairment?
Subjects and Methods:
Are described under the following four designs technical, operational, administrative, and statistical.
Design: This is a descriptive study.
Setting:
The study was conducted at the outpatient clinic of health insurance of the Fayoum governorate, which covers 223 primary schools affiliated to the management of the Fayoum education area.
Subjects of the study:
Sample:
All students enrolled in the health insurance of Fayum governorate through six months (purposive sample) were included in this study. They were 300 students; 128 male and 172 female and a representative sample from the total primary schools were (5 schools) to assess the primary school environment for students with visual impairment. The data collection was started and finished through 6 months starting from October 2019 to the end of March 2020. The recruited students were chosen according to the following inclusive criteria:
1. Students diagnosed with visual impairment equal 6/60 from student`s record.
2. Age from 6 to 12 years (primary school age) and able to participate in the study.
Tools of Data Collection:
The data for this study were collected by using three tools:
Tool I: structured interview questionnaire Appendix I :
It was used to assess socio-demographics characteristics. It was designed by the investigator based on a literature review and include the following parts:
Part A: Socio-demographic characteristics of the student and their family as following:
1-Socio-demographic characteristics of the student regarding as age, gender, number of a sibling: and birth order.
2-Socio-demographic characteristics of the family regarding age, educational level, occupation, family type, number of family members, family’s monthly income, residence, number of rooms in the house, and crowding index.
Part B: Medical history of primary school students & their families as following parts:
1- Student`s medical history includes past and current medical history regarding the history of visual impairment (age of discovery of visual impairment, causes, ocular symptoms, power of eyesight 6/60 without glasses, treatment of visual impairment).
2- Family medical history regarding consanguinity between parents, family history of visual impairment, medical history, and surgical history.
Part C: 1-Assessing parent’s knowledge regarding visual impairment regarding as, meaning, causes, signs and symptoms, complication, and treatment of visual impairment.
2- Parent`s practice regarding visual impairment regarding as: immediately referred to the doctor once the child was complaining from visual impairment, Follow-up for the eye and constantly measure eyesight, wearing the glasses continuously, changing the glasses continuously, and providing a suitable environment.
Part D: Assessing the school performance for students, to assess student`s school achievement.
Tool II: Nursing Home Vision-Targeted Health-Related Quality of Life Questionnaire (NHVQOL) Appendix II:
It was designed to assess the quality of life. This tool adapted from (Elliott et al., 2008) and modified by the investigator. It includes the following parts:
Part 1: Activity of daily living (ADLs).
Part 2: Movement and mobility.
Part 3: Psychological state.
Part 4: Social Interaction.
Part 5: Activities/hobbies.
Part 6: Reading.
Part 7: Adapting/coping.
Tool III: Community School Climate Self-Assessment Tool. Appendix III:
This tool was prepared to assess the primary school environment of students with visual impairment. The investigator filled it during school visits regarding physical environment, learning & cognitive environment, social environment, emotional environment, and moral environment.
Data collection: Data were collected over 6 (six months), from the start of October 2019 until the end of March 2020. It was devoted to reviewing the relevant literature, questionnaire paper designs, and conducting the pilot study.
The study results revealed the following:
• Regarding student`s socio-demographic characteristics the current study revealed to more than half of students with visual impairment were females, with a mean age of 10.8±2; years; and more than one-third of them have 1:3 sibling.
• Concerning family`s socio-demographic characteristics more than half of mothers aged from 35 and above the mean ages of mothers was 33.8±9.2 years, nearly two-thirds of parents were secondary education (Diploma), and only a few of them were highly educated (16.0%), nearly two-thirds of mothers were housewives.
• Concerning the student`s past medical history the study showed that all of the cases have a refractive error in this study while strabismus (22.7%), Optic nerve atrophy (12.0%), Retinitis pigmentosa (12.0%), congenital cataract (8.7%), Trauma(4.7%), Glaucoma(4.0%) and others cause as; Hypoxia at birth, Lack of vitamin A and eye allergy (20.6%).
• Concerning student`s current medical history and ocular symptoms associated with visual impairment revealed that nearly half of students had eye pain and eye redness, nearly one-quarter had an itchy eye and focusing by tilting the head and eye narrowing. And nearly two-thirds of the students had power eyesight of 6/60 (without glasses) in the two eyes, while less than one-quarter the strength of vision has 6/60 in the left eye, and also less than one-quarter the strength of vision has 6/60 in the right eye and the majority of students was treated by wearing glasses.
• Concerning consanguinity between parents revealed that more than half of the family have consanguinity between parents and more than half of students had a family history of visual impairment.
• Concerning parent`s knowledge and practice , the study showed that three-quarters of student’s parents had unsatisfactory knowledge about vision impairment and care needed for the eye. And nearly three-quarters of parents do not perform health practice toward their children with VI.
• Concerning student`s school achievements the result revealed that less than one-eighth of students had excellent, only one-quarter of students had very good, less than half of students had a good level in scholastic achievement, less than one-eighth had pass and less than one-eighth had a poor level in school achievements.
• Concerning the quality of life for students with visual impairment nearly half of them had low quality of life, more than one-third of students had average QoL and more than one-eighth of them had high QoL.
• Concerning coping and adapting the most of students used optical aids as glasses while more than one-third of them used non-optical aids as magnifier and lighting, and nearly two-thirds of students spent a lot of time in thinking about their vision or ways to control their environment to help them deal with poor vision
• Concerning school climate environment more than three-quarter of school, the building was unsuitable, most of learning/ cognitive environment in schools was unsuitable, and most of the social environment in schools was unsuitable, most of the emotional environment was unsuitable and majority of the moral environment in schools was unsuitable.
Conclusion: The result of the study presented that a statistical relations between student`s socio-demographic characteristics and quality of life for primary school students with visual impairment. And the study presented that the age, gender, childbirth, consanguinity between parents, parent`s knowledge, and student`s school achievements these all factors affect the quality of life for primary school students with visual impairment.
Recommendations:
- Nurses should conduct pre-marital counseling to eliminate hereditary factors and early detect of any vision impairment cases.
- Provide an educational program to parents with VI child and encourage parents to participate in mentoring programs of eye care and receive rehabilitation for their children
- Providing early preventive and rehabilitative efforts to prevent longitudinal deterioration through Links with other agencies, including screening services social services, health services, and psychological services with visual impairment which impact the level of quality of their life.