Changes in conceptions of meaning, effects and treatment of amblyopia. A phenomenographic analysis of interview data from parents of amblyopic children.

The research reported is an experimental study on the effects of intensified education of parents of children with amblyopia on their understanding of the nature of the defect, its origins and treatment. Parents in the control group were exposed to the ordinary information provided at two departments of paediatric ophthalmology, whereas parents in the experimental group, attending the same clinics, were asked to read a booklet aiming at enhancing their understanding of amblyopia and its treatment. Experimental as well as control subjects were thereafter interviewed about their understanding of the meaning of amblyopia and amblyopia-related phenomena. Data were generated in single subject, semi-structured, in-depth interviews which were taped and transcribed in extenso. The interviews were analyzed according to the phenomenographic approach: i.e. the outcome is a description of the various conceptions that emerged in the interviews. In almost all cases the categories of meaning could be hierarchically ordered with regard to the level of understanding implied. Parallel to the interviews the subjects had also filled out a questionnaire assessing general and specific attitudes towards disease and treatment (the Health Belief Model, HBM). The results reveal a superior understanding among parents in the experimental group. The experimental group had also changed attitudes towards disease and treatment in a direction that would favour compliance, more than could be observed in the control group. The outcome is discussed in terms of the role of understanding for a compliant behaviour. It is also emphasised that health care personnel would profit from being aware of the nature of common misconceptions of diseases and their treatment, in the sense that they would be better prepared for entering instructional dialogues with patients or, as in this case, other persons responsible for the management of prescriptions provided.