International debate exists between several disciplines about when and how young people's vision should be screened and the relationship between vision and learning. This thesis is concerned with whether adolescents' acuity and binocular functioning can be accurately screened by a registered nurse (RN) and the impact of such a Primary Health Care (PHC) initiative on the participants. The aims of this study include to: screen the monocular and binocular vision of students aged 12 - 13 years; determine the accuracy and efficacy of the screening process; gain insight into the impact of undetected visual problems on the students' experiences with schoolwork and leisure activities; determine why young people are compliant or non-compliant with optometric intervention; and to gain insight into the impact of optometric interventions. / The RN screened 222 students in Year 8 at an Adelaide secondary school and 145 of them had follow-up optometric examinations. Several months later 25 students with poor vision were interviewed about their experiences at Primary School and whether they had followed through with the suggested optometric treatment. They also completed a questionnaire about eyestrain symptoms. Case studies were created from the quantitative and qualitative data and a Health Technology Assessment framework (HTA) used to analyse the data in a manner congruent with the study aims. This framework allowed for the social impact of the vision screening battery and optometric care to be discussed and the health and educational outcomes to be synthesized. / A large percentage (72.4%) of those who had optometric examinations had one or more vision problems. The screening battery had a sensitivity of 94.6%, specificity of 66%, Predictive Value Positive 82.9%, and Predictive Value Negative 87.5%. The case study data illustrate the complexity of the vision-learning link and the educational and social benefits to numbers of students who received optometric care. For some students, poor near vision resulted in a below-average reading performance. Poor vision was also associated with slow verbal responses, puzzled facial expressions, inattention and disruptive behaviours that resulted in school suspension. These clinical features tended to be interpreted by teachers as indicating that a student was academically less-able. Two male participants were found to have extremely poor vision and both had histories of disruptive behaviour and school failure. The RN intervention and optometric treatment enabled them to become successful learners for the first time and impacted positively on their psychological and emotional health. A number of students who were achieving excellent grades were also helped by vision care that reduced their eyestrain. / The conclusion is reached that poor vision should be recognised as a sensory disability and that universal school vision screening which includes aspects of binocularity is important for students' well-being. Subtle changes to improve the accuracy of the RN screening battery are suggested. An RN is ideally suited to be the screener and liaise between optometrists, teachers, students and parents/guardians, in order to encourage follow-up care. / Finally, healthcare and education systems need to be closely allied so that the outcomes of PHC interventions can be measured in educational and social terms rather than simply by morbidity statistics. / Thesis (PhDNursing)--University of South Australia, 2005.
| Identifer | oai:union.ndltd.org:ADTP/267413 |
| Creators | Paech, Merri. |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | copyright under review |
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