- 期刊
以兒童近視治療實證為基礎探討校園護理人員在兒童近視控制之角色
Explore the Role of School Nurses in Children's Myopia Control Based on the Evidence of Children's Myopia Treatment
摘要
兒童高近視盛行率的問題受到世界各國重視，本文統整自2014年起共九篇有關近視治療的後設分析及系統性文獻分析，以此結果提出護理人員在協助兒童近視控制角色的建議。由實證性研究中可知，有效遏止近視進展的治療包含阿托品眼藥、角膜塑型片與周邊近視離焦隱形眼鏡與鏡框眼鏡。而藥理性近視治療產生的副作用是兒童中斷近視治療最大的問題，包含阿托品眼藥畏光、角膜塑型鏡片感染與中斷配戴。尤其是中斷治療將導致近視進展，造成屈光度數反彈增加，使兒童近視的狀況較未治療前更為惡化。此外，近視控制的不利因素包含：初發年齡早、父母為高度近視與未治療前近視度數增加快速者。因此，校園護理人員在兒童近視控制中，可扮演學童視力品質的守護者、高危險群個案管理者與跨領域衛生教育協力者，如能透過校園護理人員的協助，兒童與家長將更能落實近視治療，也能定期回診以監測近視進展，可使兒童近視控制更具成效。
並列摘要
The high prevalence of myopia in children has received attention worldwide. This article aimed to synthesize a total of nine meta-analyses and systematic literature analyses on myopia treatment since 2014 and make recommendations for the role of school nurses in assisting children with myopia control. Empirical studies had proposed effective treatments for preventing myopia progression, including atropine-based ophthalmic drugs, orthokeratology lenses, and peripheral myopia-defocusing contact lenses and spectacles. Notably, children's interruption of myopia treatment was affected by the side effects and complications of myopia treatment, such as atropine ophthalmic photophobia, orthokeratology lens care, and infection. Accordingly, interruption of treatment would lead to myopia progression, resulting in increased refractive power rebound and making the condition worse than before treatment. In addition, the unfavorable factors of myopia control included early age of onset, parents with high levels of myopia, and rapid increase in myopia before treatment. Therefore, school nurses can act as guardians of school children's vision quality in myopia treatment, case managers for high-risk groups, and cross-disciplinary health education coordinators. By assisting children and parents in implementing myopia treatment, regular return visits for monitoring myopia progression will make managing children's myopia more effective.