The impact of an eye drop booklet on distress in children when receiving eye drops

Purpose: Child- and family-centered care is an increasingly important area in healthcare. Up to now, little attention has been paid to the experience of children and their parents in ophthalmological healthcare. During their conversations at Bartiméus, children indicated that the administration of eye drops constituted the most stressful element that needed to be improved. This study describes the amount of distress experienced by children when receiving eye drops. Furthermore, it investigates the value and impact of the developed eye drop booklet, for children and parents. Methods: In this multicenter study on distress related to the administration of eye drops, 370 children participated with ocular disorders or Cerebral Visual Impairment CVI (4–12 years), from four ophthalmology outpatient clinics. Half of the children, randomly chosen, were presented with a booklet before receiving eye drops. A faces scale together with a numeric scale (0–10) was used to determine the level of distress before and after the eye drops were administered. Parents were asked how satisfied they were about using the booklet. Results: The average distress score of the children who did receive a booklet was 3.40 at T1 and 2.70 at T2, and, of the children who did not receive a booklet, this was 3.69 at T1 and 2.97 at T2. The largest levels of distress were found in children between the ages of 7 and 9. The majority of parents indicated to appreciate the booklet, scoring it at 7.6 on a scale of 1 to 10. Furthermore, 91% of them considered the booklet a good idea or good preparation, 69% found it to have a positive effect on their child, and 83% would use it again. Conclusions: At T1 and T2, the differences in the children’s distress scores were not statistically significant between the booklet group and the group who did not use the booklet. Children, generally, anticipated greater discomfort than what they actually experienced during the administration of eye drops. For most children, the booklet had a positive effect on their distress levels, but not for all. A large majority of parents noticed the added value of the booklet for their child. They were very positive and wanted to continue using the booklet in the future, as it appeared to give their child a sense of control during the administration of eye drops.