Page 152 - DISINVESTMENT AND IMPLEMENTATION OF VISION SCREENING TESTS BASED ON THEIR EFFECTIVENESS
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CHAPTER 8
A training programme for nurses and doctors was organised by the UMF-Cluj with support from two of the authors (AH, MF). Three courses were organised in the city of Cluj-Napoca in late 2017 with each course consisting of six hours on Saturday and Sunday. Because participation of nurses from the rural areas was low, the original implementation plan was adapted and two additional courses were organised in 2018. Travel expenses to Cluj-Napoca were not reimbursed though, nor was lodging for the two-day course. Development of the course curriculum was supervised by one of the authors (CV) and was credited with twelve points of Continuing Medical Education. The course included theory on vision problems in children as well as practical instructions on how to measure VA. Participants had to pass a test to be allowed to screen children. Because in the first six months of the implementation very few children had been screened in the rural areas, the protocol was modified by adding an alternative method of screening in August 2018: the family doctors’ nurses were advised to visit the rural kindergartens to screen the children there.
Information for parents and children
Parents’ awareness of the importance of early detection of amblyopia and their attitude towards screening, are relevant to the success of a screening programme.15 To inform parents about the purpose of screening, leaflets and posters were developed that explained the study in lay terminology. To explain the screening procedure to the children, a cartoon was developed. In adherence to the Declaration of Helsinki,16 parents’ informed consent was obtained before screening. Parents signed a consent form, approved by the UMF-Cluj’s Ethics Committee, that included detailed information about the purpose, objectives and procedures of the study and made it clear they could opt in or opt out.
After screening, the result was explained to the parents by the screener. When the child needed to be tested again, a re-examination was scheduled. In case of referral, the screeners were to instruct the parents to go to their family doctor for referral to an ophthalmologist. They were also to give the parents a list of ophthalmologists, a form with a summary of the screening result and a form for the ophthalmologist to report back the results of the examination. As it proved impossible to grant the ophthalmologists access to the project database, the parents had to return the filled- out form to the screener or to the kindergarten staff, who then had to return the filled- out form to the DASM or the UMF where secretaries entered the forms in the database.
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