DEVELOPMENT OF A PARTICIPATORY EYE CARE PROGRAM TO REDUCE EYE STRAIN IN COMPUTER USERS STAFF AT SUKHOTHAI THAMMATHIRAT OPEN UNIVERSITY, THAILAND

Abstract

Eye strain or asthenopia is a public health problem that affects more than two thirds of all computer users globally. The objectives of this study were to: (1) determine the prevalence, factors associated with eye strain, and the need for measures to prevent eye strain of computers user staff at Sukhothai Thammathirat Open University (STOU), Thailand. (2) assess the extent to which preventive strategies were associated with eye strain among computer user staff in STOU. (3) develop a participatory eye care (PEC) program, (4) compare total score of knowledge, attitude and practices (KAP), and eye strain symptoms before and after the PEC program implementation. The study consisted of 3 phases. The first phase, proportional stratified random sampling was used to select study subjects in 11 offices of STOU. A total of 295 computer user staff completed a valid self-report questionnaire including eye strain symptoms, associated factors, and the need for practical measures to prevent eye strain. Categorical variables were summarized using frequencies and percentages. Stepwise multiple regression analysis was used to evaluate the relationship among the factors. Binary logistic regression analysis was used to estimate the association of eye strain symptoms with potential variables. Subsequently, a participatory approach was held by organize a potential group of 26 stakeholders meeting to get the opinion and strategies which practical to reduce eye strain. The second phase, a participatory eye care (PEC) program was developed base on the finding of initial survey and results of the participatory approach. The third phase, 35 computer user staff were enrolled in each group of intervention group and control group. Quasi-experimental research design was used to evaluate the effectiveness of the PEC program by comparing on KAP scores and eye strain symptoms before and after the PEC program implementation for 8 weeks. Generalized linear model was used for comparison of two proportions of eye strain symptoms. Repeated measures ANOVA was used to compare group means of KAP across repeated measurements of time. The results revealed that: (1) A high prevalence (84.7%) of eye strain found in computer user staff of STOU. The average age of these participants was 42 years (age range 21- 60), and 78.3% were female. The factors significantly associated with eye strain were hours per day of computer work, continuous hours of working on computer, and distance between eyes and screen (p<0.05). The majority of participants reported that the measure they needed the most was the additional rest breaks with break reminder, followed by providing instructional materials about eye exercises, and organizing training courses on computer eye strain – 84.4%, 81.0%, and 48.8%, respectively. (2) taking regular rest breaks (OR = 0.37; 95% CI = 0.18-0.79) and doing eye exercise during computer used (OR = 0.74; 95% CI = 0.03 – 0.16) had a significant association with a lower prevalence of eye strain. (3) the participatory eye care program consisted of 3-hour training course on computer eye strain, eye care manual, break reminder for resting eyes 30 seconds every 30 minutes of computer used and 15-minute rest break (in the morning and the afternoon), mouse pad and VCD for integrated eye-neck exercises. (4) the intervention was associated with reduction in percentage of eye strain symptoms in the intervention group. Inclusion of the participatory eye care program appeared to increase the beneficial effect of the intervention on knowledge, attitude, and practice scores (p<0.05). Based on the results of the analysis, the high proportion of eye strain makes it necessary to raise concerns of eye strain in computer users. The findings of this study would be able to offer a new practical program to reduce eye strain among computer user staff in other sectors.