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Lee, Lee, Seo, and Jung: Development and Effects of Social Learning Theory Based Eye-Health Program for Preschoolers
Original Article

J Korean Acad Nurs 2018;48(4):407-418.

Published online: 15 January 2018

DOI: https://doi.org/10.4040/jkan.2018.48.4.407

Development and Effects of Social Learning Theory Based Eye-Health Program for Preschoolers

Sunghwa Lee1, Haejung Lee2, , Hyungsik Seo3, Jaeho Jung4

1Department of Nursing, Gimhae College, Gimhae

2College of Nursing, Pusan National University, Yangsan

3Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, Pusan National University Korean Medicine Hospital, Yangsan

4Ophthalmology of Pusan National University Hospital, Yangsan, Korea

Address reprint requests to : Lee, Haejung College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea Tel: +82-51-510-8344 Fax: +82-51-510-8308 E-mail: haejung@pusan.ac.kr

Received 9 March 2018       Revised 21 June 2018       Accepted 21 June 2018

Copyright © 2018 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The purpose of this study was to develop an eye-health program based on social learning theory (EPST) of preschoolers and evaluate its effectiveness.

Methods

A nonequivalent control group pre-post test design was utilized and 141 six-year-old preschoolers and their parents participated (experimental group=69, control group=72) in the study. The EPST in this study included eye-health education and eye exercises. Attention, memory, replay, motivation, reinforcement, and self-efficacy were used as interventional strategies. To examine the effectiveness of EPST, proficiency in eye-health activities, refractive power, and visual acuity were measured before and after the intervention. Data were analyzed with SPSS WIN 21.0 using the Shapiro-Wilk test, χ 2-test, Mann-Whitney U test and Wilcoxon signed rank test.

Results

Following the intervention, eye-health activities, refractive power, and visual acuity significantly improved in the experimental group compared to the control group.

Conclusion

The results of this study suggest that EPST is effective in improving eye-health activities, refractive power, and visual acuity in preschoolers, and its wider implementation in educational institutions will promise improved eye-health among preschoolers.

Keywords: Refractive Error, Visual Acuity, Child, Preschool, Health Education, Community Health Nursing

References

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Figure 1.
Eye-health Program based on Social Learning Theory (EPST).
jkan-48-407f1.tif
Figure 2.
Specific contents of eye-health program.
jkan-48-407f2.tif
Table 1.
Homogeneity Tests for General and Eye-related Characteristics of the Participants (N=141)
Characteristics Categories Exp. (n=69) n (%) Comp. (n=72) n (%) χ2/Z p
Children (n=141)
Gender M 34 (49.3) 32 (44.4) 0.33 .614
F 35 (50.7) 40 (55.6)
Wear glasses Yes 1 (1.4) 2 (2.8) 1.00† .516
No 68 (98.6) 70 (97.2)
Sleep hours/day <10 31 (44.9) 32 (44.4) 0.01 >.999
≥10 38 (55.1) 40 (55.6)
Median (IQR) 10.0 (4.5) 10.0 (6.0) -0.09§ .932
Reading Hours reading books <1 50 (72.5) 51 (70.8) 0.05 .854
books ≥1 19 (27.5) 21 (29.2)
Use auxiliary lights Yes 2 (2.9) 7 (9.7) 0.17† .093
No 67 (97.1) 65 (90.3)
Distance between <20 13 (18.8) 6 (8.3) 3.55 .169
eyes and book (cm) 20∼<30 46 (66.7) 52 (72.2)
≥30 10 (14.5) 14 (19.5)
TV Hours watching TV <1 19 (27.5) 22 (30.6) 6.14 .105
1∼< 2 29 (42.1) 34 (47.2)
2∼< 3 13 (18.8) 15 (20.8)
≥3 8 (11.6) 1 (1.4)
Distance to the <1 4 (5.8) 4 (5.6) 2.54 .468
eyes (m) 1∼< 2 33 (47.8) 26 (36.1)
2∼< 3 25 (36.2) 30 (41.7)
≥3 7 (10.2) 12 (16.6)
Smart phone Usage of smart phone Yes 68 (98.6) 70 (97.2) 1.00† .516
No 1 (1.4) 2 (2.8)
Hours using smart <1 43 (62.3) 56 (77.8) 4.12* .123
phone (n=138) 1∼< 2 21 (30.5) 14 (19.4)
≥2 5 (7.2) 2 (2.8)
Distanceto the eyes <15 17 (24.6) 8 (11.1) 5.06 .080
(cm) (n=138) 15∼<30 45 (65.3) 51 (70.8)
≥30 6 (8.7) 11 (15.3)
Duration of daytime outdoor <1 30 (43.5) 29 (40.2) 2.35 .310
activities (hours) 1∼<2 22 (31.9) 31 (43.1)
≥2 17 (24.6) 12 (16.7)
Have time to relax eyes Yes 23 (33.3) 28 (39.0) 0.47 .599
No 46 (66.7) 44 (61.0)
Wear sunglasses Yes 23 (33.3) 22 (30.6) 0.13 .857
No 46 (66.7) 50 (69.4)
Balanced meal Yes 38 (55.1) 44 (61.0) 0.53 .498
No 31 (44.9) 28 (39.0)
Nutritional supplements Yes 30 (43.5) 36 (50) 1.82 .610
No 39 (56.5) 36 (50.0)
Experience of eye exam Yes 44 (63.6) 48 (66.7) 0.13 .727
No 25 (36.4) 24 (33.4)
Interval between eye exams Every 1 year 31 (44.9) 37 (51.3) 0.63 .730
Over 1 year 9 (13.1) 9 (12.6)
Irregular or not examined 29 (42.0) 26 (36.1)
Family (N=141) Wear glasses Father Yes 31 (44.9) 37 (51.4) 0.59 .501
No 38 (55.1) 35 (48.6)
Mother Yes 30 (43.5) 22 (30.6) 2.53 .120
No 39 (56.5) 50 (69.4)
Brothers and sisters Yes 17 (24.6) 10 (13.9) 2.63 .135
No 52 (75.4) 62 (86.1)
Exp.=Experimental group; Comp.=Comparison group; IQR=Interquartile range.

† Fisher’s exact test;

§ Mann-Whitney U test.

Table 2.
Homogeneity Test for Dependent Variables of the Participants at Pretest (N=141)
Characteristics Categories Exp. (n=69) Comp. (n=72) Z p
Median (IQR) Median (IQR)
Eye-health activities 9.00 (12.00) 8.00 (12.00) -0.03 .980
Refractive power Right 0.50 (3.25) 0.50 (4.25) -0.49 .623
Left 0.50 (4.50) 0.50 (3.50) -0.55 .584
Visual acuity Right 0.80 (1.50) 0.80 (1.50) -0.11 .914
Left 0.80 (1.50) 0.80 (1.50) -0.32 .750

Exp.=Experimental group; Comp.=Comparison group; IQR=Interquartile range.

Table 3.
Effects of on Eye-Health Activities, Refractive Power, and Visual Acuity (N=141)
Variables Groups Pre-test Post-test Wilcoxon signed rank Mean differences (Post-Pre) Mann-Whitney U test (p)
Median (IQR) Median (IQR) test (p) Median (IQR)
Eye-health activities Exp. 9.00 (12.00) 10.00 (8.00) -5.54 (<.001) 1.00 (11.00) -4.12 (<.001)
Comp. 8.00 (12.00) 8.00 (8.00) -0.48 (.634) 0.00 (14.00)
Refractive power Rt Exp. 0.50 (3.25) 0.25 (2.50) -1.43 (.153) 0.00 (1.50) -2.21 (.027)
Comp. 0.50 (4.25) 0.50 (3.25) -1.54 (.123) 0.00 (2.50)
Lt Exp. 0.50 (4.50) 0.25 (3.25) -1.01 (.313) 0.00 (2.25) -2.74 (.006)
Comp. 0.50 (3.50) 0.50 (3.00) -2.74 (.006) 0.25 (2.50)
Visual acuity Rt Exp. 0.80 (1.50) 0.80 (1.50) -3.83 (<.001) 0.00 (0.57) -3.92 (<.001)
Comp. 0.80 (1.50) 0.80 (1.50) -1.55 (.121) 0.00 (0.57)
Lt Exp. 0.80 (1.50) 0.80 (1.50) -2.96 (.003) 0.00 (0.87) -4.17 (<.001)
Comp. 0.80 (1.50) 0.80 (1.50) -1.74 (.082) 0.00 (0.74)

Exp.=Experimental group, n=69; Comp.=Comparison group, n=72; IQR=Interquartile range; Rt=Right; Lt=Left.

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