Psychosocial impact of visual impairment in working-age adults

Nyman, Samuel R.; Gosney, Margot; Victor, Christina

doi:10.1136/bjo.2009.164814

Cited by 102 publications

(106 citation statements)

References 67 publications

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“…27 The only reason for these variables not appearing in our model is that we do not know their relation with patients' self-awareness and self-identification. We just know that some previous studies found an association between these variables and patients' levels of emotional distress, well-being and outcomes.…”

Section: Discussionmentioning

confidence: 98%

“…We just know that some previous studies found an association between these variables and patients' levels of emotional distress, well-being and outcomes. [27][28][29] In terms of clinical practice, these findings bring some innovative cues for the assessment and intervention work. During the follow-up of these patients, an assessment protocol that includes monitoring of their self-awareness and self-identification will help to identify the phase of the adjustment they are in.…”

Section: Discussionmentioning

confidence: 99%

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From self-awareness to self-identification with visual impairment: a qualitative study with working age adults at a rehabilitation setting

2011

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Objective: To explore the experience of vision loss, focusing on working age patients' self-awareness of impairment and self-identification with the impairment. Design: A cross-sectional and qualitative study, using semi-structured interviews. Setting: A specialized rehabilitation centre and a low vision unit at a public hospital. Participants: A convenience sample of 38 patients between the ages of 20 and 65, with sight loss caused by a serious ophthalmological condition acquired after the age of 18, and doing their rehabilitation. Main outcome measures: A semi-structured interview, addressing three core areas: the emotional impact of vision loss; adjustment; and social support. Interviews were transcribed, coded and analysed by two independent researchers. Results: Seven themes emerged from interviews. Changes in patients' identity, achievement and future life projection arose as being the main transformations caused by vision loss. Self-awareness of impairment appeared associated with the patients' first contact with their loss, while self-identification with the impairment arose connected with the later embodiment process of the vision loss. Conclusions: Patients' self-awareness and self-perceptions of impairment appear to be two important milestones in the adjustment process to vision loss. Their assessment and monitoring over the rehabilitation period might help to promote impairment acceptance and rehabilitation outcomes.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

From self-awareness to self-identification with visual impairment: a qualitative study with working age adults at a rehabilitation setting

2011

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“…The significant improvement in Mental Health seen in pegaptanib-compared with sham-treated subjects at week 102 is meaningful because baseline scores revealed that DME patients such as the ones included in this study have a substantial degree of impairment compared with normal-sighted peers. 32 Taken in aggregate, the statistically significant changes noted in several domains at week 54 and 102 demonstrate that improvement in vision after pegaptanib treatment may be translated into an improvement in the patients' confidence in their own abilities; they may have felt more control over what they can do and may have had reduced feelings of isolation.…”

Section: Discussionmentioning

confidence: 99%

Changes in Vision- and Health-Related Quality of Life in Patients with Diabetic Macular Edema Treated with Pegaptanib Sodium or Sham

Loftus

Sultan

Pleil

2011

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To compare vision function and self-reported quality of life (QoL) in patients with diabetic macular edema (DME) treated with intravitreous pegaptanib 0.3 mg or sham injection. METHODS. This randomized (1:1), controlled, multicenter trial included subjects with DME (center point thickness on OCT, Ն250 m) and visual acuity (VA) Յ65 letters and Ն35 letters. In year 1, pegaptanib or sham was administered every 6 weeks with focal/grid photocoagulation at investigator discretion after week 18. Subjects received injections as often as every 6 weeks per pre-specified criteria in year 2. Primary efficacy endpoint: proportion gaining Ն10 letters of VA from baseline to week 54. Change in QoL from baseline to weeks 54 and 102 was assessed with the 25-item National Eye Institute-Visual Function Questionnaire (NEI-VFQ 25) and the EQ-5D. RESULTS. One hundred thirty-three pegaptanib-and 127 shamtreated subjects were in the year 1 intent-to-treat population. (QoL) among DME patients is greatly affected at all stages of disease, from preliminary symptoms to diagnosis to vision loss.1-4 Treatment of DME may improve vision-related QoL in these patients. 3,5The importance of identifying safe and effective treatments for DME that result in anatomic, functional, and QoL improvements is underscored by the rising prevalence of diabetesestimated to affect more than 350 million individuals worldwide by 2030.6 Among adults with diabetes, approximately 1 in 10 experiences vision-threatening diabetic retinopathy; half (5.7% of all diabetics) go on to develop DME, 7 a condition responsible for 4.8% of blindness worldwide.8 Until recently, laser photocoagulation has been the standard treatment for DME, but vascular endothelial growth factor inhibitors have produced impressive gains in visual acuity during up to 2 years of follow-up in treating this condition (Radhakrishnan R, et al. IOVS 2010;52:ARVO E-Abstract 5042).9 -15 A recent study 14 found intravitreal (IVT) injections of pegaptanib sodium 0.3 mg to be a well-tolerated and effective treatment for DME. The study demonstrated a statistically significant difference in favor of pegaptanib over sham injection in the proportion of subjects with Ն10 letters (or 2 lines) visual acuity (VA) improvement at week 54 (primary endpoint). Improvement of at least 10 letters from baseline to week 54 was achieved by 36.8% (49/133) of subjects treated with pegaptanib compared with 19.7% (25/ 127) of sham-treated subjects (odds ratio [95% CI]: 2.38 [1.32-4.30]; P ϭ 0.0047). The clinical benefit of pegaptanib treatment for DME was further supported by statistically significant differences favoring pegaptanib with regard to several secondary endpoints (e.g., degree of retinopathy, use of focal/grid laser treatment). As part of the pivotal trial of pegaptanib in DME, changes in QoL over 54 and 102 weeks were evaluated by using the condition-specific 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ 25) and the EuroQol five-dimension (EQ-5D) health status measure. Results of thos...

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“…A recent study indicated that approximately 15 percent of the adult population in high-income countries would meet criteria for a major depressive episode during their lifetime [10]. Unfortunately, depression following irreversible vision loss in elderly individuals is associated with poor general functioning [11][12][13][14], long-term emotional distress [1,3], problems with well-being [15][16], poor quality of life [17][18], and problems in health and social participation [19]. In fact, some studies have reported that depression following vision loss represents a secondary source of disability [20][21].…”

Section: Introductionmentioning

confidence: 99%

“…Several researchers have also investigated relationships between depression and other psychological variables in adults with vision impairment, identifying higher rates of depression in patients who reported loneliness, fear of dependence, lack of self-worth, and feelings of changes in their own identity [16,24]. Other studies have associated maladaptive coping strategies, such as emotionfocused coping and a ruminative coping style, with greater levels of emotional distress and adjustment problems in those with visual impairment [25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Depression and experience of vision loss in group of adults in rehabilitation setting: Mixed-methods pilot study

Senra¹,

Vieira²,

Nicholls³

et al. 2013

J Rehabil Res Dev

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Abstract-There is a paucity of literature regarding the relationship between the experience of vision loss and depression. Therefore, the current pilot study aimed to explore whether significant differences existed in levels of depression between adults with different vision loss experiences. A group of adults aged between 20 and 65 yr old with irreversible vision loss in a rehabilitation setting was interviewed. Semistructured interviews were conducted in order to explore patients' experience of vision loss. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive levels; 39.5% (n = 15) of patients met CES-D criteria for depression. In addition, higher levels of depression (p < 0.05) were identified in patients whose interviews revealed greater selfawareness of impairment, inadequate social support, and longer rehabilitation stay. Current findings draw attention to variables such as self-awareness of impairment and perceived social support and suggest that depression following vision loss may be related to patients' emotional experiences of impairment and adjustment processes.

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Psychosocial impact of visual impairment in working-age adults

Abstract: Aim To review the evidence for the presence of lower levels of psychosocial well-being in working-age adults with visual impairment and for interventions to improve such levels of psychosocial well-being. Methods Systematic review of quantitative studies

Cited by 102 publications

References 67 publications

From self-awareness to self-identification with visual impairment: a qualitative study with working age adults at a rehabilitation setting

From self-awareness to self-identification with visual impairment: a qualitative study with working age adults at a rehabilitation setting

Changes in Vision- and Health-Related Quality of Life in Patients with Diabetic Macular Edema Treated with Pegaptanib Sodium or Sham

Depression and experience of vision loss in group of adults in rehabilitation setting: Mixed-methods pilot study

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