Self-management of Age-related Macular Degeneration at the 6-Month Follow-up

Abstract

To assess the effectiveness at the 6-month follow-up of an age-related macular degeneration (AMD) selfmanagement program consisting of health education and enhancement of problem-solving skills in improving quality of life as shown by measures of mood and function. Methods: Six-month follow-up data were analyzed from 214 of 252 older adult volunteers (mean age, 80.8 years) with advanced AMD who had been randomly assigned to a 12-hour self-management program (n = 82), a series of 12 hours of tape-recorded health lectures (n=66), or a waiting list (n=66). The primary outcome measure was emotional distress (Profile of Mood States). Secondary outcome measures included function (National Eye Institute Visual Function Questionnaire), self-confidence to handle AMD-specific challenges in daily life (AMD Selfefficacy Questionnaire), and depression status on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Results: At the 6-month follow-up, participants in the self-management program reported significantly less emotional distress (P=.008), better function (P=.05), and increased self-efficacy (P=.006) compared with control subjects. The latter effects were more pronounced in the depressed than in the nondepressed subjects. Finally, the incidence of clinical depression at the 6-month follow-up was significantly lower in the self-management group (P=.05) than in the control group. Conclusion: The sustained positive effects at the 6-month follow-up provide support for the effectiveness of the AMD self-management program in reducing distress and disability, improving self-efficacy, and preventing depression in poorly sighted elderly patients with AMD.

The Role of Preoperative Knowledge and Self-Efficacy in Predicting Postoperative Anxiety, Depression, and Vision-Related Quality of Life in Elderly Patients with Macular Degeneration Undergoing Retinal Surgery in Shiraz, Iran, 2016

“…The regression test revealed that preoperative self-efficacy could explain four percent of the variance of depression after the surgery. Another study revealed that increased self-efficacy leads to less stress, better performance, and lower depression in the elderly suffering from macular degeneration (48). The findings of the current research are in accordance with the results of Bandura et al, Ogunyemi and Mabekoje, Schwartzer and Fuchs, and Schwarzer and Luszczynska, which found a positive relationship between self-efficacy and anxiety and depression (49)(50)(51)(52).…”

Explaining the Relationship between Three Eye Diseases and Depressive Symptoms in Older Adults

“…Brody et al found that a 12-hour self-management session reduced emotional distress over a 6-month period in AMD patients, 34 while Rovner et al found that six problem-solving treatment sessions resulted in a lower 2-month incidence rate of depressive symptoms but that these results were not maintained by 6 months. 35 Further research on interventions to prevent depression in patients with eye disease is warranted and should consider strategies to alleviate mobility limitation.…”

How Effective is Low Vision Service Provision? A Systematic Review

“…41,48,49 Self-management programs are becoming increasingly popular, adopting a group-based approach, with the aim of helping participants to take control in managing the consequences of visual impairment and developing problem solving skills through sharing experiences and coping strategies. 22,23,60,109,114 Given the wealth of different strategies employed in providing vision rehabilitation, there is a real need for evidence-based studies evaluating the effectiveness and cost-effectiveness of the various types of rehabilitation.…”