Rehabilitation needs and activity limitations of adults with a visual impairment entering a low vision rehabilitation service in England

Macnaughton, Jane and Latham, Keziah and Vianya-Estopa, Marta (2019) Rehabilitation needs and activity limitations of adults with a visual impairment entering a low vision rehabilitation service in England. Ophthalmic and Physiological Optics, 39 (2). pp. 113-126. ISSN 1475-1313

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Purpose: To evaluate outcome measures of the Participation and Activity Inven- tory (PAI) in a sample of adults with acquired visual impairment entering vision rehabilitation. Both Priority Scores, indicating level of rehabilitative need, and Person Measures, indicating goal difficulty, were considered. Methods: Participants were newly registered adults with visual impairment within Leicestershire, United Kingdom. The importance and difficulty of 48 goals of the PAI were assessed, as were demographic factors, clinical visual function (visual acuity, contrast sensitivity, reading function) and psychosocial function (adjustment to visual loss, depression, anxiety and fear of falling). Priority scores were calculated as the product of importance and difficulty of each goal. All questionnaires were Rasch analysed, and person and item measures of perceived difficulty with goals were derived. Results: Sixty people (mean age  S.D. = 75.8  13.8 years) took part. PAI goals with greatest rehabilitative need were reading (6.82  2.91), mobility out- doors (6.55  3.92), mobility indoors within an unfamiliar environment (5.52  3.93) and writing (5.27  3.02). Greater rehabilitative need was associ- ated with younger age (b = 0.46, p < 0.001), and with higher depressive symp- tomatology (b = 0.35, p < 0.01; model R 2 34%). Goals with greatest difficulty were mending clothing (1.95  0.35 logits) and hobbies and crafts (1.32  0.23 logits). Greater difficulty was associated with higher depressive symptomatology (b = 0.39, p < 0.001), lower visual acuity (b = 0.42, p < 0.001) and lower adjustment of visual loss (b = 0.31, p < 0.01; model R 2 53%). Conclusions: Key rehabilitation needs for adults at entry to services require both optical and non-optical interventions. As rehabilitative need was not associated with the level of visual impairment, eyecare professionals should not wait until the end of medical treatment before referral for support. Similarly, rehabilitative need was associated with younger age, indicating the importance to refer younger people with sight loss at an early stage. The use of structured assessment, such as the PAI, ensures goals that have an impact upon quality of life are specifically identified. Depression screening on entry to rehabilitation is relevant as it predicts both perceived difficulty and rehabilitative need

Item Type: Journal Article
Keywords: activities of daily living, Rasch analysis, low vision, rehabilitation, visual impairment
Faculty: Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 07 Feb 2019 08:42
Last Modified: 09 Sep 2021 18:55

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