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BL Brody, A-C Roch-Levecq, AC Gamst, KK Maclean, MD Redelings, RM Kaplan, SI Brown; Self-Management Of Age-Related Macular Degeneration and Quality of Life: A Randomized Controlled Trial . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3838.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To assess the effectiveness of an age-related macular degeneration (AMD) self-management program consisting of health education and enhancement of problem solving skills in improving quality of life as shown by measures of distress and disability. Method: In a prospective, randomized controlled study 231 community volunteers (mean age=80.6 years) with advanced AMD were randomly assigned to a 12 hour self-management program (N=86), 12 hours of tape-recorded health lectures (N=74), or a waitlist (N=72). The self-management program utilized standard cognitive therapy techniques. The primary outcome measure was emotional distress (Profile of Mood States -POMS). Secondary outcome measures were function (National Eye Institute - Visual Function Questionnaire NEI-VFQ) and self-confidence to handle AMD specific challenges in daily life (AMD Self-Efficacy Questionnaire AMD SEQ). Clinical depression was determined with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Axis I, Fourth Edition, Research Version (SCID-IV). Standard methods of assessment and data analyses were performed. Results: Randomization produced comparable groups at baseline. There were no differences in attrition. Differences between tape and wait list groups were non-significant, and therefore collapsed into one control group. Repeated-measure analyses of variance revealed that the participants in the self-management program reported significantly less emotional distress, F (1, 215) = 8.47, p = .004, better function, F (1, 225) = 3.68, p = .056, and increased self-efficacy, F (1,213) = 6.03,p=.014. The positive effects of the self-management program were more pronounced in depressed subjects compared to the depressed in the control group in terms of emotional distress (POMS), F (1,215) = 11.15, p =.001, and function (NEI-VFQ) , F(1, 225) = 5.14, p =.024. Conclusion: Findings support that the AMD self-management program is an effective intervention to reduce distress and disability of poorly sighted elderly with AMD, especially those who are depressed.
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