Abstract
Introduction::
Successful rehabilitation using assistive technology devices, such as Closed Circuit Television (CCTV) systems, occurs in a sequence of events that includes adoption of the device, acceptance of the device, adherence to prescription, and satisfaction with the device. The Consortium for Assistive Technology Outcomes Research (CATOR) framework is a time-dependent model that acknowledges the potential for functional and psychosocial outcomes to be coupled and uncoupled. We examined changes in functional vision status and psychosocial status of elderly patients with ARMD who obtained a CCTV device. The NEI-VFQ 25 measures the influence of vision loss on generic health domains such as emotional well-being and social functioning, in addition to task-oriented domains related to daily visual functioning. The Psychosocial Impact of Assistive Devices Scale (PIADS) measures the impact of an assistive device on functional independence, well-being, and quality of life.
Methods::
Subjects were 65 years and older, had a primary diagnosis of age related macular degeneration, and were first time users of a CCTV system. NEI-VFQ 25 and PIADS data were obtained from an ongoing, prospective cohort study of low vision device outcomes. Data from four assessments are analyzed (2 weeks, 1 month, 3 months, and 6 months following CCTV adoption).These intervals were selected to examine the critical, early period of device adoption, as well as the results associated with long term device use.
Results::
The NEI-VFQ 25 results suggest that there is a relatively healthy and stable effect of CCTV device use on visual function over a six-month post-adoption period. As hypothesized, the PIADS findings indicated that the maximum, positive psychosocial impact of CCTV devices was not experienced by the device users until around one month following device adoption, but then attenuated over the longer term as we had observed in previous research. The PIADS was sensitive to the difference between groups (Wet vs. Dry ARMD) while the NEI-VFQ-25 was not.
Conclusions::
Assistive devices, such as CCTV systems, have an immediate, positive and robust impact on the functional status of their users. While functional benefit is stable for some time following device adoption, the psychosocial impact of the CCTV is greatest within the first month following adoption and then appears to wane.
Keywords: low vision • quality of life • age-related macular degeneration