Abstract
Purpose: :
Quality of life is a dynamic construct that is defined conceptually as "the degree to which an individual enjoys the important possibilities of their life." Vision rehabilitation outcome measures primarily focus on the functional impacts of interventions, with less attention being paid to any associated psychosocial impacts. This study examines the relationship between measures of visual function status and assistive device impact for elderly patients who are first time assistive device users.
Methods: :
Ninety–five patients who obtained their first low vision device were included in this study. The measures used were the National Eye Institute Visual Function Questionnaire (NEI–VFQ 25) and the Psychosocial Impact of Assistive Devices Scales (PIADS). The NEI–VFQ 25 is a measure of the status of visual function. The PIADS is a device impact measure that explores psychosocial impact on three domains: competence, adaptability, and self–esteem. These measures were administered two weeks following device adoption.
Results: :
Subjects were 66% female with a mean age of 73 yrs and 89% had AMD as the primary diagnosis. Prescribed devices included hand/stand magnifiers (39%), electro–optical devices (27%), emmetropizing spectacles (7%), spectacle magnifiers (7%), filter lenses (6%), spectacle telescopes (6%), hand telescope/binoculars (4%), field enhancement devices (2%), computer adaptations (1%), and non–optical devices (1%). Significant correlations were found between vision function status in the areas of near/distance activities and role difficulties (as revealed by NEI–VFQ 25) and psychosocial impact on competence (as revealed by PIADS). Vision function statuses in the areas of near/distance activities, mental health, and role difficulties are correlated with adaptability. No significant correlations were found between PIADS self–esteem and the NEI–VFQ 25 subscales.
Conclusions: :
These results are consistent with our expectations that subjective reports of functional changes should have some correlation with psychosocial impact of devices. However, owing to the dynamic nature of quality of life, the relationship can be expected to change over time as patients adapt to their newly acquired low vision devices. The longer term data from this prospective cohort study should provide more reliable indicators of successful device adoption.
Keywords: quality of life • low vision • age-related macular degeneration