Overview of Quality of Life Research in Older People with Visual Impairment

Wang, Chongwen; Chan, Cecilia L. W.; Chi, Iris

doi:10.4236/aar.2014.32014

Cited by 26 publications

(21 citation statements)

References 116 publications

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“…EuroQol Questionnaire). 69 Measurements of VA and other measures of visual performance, such as contrast sensitivity, are highly correlated with activities of daily living. 9 Performance on various tasks of daily living was assessed in a study of > 2500 participants aged between 65 and 84 years, which excluded those with Standardised Mini-Mental State Examination (sMMSE) scores of < 18 (i.e.…”

Section: Quality Of Life and Visual Impairmentmentioning

confidence: 99%

“…The association between VI and various aspects of daily living, both social and physical, is well documented. 11,45,[69][70][71]76,145 However, people with moderate to severe cognitive impairment have often been excluded from these studies. 56,70,145 PrOVIDe uses only VA to define VI, and other aspects of visual function are known to influence visual performance, notably contrast sensitivity 70,76 and visual fields.…”

Section: Visual Impairment and Behavioural And Functional Abilitymentioning

confidence: 99%

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The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

Bowen

Edgar

Hancock

et al. 2016

Health Serv Deliv Res

121

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BackgroundThe prevalence of visual impairment (VI) and dementia increases with age and these conditions may coexist, but few UK data exist on VI among people with dementia.ObjectivesTo measure the prevalence of eye conditions causing VI in people with dementia and to identify/describe reasons for underdetection or inappropriate management.DesignStage 1 – cross-sectional prevalence study. Stage 2 – qualitative research exploring participant, carer and professional perspectives of eye care.SettingStage 1 – 20 NHS sites in six English regions. Stage 2 – six English regions.ParticipantsStage 1 – 708 participants with dementia (aged 60–89 years): 389 lived in the community (group 1) and 319 lived in care homes (group 2). Stage 2 – 119 participants.InterventionsStage 1 gathered eye examination data following domiciliary sight tests complying with General Ophthalmic Services requirements and professional guidelines. Cognitive impairment was assessed using the Standardised Mini-Mental State Examination (sMMSE) test, and functional ability and behaviour were assessed using the Bristol Activities of Daily Living Scale and Cambridge Behavioural Inventory – Revised. Stage 2 involved individual interviews (36 people with dementia and 11 care workers); and separate focus groups (34 optometrists; 38 family and professional carers).Main outcome measures.VI defined by visual acuity (VA) worse than 6/12 or worse than 6/18 measured before and after refraction.ResultsStage 1 – when participants wore their current spectacles, VI prevalence was 32.5% [95% confidence interval (CI) 28.7% to 36.5%] and 16.3% (95% CI 13.5% to 19.6%) for commonly used criteria for VI of VA worse than 6/12 and 6/18, respectively. Of those with VI, 44% (VA < 6/12) and 47% (VA < 6/18) were correctable with new spectacles. Almost 50% of remaining uncorrectable VI (VA < 6/12) was associated with cataract, and was, therefore, potentially remediable, and one-third was associated with macular degeneration. Uncorrected/undercorrected VI prevalence (VA < 6/12) was significantly higher in participants in care homes (odds ratio 2.19, 95% CI 1.30 to 3.73;p < 0.01) when adjusted for age, sex and sMMSE score. VA could not be measured in 2.6% of group 1 and 34.2% of group 2 participants (p < 0.01). The main eye examination elements (excluding visual fields) could be performed in > 80% of participants. There was no evidence that the management of VI in people with dementia differed from that in older people in general. Exploratory analysis suggested significant deficits in some vision-related aspects of function and behaviour in participants with VI. Stage 2 key messages – carers and care workers underestimated how much can be achieved in an eye examination. People with dementia and carers were unaware of domiciliary sight test availability. Improved communication is needed between optometrists and carers; optometrists should be informed of the person’s dementia. Tailoring eye examinations to individual needs includes allowing extra time. Optometrists wanted training and guidance about dementia. Correcting VI may improve the quality of life of people with dementia but should be weighed against the risks and burdens of undergoing examinations and cataract surgery on an individual basis.LimitationsSampling bias is possible owing to quota-sampling and response bias.ConclusionsThe prevalence of VI is disproportionately higher in people with dementia living in care homes. Almost 50% of presenting VI is correctable with spectacles, and more with cataract surgery. Areas for future research are the development of an eye-care pathway for people with dementia; assessment of the benefits of early cataract surgery; and research into the feasibility of specialist optometrists for older people.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Quality Of Life and Visual Impairmentmentioning

confidence: 99%

Section: Visual Impairment and Behavioural And Functional Abilitymentioning

confidence: 99%

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

Bowen

Edgar

Hancock

et al. 2016

Health Serv Deliv Res

121

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“…A combination of limitations has the potential to impact on an individual's mood and motivation. These sequelae have been reported in populations with visual impairment (Chia et al, 2004;McBain et al, 2014;Tsai et al, 2003;Wang, Chan, & Chi, 2014).…”

Section: Introductionmentioning

confidence: 79%

Using Delphi methodology in the development of a new patient‐reported outcome measure for stroke survivors with visual impairment

Hepworth

Rowe

2018

Brain and Behavior

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IntroductionThe aim of this study was to ascertain what items stroke survivors and stroke care professionals think are important when assessing quality of life for stroke survivors with visual impairment for inclusion in the new patient‐reported outcome measure.MethodsA reactive Delphi process was used in a three‐round electronic‐based survey. The items presented consisted of 62 items originally sourced from a systematic review of existing vision‐related quality of life instruments and stroke survivor interviews, reduced and refined following a ranking exercise and pilot with stroke survivors with visual impairment. Stakeholders (stroke survivors/clinicians) were invited to take part in the process. A consensus definition of ≥70% was decided a priori. Participants were asked to rank importance on a 9‐point scale and categorize the items by relevance to types of visual impairment following stroke or not relevant. Analysis of consensus, stability, and agreement was conducted.ResultsIn total, 113 participants registered for the Delphi survey of which 47 (41.6%) completed all three rounds. Response rates to the three rounds were 78/113 (69.0%), 61/76 (81.3%), and 49/64 (76.6%), respectively. The participants included orthoptists (45.4%), occupational therapists (44.3%), and stroke survivors (10.3%). Consensus was reached on 56.5% of items in the three‐round process, all for inclusion. A consensus was reached for 83.8% in the categorization of items. The majority (82.6%) of consensus were for relevant to ‘all visual impairment following stroke’; two items were deemed ‘not relevant’.ConclusionThe lack of item reduction achieved by this Delphi process highlights the need for additional methods of item reduction in the development of a new PROM for visual impairment following stroke. These results will be considered alongside Rasch analysis to achieve further item reduction. However, the Delphi survey remains important as it provides clinical and patient insight into each item rather than purely relying on the psychometric data.

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“…The consequences of vision impairment span across the lifecycle and its severity depends on the age of occurrence. As reviewed in the World's Report on Vision in 2010, the consequences of vision impairment in adults with vision impairment are associated with poor quality of life (QoL) [3], lower rates of workforce participation and productivity, and higher rates of depression and anxiety when compared to the general population [1].…”

Section: Background Informationmentioning

confidence: 99%

“…This influence can be attributed to the individual reactions to surgical outcome, as failure to meet self-perceived expectations may potentiate psychological disorders and worsen the QoL [17]. Furthermore, the presence of postoperative complications like macular oedema, intraocular haemorrhages and postoperative emmetropia which obstructs visual acuity may worsen visual functions and activates the presence of common psychiatric disorders and by extension the QoL [3].…”

Section: Background Informationmentioning

confidence: 99%

The effect of ophthalmic surgery on quality of life, depression, and anxiety disorders in visually impaired adults, National Eye Center, Kaduna, Nigeria.

Babalola¹,

Alhassan²,

Nuhu³

2020

Preprint

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Introduction: Visual impairment caused severe disability in 2.2 billion people globally in 2010. This disability, which interacts with the physical, social, or attitudinal environment, spans across the lifecycle, and is associated with psychological distress and poor quality of life. This study aimed at describing the effect of surgery on blindness, QoL, anxiety and depressive disorders.Methods A one arm pre – post study was conducted among systematically-selected visually impaired adults (> 18 years) requiring surgery at the National Eye Centre (NEC), Nigeria. Trained research assistants used a pre-tested semi-structured questionnaire to interview participants at pre – and 10–12 week’s post-surgery. The visual function was measured with presenting visual acuity. Presence of psychological distress was defined by a scores ≥ 8 on the Hospital Anxiety and Depression scale (HADs), and confirmed the presence of anxiety, and depression using Mini International Neuropsychiatric Interview (MINI) questionnaire. The World Health Organization Quality of Life-Bref questionnaire was used to assess the quality of life. Descriptive analysis for frequency and proportions was carried out while Chi square McNemar test used to detect the effect of surgery on blindness, anxiety, depression and QoL. Statistically significant was set at p Value < 0.05.Results Of the 180 respondents, males accounted for 56.7%, and 72.2% had Cataract. Pre-surgical psychological distress, anxiety and depression were 38.9%, 25.6%, and 30.0%, respectively. Pre-surgery, a third had poor QoL on social relationship domain of WHOQoL-Bref. Ophthalmic surgery significantly improved blindness, anxiety, and social relationship QoL. No significant effect on depression.Conclusions Ophthalmic surgery influences social relationships QoL, and anxiety. It however has no effect on depression. Apart from surgical interventions, holistic care of vision impairment should involve mental care to improve QoL.

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Overview of Quality of Life Research in Older People with Visual Impairment

Cited by 26 publications

References 116 publications

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

Using Delphi methodology in the development of a new patient‐reported outcome measure for stroke survivors with visual impairment

The effect of ophthalmic surgery on quality of life, depression, and anxiety disorders in visually impaired adults, National Eye Center, Kaduna, Nigeria.

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