The effectiveness of low-vision rehabilitation on participation in daily living and quality of life
The effectiveness of low-vision rehabilitation on participation in daily living and quality of life
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DOI：
10.1167/iovs.06-0610
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发表时间：
2007-04-01
影响因子：
4.4
通讯作者：
Keeffe, Jill E.
中科院分区：
文献类型：
--
作者：
Lamoureux, Ecosse L.;Pallant, Julie F.;Keeffe, Jill E.
目的.评价多学科低视力康复计划对视力损害影响（IVI）量表评价的生活质量的有效性。首次转诊至低视力诊所的患者在康复前后（3-6个月）进行评估。Rasch分析用于估计三个IVI子量表和区间量表上的总体值。一个混合的受试者之间的方差分析被用来确定是否呈现视力与康复变化的相互作用的影响。Cohen d值用于估计变化的幅度，并选择标准化反应平均值（SRM）程序来确定康复引起的变化的临床意义。124名女性和68名男性（平均年龄80.3岁）完成了康复。大多数患有年龄相关性黄斑变性（62%，119），中度至重度视力受损（< 6/18; 78%，149）。康复后，整体IVI评分（P = 0.006）和两个分量表：阅读和获取信息和情绪幸福感（P = 0.007和0.009，分别）有显着改善。活动性和独立性子量表无显著改善（P = 0.07）。发现干预后改善的幅度相对中等（Cohen d = 0.17-0-30）和临床适度（SRM = 0.22-0.42）。研究发现，低视力患者的整体生活质量和两个特定的日常生活领域有了显着改善，尽管康复带来的收益的幅度和临床意义不大。需要对其他低视力康复模式进行进一步研究，以优化低视力患者的生活质量。
PURPOSE. To evaluate the effectiveness of a multidisciplinary low-vision rehabilitation program on quality of life evaluated by the Impact of Vision Impairment (IVI) instrument.METHODS. First-time referrals to low-vision clinics were assessed before and after rehabilitation (3-6 months). Rasch analysis was used to estimate the three IVI subscale and overall values on an interval scale. A mixed between-within subjects ANOVA was used to identify whether presenting visual acuity had an interaction effect with rehabilitation change. Cohen d values were used to estimate the magnitude of the change and the standardized response mean (SRM) procedure was selected to determine the clinical significance of the rehabilitation-induced changes.RESULTS. One hundred twenty-four women and 68 men (mean age, 80.3 years) completed the rehabilitation. Most had age-related macular degeneration (62%, 119) and were moderately to severely vision impaired (< 6/18; 78%, 149). After rehabilitation, significant improvements were recorded for the overall IVI score (P = 0.006) and two subscales: reading and accessing information and emotional well-being (P = 0.007 and 0.009, respectively). No significant improvement was found on the mobility and independence subscale (P = 0.07). The magnitude of the postintervention improvement was found to be relatively moderate (Cohen d = 0.17-0-30) and clinically modest (SRM = 0.22-0.42).CONCLUSIONS. Significant improvements in overall quality of life and two specific areas of daily living in people with low vision were found, although the magnitude and clinical significance of the rehabilitation-induced gains were modest. Further investigation in other models of low-vision rehabilitation is needed to optimize quality of life gains in people with low vision.