Control Strategies & Mental Health in Impaired Elders

这项纵向研究的主要目的是研究视力障碍老年人在日常生活中使用的平衡和再平衡控制策略，并了解这些策略的过程和后果。由于晚年视力丧失对一个人的能力感和控制力构成了重大威胁，因此本研究提供了一个独特的机会，将生命周期控制理论应用于以逐渐发病和渐进式恶化为特征的典型年龄相关视力丧失。此外，同化性和适应性应对倾向的差异可能是控制相关应对行为模式的基础。具体目标是：1.；确定用于适应与年龄相关的视力丧失的控制策略，并评估策略随时间变化或稳定的程度。2. 确定性格同化和适应性应对方式随时间变化或稳定的程度。3. 探讨视障长者控制策略与处置性应对方式的关系及其随时间的稳定性或变化。4. 确定控制策略和性格应对方式，以及每种方式的变化模式，这些模式随着时间的推移可以预测更积极的结果（功能能力，心理健康）。参与者将是362名最近出现与年龄相关的视力丧失的老年人。将在基线进行面对面访谈，并进行1年和2年的随访，每隔3个月进行一次临时电话访谈，以了解控制策略使用的短期和长期稳定性/变化，以及这些策略与功能和心理健康的关系。横截面和纵向关系将检查使用回归，个人成长模型和结构方程模型。研究结果将有助于识别适应能力差的老年人，并指导康复服务的开发和提供，最大限度地提高功能和心理健康。

The primary aim of the proposed longitudinal study is to examine the strategies used by older persons with visual impairment to balance and rebalance control in daily life, and to understand the course and consequences of such strategies over time. Because late-life vision loss constitutes a major threat to one's sense of competence and control, the proposed study provides a unique opportunity to apply the life-span theory of control to a prototypical age-related loss characterized by gradual onset and progressive deterioration. In addition, differences in assimilative and accommodative coping dispositions that may underlie patterns of control-related coping behavior will be examined. Specific aims are: 1. To identify the control strategies used in adapting to age-related vision loss and to assess the extent of change or stability in strategies over time. 2. To identify the extent of change or stability in dispositional assimilative and accommodative coping styles over time. 3. To examine the relationship between control strategies and dispositional coping styles among visually impaired elders and the stability or change in this relationship over time. 4. To identify the control strategies and dispositional coping styles, and patterns of change in each, that are predictive of more positive outcomes (functional competence, psychological well-being) over time. Participants will be 362 older adults with recent onset age-related vision loss. In-person interviews will be conducted at baseline, and 1- and 2-year follow-ups, with interim telephone interviews at 3-month intervals to capture both short- and long-term stability/change in control strategy use, and how such strategies relate to functional and psychological well-being. Cross-sectional and longitudinal relationships will be examined using regression, individual growth modeling, and structural equation modeling. Findings will help to identify elders at risk for poor adaptation and guide the development and delivery of rehabilitation services that maximize functional and psychological well-being.