Control Strategies & Mental Health in Impaired Elders

拟议的纵向研究的主要目的是研究视力受损的老年人在日常生活中平衡和重新平衡控制所使用的策略，并了解随着时间的推移这些策略的过程和后果。由于晚年视力丧失是对人的能力和控制感的主要威胁，这项拟议的研究提供了一个独特的机会，将终身控制理论应用于以逐渐发病和进行性恶化为特征的典型年龄相关性视力丧失。此外，同化和通融应对倾向的差异可能是与控制相关的应对行为模式的基础，也将被考察。具体目标是：1.确定用于适应年龄相关性视力丧失的控制策略，并评估随着时间的推移策略的变化或稳定程度。2.确定倾向性、同化性和融合性应对方式随时间的变化或稳定程度。3.考察视障老年人的控制策略与倾向应对方式之间的关系，以及这种关系随时间的稳定或变化。4.确定控制策略和倾向应对方式，以及每种方式的变化模式，预测随着时间的推移会产生更积极的结果(功能能力和心理健康)。参与者将是362名最近出现年龄相关性视力丧失的老年人。面谈将在基线上进行，并在一年和两年的后续行动中进行，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/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使用回归、个体生长模型和结构方程模型进行检验。研究结果将有助于确定面临适应不良风险的老年人，并指导康复服务的发展和提供，以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.