Design of the low vision quality-of-life questionnaire (LVQOL) and measuring the outcome of low-vision rehabilitation

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Abstract

PURPOSE: To design and validate a vision-specific quality-of-life assessment tool to be used in a clinical setting to evaluate low-vision rehabilitation strategy and management.

METHODS: Previous vision-related questionnaires were assessed by low-vision rehabilitation professionals and patients for relevance and coverage. The 74 items selected were pretested to ensure correct interpretation. One hundred and fifty patients with low vision completed the chosen questions on four occasions to allow the selection of the most appropriate items. The vision-specific quality of life of patients with low vision was compared with that of 70 age-matched and gender-matched patients with normal vision and before and after low-vision rehabilitation in 278 patients.

RESULTS: Items that were unreliable, internally inconsistent, redundant, or not relevant were excluded, resulting in the 25-item Low Vision Quality-of-Life Questionnaire (LVQOL). Completion of the LVQOL results in a summed score between 0 (a low quality of life) and 125 (a high quality of life). The LVQOL has a high internal consistency (α = 0.88) and good reliability (0.72). The average LVQOL score for a population with low vision (60.9 ± 25.1) was significantly lower than the average score of those with normal vision (100.3 ± 20.8). Rehabilitation improved the LVQOL score of those with low vision by an average of 6.8 ± 15.6 (17%).

CONCLUSIONS: The LVQOL was shown to be an internally consistent, reliable, and fast method for measuring the vision-specific quality of life of the visually impaired in a clinical setting. It is able to quantify the quality of life of those with low vision and is useful in determining the effects of low-vision rehabilitation.

Section snippets

Methods

The literature was reviewed to collect all the subjective questionnaires previously designed for assessing quality of life (Table 1). The resulting questions were merged, so no items were repeated. The items were then assessed by a multidisciplinary team of low-vision rehabilitation staff (including ophthalmologists, optometrists, orthoptists, occupational therapists, welfare officers, audiologists, and those with low vision) for relevance: questions not relevant to the majority of patients

Selection of appropriate items for the lvqol

To select the most appropriate items for the LVQOL from the initial pool of questions, the following exclusion criteria were implemented:

Discussion

There is a need for a quality-of-life assessment tool for clinical low-vision practice to gain a better understanding of patients’ needs and goals and whether they have been met by rehabilitation. Excluding items that had a low or high endorsement, a poor internal consistency, and that were not reliable allowed the pool of 74 items, selected by a multidisciplinary team of rehabilitation professionals and patients with low vision, to be reduced to a 25-item LVQOL. Implementation of the LVQOL

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    This projected was funded by a grant from the Victorian College of Optometry, Victoria, Australia, and Vision Australia Foundation, Australia.

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