The determinants of participation in activities of daily living in people with impaired vision

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Abstract

Purpose

To investigate the determinants of participation in daily activities in people with impaired vision using the Impact of Vision Impairment (IVI) instrument.

Design

Cross-sectional study.

Methods

We recruited 319 participants with no vision rehabilitation history, distance visual acuity (VA) <6/12 (better eye), the ability to converse in English, and 18 years or older. Participants completed the 32-item IVI questionnaire and provided demographic, personal, cultural, and environmental details on vision-related functioning. Visual acuity data were either abstracted from the participants' files or assessed by qualified personnel. Participants also completed the SF-12 to evaluate physical (PCS-12) and mental health (MCS-12).

Results

The areas of greatest restriction of participation were associated with reading, outdoor mobility, participation in leisure activities, and shopping. In stepwise linear regression presenting VA, the PCS-12 and MCS-12 explained the variance in leisure and work (60 participants or 19%), consumer and social interaction (92 participants or 30%), household and personal care (76 participants or 24%), mobility (92 participants or 30%), emotional reaction to visual loss and (106 participants or 33%), and total IVI score (114 participants or 36%). Having age-related macular degeneration contributed marginally to the IVI domains and total score (P < .05–.01), except for the emotional domain. Belonging to a social group explained 3% and 2% of the variance in the consumer and social interaction and emotional domains, respectively (P < .05).

Conclusions

Distance VA and physical and mental health explained more than a third of the variance of the total score, suggesting that an intervention aimed at improving quality of life may include strategies to improve not only vision-related rehabilitation but also mental and physical health.

Section snippets

Methods

The participants for the study were recruited from the Vision Australia Foundation (VAF), a low vision service provider, and the Royal Victorian Eye and Ear Hospital (RVEEH). The inclusion criteria were participants with no history of vision rehabilitation, distance visual acuity (VA) <6/12 (20/40) in the better eye, the ability to converse in English, and being 18 years or older. Before the start of the study, the participants provided informed consent to their involvement in the project. The

Results

The characteristics of the 319 participants of which 202 were females (63%) are presented in Table 1. The mean age of the group was 78 years with almost two thirds of the participants born in Australia. The most common cause of vision loss was age related macular degeneration (AMD)(171 participants or 54%) followed by diabetic retinopathy (50 participants or 16%). Over 227 of the participants (90%) lived in a house or apartment with over 175 participants (55%) living with a spouse or a

Discussion

Understanding the factors that influence restriction of participation in daily living is challenging but important to those interested in increasing participation in activities of daily living and thus improving quality of life. Our baseline study of people with impaired vision showed that distance visual acuity, and mental and physical health were significant determinants of participation in daily activities grouped under five life domains. That these three determinants explain more than a

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