title: Cognitive appraisals, distress and disability among persons in low vision rehabilitation.
abstract: OBJECTIVE
  Examined cognitive appraisals of interference and tolerance in the prediction of distress and self-reported disability among persons presenting for low vision rehabilitation.
  
  
  METHODS
  Cross-sectional; correlational and path analyses.
  
  
  METHODS
  One-hundred and thirteen patients (mean age, 71 years; 52 men and 61 women) presenting for low vision rehabilitation at a university-based centre for low vision rehabilitation participated in an initial clinical vision examination and completed several questionnaires to evaluate cognitive appraisals, emotional distress and self-reported disability.
  
  
  RESULTS
  Path analyses indicated that greater tolerance was associated with less interference imposed by vision loss. Greater tolerance was also associated with less emotional distress and symptom severity (visual acuity) was associated with self-reported disability. Cognitive appraisals (tolerance and interference) indirectly influenced self-reported disability through emotional distress.
  
  
  CONCLUSIONS
  The data indicate that appraisals of personal ability to tolerate vision loss and the perceived interference of vision loss on goal-directed behaviour and expected activities have greater influence on distress and are subsequently predictive of disability in comparison with objective symptoms (visual acuity). Implications for clinical interventions and further research are discussed.
authors.affiliation: Department of Ophthalmology, Center for Low Vision Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35233, USA. dreer@uab.edu
authors.forename: Laura E
authors.initials: LE
authors.lastname: Dreer
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Elliott
authors.forename: Jack
authors.initials: J
authors.lastname: Berry
authors.forename: Donald C
authors.initials: DC
authors.lastname: Fletcher
authors.forename: Marsha
authors.initials: M
authors.lastname: Swanson
authors.forename: J
authors.initials: J
authors.lastname: Christopher McNeal
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D011237:Predictive Value of Tests; D020377:Self Efficacy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014792:Visual Acuity; D016138:Walking