Predicting the need for low vision rehabilitation services.
OBJECTIVE
To determine the independent predictors of rehabilitation needs for people with low vision using the Impact of Vision Impairment questionnaire (IVI) to measure the quality-of-life consequences of vision-specific restrictions on participation in activities of daily living.


METHODS
Patients attending low vision clinics completed the IVI and provided personal and clinical information such as co-morbidities and visual acuity. Rasch analysis was used to generate person measures for the IVI total and three domain scores. Rehabilitation needs were based on "mild", "moderate" or "severe" levels of restriction in participation as determined by the lower, moderate and higher tertiles of persons measures. Logistic regression analyses were used to determine independent predictors of rehabilitation needs.


RESULTS
477 patients (56% women) with a mean age 72 years (SD 15.3) were recruited. Most (74%) had moderate or severe vision loss (presenting visual acuity (VA)<6/18), and 43% had age-related macular degeneration (AMD). Females, shorter duration of vision impairment, having AMD, worse VA, a greater impact of co-morbidities on daily living and reliance on family or friends were univariately associated with poorer IVI scores (p<0.05). In all regression models, VA, the impact of comorbidities on daily living and dependence on family/friends emerged as the three strongest independent predictors of rehabilitation needs.


CONCLUSIONS
In addition to vision, clinicians also need to consider issues relating to dependency when assessing rehabilitation needs. A more holistic approach to patient referral and rehabilitation provision is therefore warranted.
O'Connor
P M
PM
Centre for Eye Research Australia, Locked Bag 8, East Melbourne 8002, Australia. ocp@unimelb.edu.au
Lamoureux
E L
EL
Keeffe
J E
JE
D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D016017:Odds Ratio; D011788:Quality of Life; D012017:Referral and Consultation; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D014739:Victoria; D015354:Vision, Low / Q000503:physiopathology / Q000534:rehabilitation*; D014792:Visual Acuity