Vision self-management for older adults: a randomised controlled trial.
OBJECTIVE
Ageing of the population will result in unprecedented numbers of older adults living with age-related vision loss (ARVL). Self-management models improve health outcomes and reduce healthcare costs; however, the principles have rarely been applied in low vision services.


METHODS
A two-armed randomised controlled trial of older adults (n=77) with ARVL compared 'usual care' provided by a not-for-profit community agency with an extended model of care (usual care+self-management group intervention). The primary outcome variable (participation in life situations) was measured using the Activity Card Sort. Secondary outcome measures examined general health and vision-specific domains.


RESULTS
The intention-to-treat analysis demonstrated that the extended model produced significantly better participation in life situations at post-test when compared with the usual care only group. Gains were made regardless of whether participants were, or were not, depressed at baseline. The addition of the self-management group was also successful in significantly reducing depression, increasing physical and mental health, generalised and domain-specific self-efficacy, and adjustment to ARVL. With the exception of adjustment and mental health, differences were still apparent at 12 weeks' follow-up.


CONCLUSIONS
Addition of self-management significantly improved general health and vision-specific rehabilitation outcomes for older adults with ARVL.
Girdler
Sonya J
SJ
Centre for Research into Disability and Society within the Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Australia.
Boldy
Duncan P
DP
Dhaliwal
Satvinder S
SS
Crowley
Margaret
M
Packer
Tanya L
TL
D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000458:organization & administration; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D012959:Socioeconomic Factors; D014786:Vision Disorders / Q000523:psychology / Q000534:rehabilitation*