title: Psychosocial impact of visual impairment and coping strategies in female ex-Service personnel.
abstract: OBJECTIVE
  To examine how vision loss affects the psychosocial well-being of female ex-Service personnel and how they cope with their visual impairment.
  
  
  METHODS
  A cross-sectional study was conducted consisting of two study phases. During phase 1, a questionnaire was undertaken via the telephone with nine female ex-Service personnel (all under 55 years of age) using clinical screening measures to identify the probable presence of the following mental health disorders: depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder Assessment), post-traumatic stress disorder (PTSD, PTSD Checklist-Civilian) and alcohol misuse (Alcohol Use Disorders Identification Test). In phase 2, eight of the participants were interviewed face to face regarding the impact being visually impaired had had on their daily lives.
  
  
  RESULTS
  Approximately 1 in 10 women screened positive for probable depression, probable PTSD or alcohol misuse; 1 in 5 fulfilled the criteria for probable anxiety disorder. Participants struggled to adjust to the loss of vision and its impact on their lives. They reported low self-esteem, feeling down and social withdrawal. As time went by, the women were able to apply various coping strategies such as having a positive attitude, relearning skills and integrating low vision aids in their daily routine. However, some coping strategies, such as alcohol misuse and lack of help-seeking when needed, hindered participants' success in adjusting to their visual impairment.
  
  
  CONCLUSIONS
  Sustaining a visual impairment negatively affects psychosocial well-being in female ex-Service personnel. Over time, participants learnt to cope with the challenges and limitations associated with being visually impaired.
authors.affiliation: King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: Sharon A M
authors.initials: SA
authors.lastname: Stevelink
authors.affiliation: King's Centre for Military Health Research, King's College London, London, UK Academic Department of Military Mental Health, King's College London, London, UK.
authors.forename: N T
authors.initials: NT
authors.lastname: Fear
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000437:Alcoholism / Q000523:psychology; D001008:Anxiety Disorders / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D012649:Self Concept; D058992:Social Participation; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology*; D014786:Vision Disorders / Q000523:psychology*
keywords: MENTAL HEALTH; OPHTHALMOLOGY; PSYCHIATRY; QUALITATIVE RESEARCH; visual impairment; women