Gold Deborah, Zuvela Biljana, Hodge William G
Canadian National Institute for the Blind, Toronto, ON.
Can J Ophthalmol. 2006 Jun;41(3):348-54. doi: 10.1139/I06-025.
A review of the literature and current practice patterns for vision rehabilitation care in Canada provide a basis for this pilot study, which was undertaken to explore related issues from the perspectives of older adults and low vision service providers. The pilot study was overseen by a number of collaborators whose names are listed at the end of this paper.
Thirty people aged 60 years or older who had vision impairments and were clients of the Canadian National Institute for the Blind were surveyed by telephone. Ophthalmologists, optometrists, and opticians completed a mail questionnaire. Vision rehabilitation practitioners and nurses, ophthalmic technicians, and service providers for low vision technical aids were surveyed by e-mail.
Ophthalmologists are a primary source of referrals to low vision services, but low functional vision does not always trigger such referrals, nor are referrals always timely. Optometrists are primary providers of low vision services, including dispensing of low vision aids, but such aids are expensive, and inadequate training in their use may contribute to noncompliance. Costs associated with providing low vision assessments and services are higher than compensation to vision service providers, whose capacity to meet increasing demand is limited. In addition, there are disparities between rural and urban areas and among provinces in the availability of, and funding for, services and aids.
On the basis of the findings, an emergent theory is proposed on the consequences resulting from lack of planning and standards for vision rehabilitation care. The implications of this study form the basis for further research.
对加拿大视力康复护理的文献和当前实践模式进行回顾,为本项试点研究提供了依据,该研究旨在从老年人和低视力服务提供者的角度探讨相关问题。这项试点研究由多位合作者监督,他们的名字列在本文末尾。
通过电话对30名60岁及以上有视力障碍且是加拿大国家盲人研究所客户的人进行了调查。眼科医生、验光师和配镜师完成了一份邮寄问卷。通过电子邮件对视力康复从业者、护士、眼科技术人员以及低视力辅助器具服务提供者进行了调查。
眼科医生是低视力服务转诊的主要来源,但低功能性视力并不总是引发此类转诊,转诊也不总是及时的。验光师是低视力服务的主要提供者,包括提供低视力辅助器具,但此类辅助器具价格昂贵,使用培训不足可能导致不依从。提供低视力评估和服务的相关成本高于对视力服务提供者的补偿,他们满足不断增长需求的能力有限。此外,农村和城市地区以及各省之间在服务和辅助器具的可获得性及资金方面存在差异。
基于研究结果,提出了一种关于视力康复护理缺乏规划和标准所导致后果的新兴理论。本研究的意义构成了进一步研究的基础。