Dreer Laura E, Elliott Timothy R, Berry Jack, Fletcher Donald C, Swanson Marsha, Christopher McNeal J
Department of Ophthalmology, Center for Low Vision Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Br J Health Psychol. 2008 Sep;13(Pt 3):449-61. doi: 10.1348/135910707X209835. Epub 2007 May 14.
Examined cognitive appraisals of interference and tolerance in the prediction of distress and self-reported disability among persons presenting for low vision rehabilitation.
Cross-sectional; correlational and path analyses.
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.
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.
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.
研究在低视力康复患者中，对干扰和耐受的认知评估在预测痛苦和自我报告的残疾方面的作用。
横断面研究；相关性和路径分析。
113名在大学低视力康复中心接受低视力康复治疗的患者（平均年龄71岁；52名男性和61名女性）参加了初始临床视力检查，并完成了几份问卷，以评估认知评估、情绪困扰和自我报告的残疾情况。
路径分析表明，更高的耐受性与视力丧失带来的干扰减少有关。更高的耐受性还与更少的情绪困扰相关，而症状严重程度（视力）与自我报告的残疾相关。认知评估（耐受性和干扰）通过情绪困扰间接影响自我报告的残疾。
数据表明，与客观症状（视力）相比，对忍受视力丧失的个人能力的评估以及视力丧失对目标导向行为和预期活动的感知干扰对痛苦有更大影响，并随后可预测残疾情况。讨论了对临床干预和进一步研究的启示。
