Nia Keon, Markowitz Samuel N
Low Vision Service, University Health Network Hospitals, Department of Ophthalmology and Vision Sciences, University od Toronto, Ontario, Canada.
Can J Ophthalmol. 2007 Oct;42(5):698-702. doi: 10.3129/i07-124.
Demographic changes expected to occur in the near future and the need for planning to address them are behind the urgent drive to assess present day provision and utilization of low-vision rehabilitation (LVR) services in the community. Current data available in Canada in this regard are mostly from Canadian National Institute for the Blind (CNIB) sources from clients accessing services, and are therefore incomplete. The purpose of this study, therefore, was to survey the provision and utilization of LVR services as reported by patients identified with low vision (LV) outside the CNIB system, specifically among those attending hospital-based ophthalmology clinics.
The study design was a prospective, nonrandomized, observational case series based on interviews with LV patients. Cases with LV identified according to preset criteria were interviewed and tested for best-corrected visual acuity. The interview format included questions on multiple outcome measures of LVR, which provided answers addressing the theme of this study. A separate questionnaire was used to assess quality-of-life measures.
Thirty-four subjects were recruited for the study, 21 females and 13 males, with a mean age of 74 (SD 16) years. LV had been present for a mean of 8.26 (SD 12.2) years, mostly caused by age-related macular degeneration (44%) and other maculopathies (38%). Patients classified as having LV were referred to LVR services only in 50% of cases and mostly to CNIB offices (47%). The majority of cases (59%) used magnifiers as the most common remedy for LVR. A majority of cases (59%) felt that current rehabilitation services are insufficient and that more LVR interventions were warranted in their case.
Many cases with LV are not referred to LVR services. Those referred are directed mainly to the CNIB, bypassing other advanced and comprehensive suppliers of LVR services. The majority of cases express dissatisfaction with the current LVR services provided. There is a clear and urgent need to expand and reform the delivery of current LVR services.
预计在不久的将来会发生人口结构变化，且需要制定计划来应对这些变化，这推动了对社区低视力康复（LVR）服务当前提供情况和利用情况进行评估的迫切需求。加拿大目前在这方面可获得的数据大多来自加拿大国家盲人研究所（CNIB）的服务对象，因此并不完整。因此，本研究的目的是调查CNIB系统之外被确定为低视力（LV）的患者所报告的LVR服务提供情况和利用情况，特别是在那些前往医院眼科诊所就诊的患者中。
本研究设计为基于对低视力患者访谈的前瞻性、非随机观察性病例系列。根据预设标准确定的低视力病例接受访谈，并进行最佳矫正视力测试。访谈形式包括关于LVR多种结果指标的问题，这些问题提供了与本研究主题相关的答案。使用单独的问卷来评估生活质量指标。
本研究招募了34名受试者，其中女性21名，男性13名，平均年龄为74（标准差16）岁。低视力平均存在8.26（标准差12.2）年，主要由年龄相关性黄斑变性（44%）和其他黄斑病变（38%）引起。被归类为低视力的患者仅在50%的病例中被转介至LVR服务，且大多被转介至CNIB办事处（47%）。大多数病例（59%）使用放大镜作为最常见的LVR补救措施。大多数病例（59%）认为当前的康复服务不足，他们的情况需要更多的LVR干预措施。
许多低视力病例未被转介至LVR服务。那些被转介的病例主要被引导至CNIB，而绕过了其他先进和全面的LVR服务供应商。大多数病例对当前提供的LVR服务表示不满。显然迫切需要扩大和改革当前LVR服务的提供。
