Centre for Research into Disability and Society within the Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Australia.
Br J Ophthalmol. 2010 Feb;94(2):223-8. doi: 10.1136/bjo.2008.147538.
BACKGROUND/AIMS: 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.
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.
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.
Addition of self-management significantly improved general health and vision-specific rehabilitation outcomes for older adults with ARVL.
背景/目的：人口老龄化将导致前所未有的大量老年人患有与年龄相关的视力障碍（ARVL）。自我管理模式可以改善健康结果并降低医疗保健成本；然而，这些原则很少在低视力服务中应用。
一项针对患有 ARVL 的老年人（n=77）的双臂随机对照试验将非营利性社区机构提供的“常规护理”与扩展的护理模式（常规护理+自我管理组干预）进行了比较。主要结局变量（参与生活情况）使用活动卡片分类法进行测量。次要结局指标检查了一般健康和特定于视力的领域。
意向治疗分析表明，与仅接受常规护理的组相比，扩展模型在测试后显著提高了生活参与度。无论参与者在基线时是否抑郁，都取得了进展。自我管理组的加入还成功地显著降低了抑郁程度，提高了身心健康、一般和特定领域的自我效能感，以及对 ARVL 的适应。除了适应和心理健康外，12 周随访时仍存在差异。
自我管理的加入显著改善了患有 ARVL 的老年人的一般健康和特定于视力的康复结果。
