Boon Mei Ying, Chu Byoung Sun, Lee Pei-Chu, Chiang Te-Ju, Alshamli Nasser, Alghamdi Waleed, Lai Jennifer, Yeung Wendy, Bridge Catherine
*PhD, BOptom(Hons), FAAO †PhD, MOptom, FAAO ‡BOptom §MOptom ∥BOptom, BSc ¶PhDArch, MCogSci School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia (MYB, BSC, P-CL, T-JC, NA, WA, JL, WY); School of Optometry and Vision Science, Catholic University of Daegu, Gyeongsan, South Korea (BSC); and Faculty of the Built Environment, University of New South Wales, Sydney, New South Wales, Australia (CB).
Optom Vis Sci. 2015 Oct;92(10):995-1002. doi: 10.1097/OPX.0000000000000695.
It is widely known that visual impairment (VI) is a risk factor for falls, but patients or their eye care practitioners may not recognize other kinds of incidents as being problematic because of their vision. Consequently, older people with VI may have unmet needs for advice on how to carry out activities of daily living safely. Therefore, the purpose of this study was to understand whether older people with VI consider their vision as a causative factor of incidents they experience and their perceptions regarding the prevention of future incidents. If sample size permitted, a secondary aim was to evaluate whether quantitative findings supported their perceptions.
The study design was a prospective cohort study evaluating injurious and damaging incidents and related near misses using open questions in a written 2-weekly large-print diary with active follow-up over 8 weeks in older people (>60 years, n = 80) with and without VI. Baseline measures included habitual binocular visual acuity, contrast sensitivity, visual fields, 3-m walk test, and Short Form 12 physical and mental component scores. Participants' diary entries were coded. Factor analysis and binary logistic analysis were used to investigate whether baseline measures were predictive of incident occurrence. Risk and preventative factors identified were compared.
Participants perceived that their vision was implicated in bump and fall incidents. Quantitative analysis indicated that contrast sensitivity and fitness were significant predictors of incident occurrence. Six vision-related and five non-vision-related causative factors were identified by participants as contributing factors. Participants frequently stated "don't know" when asked to identify solutions to prevent incident recurrence.
Participants had unmet needs for advice in relation to incident prevention. It would be prudent for eye care practitioners to raise incident prevention in eye care consultations regardless of voiced patient concerns.
众所周知，视力障碍（VI）是跌倒的一个风险因素，但患者或其眼科护理从业者可能未意识到其他类型的事件因其视力问题而存在问题。因此，患有视力障碍的老年人在如何安全进行日常生活活动方面可能有未得到满足的建议需求。所以，本研究的目的是了解患有视力障碍的老年人是否将其视力视为他们所经历事件的一个致病因素以及他们对预防未来事件的看法。如果样本量允许，次要目的是评估定量研究结果是否支持他们的看法。
本研究设计为一项前瞻性队列研究，使用两周一次的大字印刷书面日记中的开放性问题评估伤害性和破坏性事件以及相关的未遂事故，并对80名年龄大于60岁、有或无视力障碍的老年人进行为期8周的积极随访。基线测量包括习惯性双眼视力、对比敏感度、视野、3米步行测试以及简短健康调查问卷12项身体和心理成分得分。对参与者的日记条目进行编码。采用因子分析和二元逻辑分析来调查基线测量是否可预测事件的发生。对识别出的风险因素和预防因素进行比较。
参与者认为他们的视力与碰撞和跌倒事件有关。定量分析表明，对比敏感度和身体状况是事件发生的重要预测因素。参与者确定了六个与视力相关和五个与视力无关的致病因素为促成因素。当被要求确定预防事件复发的解决方案时，参与者经常回答“不知道”。
参与者在事件预防方面有未得到满足的建议需求。无论患者是否表达了担忧，眼科护理从业者在眼科护理咨询中提出事件预防建议都是谨慎之举。
