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与使用放大镜式低视力助具相关的因素:范围综述。

Factors related to the use of magnifying low vision aids: a scoping review.

机构信息

School of Optometry, University of Montreal, Montreal, QC, Canada.

Centre de Recherche Interdisciplinaire en Réadaptation de Montréal métropolitain, Montreal, QC, Canada.

出版信息

Disabil Rehabil. 2020 Dec;42(24):3525-3537. doi: 10.1080/09638288.2019.1593519. Epub 2019 May 23.

Abstract

The decision process around the (non-)use of assistive technologies is multifactorial. Its determinants have previously been classified into , , and categories. Whether these categories specifically apply to the use of magnifying low vision aids was explored here, using this classification. A scoping review (Embase, MedLine, Cochrane, ERIC ProQuest, CINAHL, NICE Evidence, Trip Database) was conducted to summarize the extent, range, and nature of research regarding the categories that are associated with low vision aid (non-)usage. A combination of key words and MeSH terms was used based upon the identified core concepts of the research question: , and . Inter-rater reliability for the selection process was considered acceptable (kappa = 0.87). A combination of numerical and qualitative description of 21 studies was performed. Studies report high variability rates of people possessing devices but not using them (range: 2.3-50%, M = 25%, SD = 14%). We were able to replicate the conceptual structure of the four categories that had previsouly been identified with other devices. Age, diagnosis and visual acuity demonstrated contradictory influence on optical low vision aid usage. Change in vision, appropriate environment, consistent training, patient's motivation and awareness of low vision services, emerged as contributor factors of use. This review provides evidence that clinicians should not rely on traditionally available clinical factors to predict device use behavior. Worsening vision and low motivation appear as predictors of device nonuse and should be considered from the clinician's point of view. Education about potential facilitating factors and promotion of innovative care are strongly encouraged.Implications for rehabilitationInvestigation of the factors predicting (non-)use of magnifying low vision aids is important. These findings can help clinicians to identify patients with a higher risk of non-use of low vision aids as well as provide evidence for interventions designed to improve use.Knowledge of low vision services and types of magnifying low vision aids available to patients appears as fundamental in the process of device use and needs to be supported by more educational programs.Psychological factors predicting (non-)use of low vision aids need to be considered in the choice of rehabilitation and follow-up strategies by a multidisciplinary team, focusing more on mechanisms of adaptation and patient's motivation.Training intensity should play a central role in the development of innovative intervention programs to reduce device abandonment.

摘要

辅助技术使用与否的决策过程是多因素的。其决定因素以前被分为 、 、 和 类别。在这里,我们使用这种分类方法来探讨这些类别是否专门适用于放大镜式低视力辅助器具的使用。进行了范围综述(Embase、MedLine、Cochrane、ERIC ProQuest、CINAHL、NICE Evidence、Trip Database),以总结与低视力辅助器具(不)使用相关的类别研究的程度、范围和性质。根据研究问题的核心概念,使用了关键词和 MeSH 术语的组合: 、 和 。选择过程的观察者间信度被认为是可接受的(kappa = 0.87)。对 21 项研究进行了数值和定性描述的组合。研究报告称,拥有设备但不使用的人的高变异性率(范围:2.3-50%,M = 25%,SD = 14%)。我们能够复制以前与其他设备一起确定的四个类别的概念结构。年龄、诊断和视力对光学低视力辅助器具使用的影响相互矛盾。视力变化、适当的环境、持续的训练、患者的动机和对低视力服务的认识,成为使用的促成因素。本综述提供的证据表明,临床医生不应仅依赖传统的临床因素来预测设备使用行为。视力恶化和低动机似乎是设备不使用的预测因素,应从临床医生的角度考虑。强烈鼓励对潜在促进因素进行教育和创新护理的推广。

康复意义

调查预测放大镜式低视力辅助器具(不)使用的因素很重要。这些发现可以帮助临床医生识别出低视力辅助器具使用风险较高的患者,并为旨在提高使用的干预措施提供证据。

患者对低视力服务和可用的放大镜式低视力辅助器具的了解似乎是设备使用过程的基础,需要通过更多的教育计划来支持。

预测低视力辅助器具(不)使用的心理因素需要在多学科团队选择康复和随访策略时考虑,重点更多地放在适应机制和患者的动机上。

训练强度应在创新干预计划的发展中发挥核心作用,以减少设备废弃。

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