Stacy Smallfield, DrOT, MSOT, OTR/L, BCG, FAOTA, is Associate Professor of Occupational Therapy and Medicine and Assistant Director, Occupational Therapy Entry-Level Professional Programs, Washington University School of Medicine, St. Louis, MO;
Jennifer Kaldenberg, DrPH, MSA, OTR/L, SCLV, FAOTA, is Clinical Assistant Professor of Occupational Therapy, Boston University, College of Health and Rehabilitation Sciences: Sargent College, Boston, MA.
Am J Occup Ther. 2020 Jan/Feb;74(1):7401185030p1-7401185030p18. doi: 10.5014/ajot.2020.038380.
Low vision affects many older adults and is expected to significantly increase over the next several decades. It has a significant impact on all aspects of daily life, including the reading required for participation in occupations.
To determine the effectiveness of interventions within the scope of occupational therapy to improve reading required for the performance of occupations by older adults with low vision.
We conducted a systematic review of literature published in the Cochrane Database of Systematic Reviews, MEDLINE, PsycINFO, CINAHL, and OTseeker databases from 2010 through 2016. The references of retrieved articles were also hand searched.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to abstract and assess data quality and validity. This review followed the established methodology of the American Occupational Therapy Association Evidence-Based Practice Project.
Sixteen articles met the inclusion criteria and were categorized into three themes: (1) technology, (2) visual skills training, and (3) multicomponent interventions. Moderate evidence supports stand-based electronic magnification and eccentric viewing training to improve reading outcomes. Strong evidence supports multicomponent interventions.
Occupational therapy practitioners working with older adults with low vision are strongly encouraged to integrate stand-based electronic magnification, eccentric viewing training, and comprehensive low vision services into routine care. Further research with larger sample sizes and functional reading outcome measures is needed.
This review provides additional support for the use of select occupational therapy interventions (stand-based electronic magnification, eccentric viewing training, and comprehensive low vision services) to support the reading required for occupational performance for older adults with low vision. The findings provide guidance to occupational therapy practitioners for selection and implementation of evidence-based interventions for reading.
低视力影响许多老年人,预计在未来几十年内会显著增加。它对日常生活的各个方面都有重大影响,包括参与职业所需的阅读。
确定职业治疗范围内的干预措施在多大程度上可以改善低视力老年人从事职业所需的阅读能力。
我们对 Cochrane 系统评价数据库、MEDLINE、PsycINFO、CINAHL 和 OTseeker 数据库 2010 年至 2016 年发表的文献进行了系统评价。还对检索到的文章的参考文献进行了手工搜索。
采用系统评价和荟萃分析的首选报告项目(PRISMA)指南来提取和评估数据质量和有效性。本综述遵循美国职业治疗协会循证实践项目的既定方法。
有 16 篇文章符合纳入标准,并分为三个主题:(1)技术,(2)视觉技能训练,(3)多组分干预。有中等证据支持基于支架的电子放大和偏心观看训练可改善阅读结果。强有力的证据支持多组分干预。
强烈鼓励从事低视力老年人工作的职业治疗师将基于支架的电子放大、偏心观看训练和综合低视力服务整合到常规护理中。需要进一步开展具有更大样本量和功能阅读结果测量的研究。
本综述为选择职业治疗干预措施(基于支架的电子放大、偏心观看训练和综合低视力服务)提供了更多支持,以支持低视力老年人从事职业所需的阅读能力。研究结果为职业治疗师选择和实施阅读的循证干预措施提供了指导。