Dillon Lisa, Tang Diana, Liew Gerald, Hackett Maree, Craig Ashley, Gopinath Bamini, Keay Lisa
School of Optometry and Vision Science, Faculty of Science, UNSW Sydney, Sydney, NSW, 2052, Australia.
The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, PO Box M201 Missenden Rd, Sydney, NSW, 2050, Australia.
Eye (Lond). 2020 Jul;34(7):1287-1295. doi: 10.1038/s41433-020-0992-z. Epub 2020 May 28.
Older adults with vision impairment experience high rates of mental health problems, but very few access psychological support. We investigated community and stakeholder perspectives of the barriers and facilitators to participation in mental well-being programs for older adults with vision impairment.
Adults aged ≥ 50 years with vision impairment (community) were recruited from the client database, and low vision rehabilitation (LVR) professionals (stakeholders) from staff of a LVR provider. Participants completed one-on-one semi-structured interviews, which were designed and analyzed using behavior change theory.
Twenty-nine participants were interviewed; 16 community members and 13 stakeholders. Both groups cited mental health problems as a major concern, with many stakeholders reporting the grief and distress associated with vision loss experienced by their clients as having a negative impact on their mental and physical health. Major barriers to participation in mental well-being programs included a lack of awareness and difficulties accessing such programs, with stakeholders adding that their clients' lack of insight into their own mental health problems may reduce motivation to participate. Facilitators to participation in programs included the appeal of social interaction and inspirational speakers. An appropriate intervention could overcome these barriers, or enhance participation through education, persuasion, incentivisation, modeling, environmental restructuring, training, and enablement.
While barriers were discussed more than facilitators to participation, there was general support for mental well-being programs. This study provides guidance from stakeholders for the development of mental well-being programs to address mental health problems in the growing number of older adults with vision impairment.
视力受损的老年人心理健康问题发生率较高，但很少有人能获得心理支持。我们调查了社区和利益相关者对于视力受损老年人参与心理健康项目的障碍和促进因素的看法。
从客户数据库中招募年龄≥50岁的视力受损成年人（社区成员），并从一家低视力康复（LVR）机构的工作人员中招募低视力康复专业人员（利益相关者）。参与者完成一对一的半结构化访谈，访谈采用行为改变理论进行设计和分析。
共访谈了29名参与者，其中16名社区成员和13名利益相关者。两组都将心理健康问题视为主要关注点，许多利益相关者报告称，他们的客户因视力丧失而产生的悲伤和痛苦对其身心健康产生了负面影响。参与心理健康项目的主要障碍包括缺乏认知以及难以获得此类项目，利益相关者还补充说，他们的客户对自身心理健康问题缺乏洞察力可能会降低参与的积极性。参与项目的促进因素包括社交互动的吸引力和鼓舞人心的演讲者。适当的干预措施可以克服这些障碍，或者通过教育、劝说、激励、示范、环境重组、培训和赋能来提高参与度。
虽然讨论障碍比讨论参与的促进因素更多，但对于心理健康项目普遍表示支持。本研究为利益相关者制定心理健康项目提供了指导，以解决越来越多视力受损老年人的心理健康问题。
