Ophthalmology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
Expertise Innovation Knowledge, Robert Coppes Foundation, Vught, The Netherlands.
BMC Health Serv Res. 2021 Jul 28;21(1):749. doi: 10.1186/s12913-021-06682-z.
Depression and anxiety are highly prevalent, but often unrecognized in adults with vision impairment (VI) or blindness. The purpose of this study was to explore visually impaired and blind adults' views on facilitators and barriers in recognizing and discussing mental health problems.
Semi-structured interviews, based on the Integrated Model for Change, were conducted with 16 visually impaired or blind adults receiving support from three Dutch low vision service organizations. Interview data was analyzed using the framework approach.
Participants perceived their focus on practical support with regard to their VI, lack of mental health literacy, and misattribution of symptoms of depression or anxiety as barriers for recognizing mental health problems. With regard to discussing mental health problems, they perceived difficulties in acknowledging their VI and mental health problems due to feelings of vulnerability and inequality. Participants mentioned that their social support system and healthcare providers (could) facilitate them in recognizing and discussing mental health problems. However, participants thought that healthcare providers currently often lacked the knowledge, skills and attitude to recognize and discuss this topic with their clients.
Our findings suggest that visually impaired and blind adults may experience several barriers to recognize, acknowledge and discuss mental health. Healthcare providers and social support systems seem essential for them in reducing these barriers. However, there might be a mismatch between the needs of visually impaired and blind adults and healthcare providers' knowledge, skills and attitude. Training healthcare providers may improve detection of depression and anxiety in adults with VI or blindness, and enhance clinician-patient communication on mental health.
抑郁症和焦虑症在视力障碍（VI）或失明的成年人中非常普遍，但往往未被识别。本研究的目的是探讨视力障碍和失明成年人对识别和讨论心理健康问题的促进因素和障碍的看法。
基于综合变革模型，对来自三个荷兰低视力服务机构的 16 名视力障碍或失明的成年人进行了半结构化访谈。使用框架方法对访谈数据进行分析。
参与者认为他们对 VI 的关注重点是实际支持、心理健康素养的缺乏以及将抑郁或焦虑症状归因不当，这些是识别心理健康问题的障碍。在讨论心理健康问题方面，他们认为由于感到脆弱和不平等，他们难以承认自己的 VI 和心理健康问题。参与者提到，他们的社会支持系统和医疗保健提供者（可以）帮助他们识别和讨论心理健康问题。然而，参与者认为，医疗保健提供者目前往往缺乏识别和讨论这一话题的知识、技能和态度。
我们的研究结果表明，视力障碍和失明成年人在识别、承认和讨论心理健康问题时可能会遇到多种障碍。医疗保健提供者和社会支持系统对他们来说是必不可少的，可以帮助他们减少这些障碍。然而，视力障碍和失明成年人的需求与医疗保健提供者的知识、技能和态度之间可能存在不匹配。培训医疗保健提供者可能会提高对 VI 或失明成年人中抑郁和焦虑的检测率，并增强临床医生与患者在心理健康方面的沟通。
