Vision & Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK.
Ophthalmic Physiol Opt. 2022 May;42(3):491-503. doi: 10.1111/opo.12950. Epub 2022 Feb 8.
Longitudinal changes in priority rehabilitation needs, vision-related activity limitation and importance of visual goals were evaluated in a sample of people with a visual impairment over a year following entry to low vision rehabilitation services in England.
Participants were adults with newly registered visual impairment within Leicestershire. Priority scores, indicating the level of rehabilitative need, were determined from the importance and difficulty scores of the 48 goals of the Participation and Activity Inventory (PAI). Rasch analysis of the difficulty and importance scores examined activity limitation and importance separately. PAI outcome measures were assessed on entry to rehabilitation services and at 4 and 12 months thereafter.
Forty-eight participants (mean age 74.2, SD 14.1 years) completed three visits. Overall, there was a statistically significant reduction in the perceived need for rehabilitation over time (p < 0.001, η = 0.29), driven by reduced perceived difficulty (p < 0.001, η = 0.32) but stable importance (p = 0.73) of goals, with most change occurring between baseline and 4 months. PAI goals with greatest rehabilitative need at study entry were reading, mobility and writing, and these remained of highest priority over time. The greatest priority score decrease was for the goal 'Hobbies and crafts'. The largest decrease in importance was for 'Mobility outdoors', whereas 'Relationship with loved ones' increased most.
Despite a decline in the perceived need for rehabilitation over the study period, there remains a need for continued support and intervention at 12 months following registration with rehabilitation services, particularly for the key goals of reading, writing and mobility. Early identification and support for individuals' important but difficult goals could prevent such goals being relinquished. Goals concerning relationships and communication became more important over time, indicating that re-evaluation of needs at follow-up is necessary to inform ongoing service provision.
在英格兰的低视力康复服务中，对新登记的视力障碍患者进行了为期一年的随访，评估了他们在康复需求、与视力相关的活动受限以及视觉目标重要性方面的纵向变化。
研究对象为莱斯特郡新登记的视力障碍成年人。优先分数是通过参与和活动清单（PAI）的 48 个目标的重要性和难度分数来确定的。对难度和重要性分数进行 Rasch 分析，分别评估活动受限和重要性。在进入康复服务时以及之后的 4 个月和 12 个月评估 PAI 结果测量。
48 名参与者（平均年龄 74.2 岁，标准差 14.1 岁）完成了三次访问。总体而言，随着时间的推移，康复需求的感知明显减少（p<0.001，η=0.29），这是由于感知难度降低（p<0.001，η=0.32），但目标的重要性稳定（p=0.73），大多数变化发生在基线和 4 个月之间。研究开始时，最需要康复的 PAI 目标是阅读、移动和书写，并且这些目标随着时间的推移仍然是最重要的。优先级得分下降最大的目标是“爱好和手工艺”。“户外活动的移动性”重要性下降最大，而“与爱人的关系”增加最多。
尽管在研究期间康复需求的感知有所下降，但在注册康复服务后的 12 个月内，仍然需要持续的支持和干预，特别是对于阅读、写作和移动等关键目标。早期识别和支持个人重要但困难的目标可以防止这些目标被放弃。随着时间的推移，与人际关系和沟通有关的目标变得更加重要，这表明需要在随访时重新评估需求，以告知持续的服务提供。
