Wahl H W
Institut für Gerontologie, Universität Heidelberg.
Z Gerontol. 1994 Nov-Dec;27(6):399-409.
In the conceptual part of this article, the existential dimension of experiencing a dramatic visual loss in late life is highlighted. Three theoretical avenues are proposed to approach age-related vision loss: 1) a stress and burden perspective; 2) a coping perspective, 3) an environmental psychology perspective. The empirical study is based on 84 elderly subjects suffering from vision loss (42 visually impaired, 42 blind), a comparison group of 42 subjects with mobility impairments, and a control group of 42 healthy subjects (particularly not impaired in vision or mobility). In all impaired groups, the impairment appeared after the age of 55 years; identification of subjects was based on medical expertise. Mean age varies between groups from 75 to 78 years with 30 females and 12 males in each group. Data based on person (e.g., ADL-functioning, subjective well-being, depressivity) as well as person-environment-transaction measures (e.g., microecology within the house, action range outside the house) were collected. Results revealed a reduced ADL-competence, lower subjective well-being, higher depressivity, and a shrinkage of action range in subjects suffering from visual loss. However, there was also a need for a differential perspective: For example, depending on person variables (living alone/not alone, degree of visual loss, coping style, coexisting illnesses), a different "resilience" against environmental pressure was observed. These findings point to the importance of a "differential" environmental gerontology.
在本文的概念部分,着重强调了晚年经历严重视力丧失的生存维度。提出了三种理论途径来探讨与年龄相关的视力丧失:1)压力与负担视角;2)应对视角;3)环境心理学视角。实证研究基于84名患有视力丧失的老年人(42名视力受损者,42名盲人)、一个由42名行动不便者组成的对照组以及一个由42名健康受试者(特别是视力或行动能力未受损者)组成的控制组。在所有受损组中,损伤均出现在55岁之后;受试者的确定基于医学专业知识。各组的平均年龄在75至78岁之间,每组有30名女性和12名男性。收集了基于个人的数据(如日常生活活动功能、主观幸福感、抑郁程度)以及人与环境相互作用的测量数据(如房屋内的微生态、房屋外的活动范围)。结果显示,视力丧失的受试者日常生活活动能力下降、主观幸福感降低、抑郁程度升高且活动范围缩小。然而,也需要一种差异化的视角:例如,根据个人变量(独居/非独居、视力丧失程度、应对方式、并存疾病),观察到对环境压力的“复原力”有所不同。这些发现指出了“差异化”环境老年学的重要性。