Social interactions, experiences with adverse life events and depressive symptoms in individuals with visual impairment: a cross-sectional study

Effectiveness of exercise rehabilitation interventions on depressive symptoms in older adults post hip fracture: a systematic review and meta-analysis

This study determines the effectiveness of exercise rehabilitation interventions on depressive symptoms in older adults after hip fracture. Ovid MEDLINE, Embase, Global Health, APAPsych, CENTRAL, CIHAHL, PEDro and Open Grey were searched from database inception to June 10, 2022 for definitive, pilot or feasibility randomised controlled trials of rehabilitation interventions (versus any comparator) which reported depressive symptoms among older adults post hip fracture. Nonrandomised trials and those not published in English were excluded. Selection, quality appraisal (Cochrane Risk of Bias 2) and extraction in duplicate. Results were synthesised narratively and with meta-analysis (Hedge's g for intervention effect, I2 for heterogeneity). Eight trials (1146 participants) were included. Interventions were predominantly face-to-face exercise rehabilitation (range three to 56 sessions) at home versus usual care. Three trials were assigned overall low risk of bias, three some concerns and two high risk. The pooled effect of rehabilitation on depressive symptoms at intervention end favoured the intervention group (Hedges's g -0.43; 95% CI: -0.87, 0.01; four trials). Three trials demonstrated no between group difference following adjustment for baseline depressive symptoms. One trial found lower odds of depression when the intervention additionally included falls prevention, nutrition consultation and depression management. There is a potential benefit of exercise rehabilitation interventions on depressive symptoms after hip fracture. A mechanism for benefit may relate to baseline symptom severity, exercise frequency, frequency of health professional contacts, addition of a psychological component or of the quality of the underlying trials. To appropriately inform clinical guidelines, further appropriately powered trials with follow-up are warranted. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: CRD42022342099.

Predictors of Job Satisfaction for People with Visual Impairments

Introduction: Job satisfaction research has focused on the general population or specific careers. Little attention has focused on the job satisfaction of persons with visual impairments, particularly using standardized measures of job satisfaction. This study examined how relationships with colleagues and supervisors, opportunities for advancement, and employee demographics predict job satisfaction for employees with visual impairments. Methods: Researchers analyzed data from 195 employed participants from a larger study on job retention and career advancement. The Brief Job Satisfaction Measure II measured job satisfaction, and predictor variables focused on relationships with colleagues and supervisors, promotion opportunities, and demographics. Researchers used multiple linear regression to identify predictors of job satisfaction. Results: Individuals with visual impairments had high job satisfaction if they believed colleagues treated them the same as sighted colleagues and had supervisor support. Underemployed individuals with visual impairments experienced lower job satisfaction. Employees who identified their race as other, those who experienced vision loss after their first job, and participants with an additional disability had higher job satisfaction. Discussion: Social interactions with colleagues and supervisors contributed to the job satisfaction of employees with visual impairments. These interactions may make employees with visual impairments feel comfortable asking for workplace accommodations and more integrated into the workspace. While income was not a predictor of job satisfaction, underemployment was, indicating that individuals with visual impairments may not have achieved their maximum vocational potential. Implications for Practitioners: Individuals with visual impairments and service providers should look for opportunities to promote social interactions at work. Training co-workers and supervisors about working with persons with visual impairments and accommodations could be beneficial. Vocational rehabilitation counselors should also ensure program participants have employment opportunities that are both economically sustainable and commensurate with their interests and abilities.

A cross-lagged study of psychosocial adaptation among students with visual impairments: Coping, self-esteem, and social integration

BACKGROUND

As three key indicators of psychosocial adaptation, coping, self-esteem, and social integration are vital for students with visual impairments.

AIMS

This study aimed to examine the reciprocal relationships among visually impaired students' coping, self-esteem, and social integration.

METHODS

Students with visual impairments (N_Time1 = 311, N_Time2 = 170) from four special schools in mainland China responded to three inventories at two timepoints over one year. Cross-lagged panel modelling was performed to analyse the data.

RESULTS

After controlling for gender, self-esteem positively predicted self-directed coping and negatively predicted relinquished-control coping. An inverse path was found in the prediction of relinquished-control coping to self-esteem. Social integration positively predicted self-esteem. Furthermore, gender did not moderate the relationships in the cross-lagged model.

CONCLUSIONS AND IMPLICATIONS

Evidence is provided for a negative loop between self-esteem and relinquished-control coping. Social integration could be a precursor of self-esteem, and self-esteem could be a precursor of self-directed coping. Moreover, the study has practical implications for special schools, teachers, parents, and students on enhancing visually impaired students' psychosocial adaptation.

Is Telemedicine in Primary Care a Good Option for Polish Patients with Visual Impairments Outside of a Pandemic?

With the proliferation of telemedicine during the COVID-19 pandemic, attention began to turn to the risk of health disparities associated with its use among people with disabilities. Therefore, the present study investigates the level of interest in using teleconsultations (TCs) in primary healthcare among people with visual impairments (PVIs) and identifies their motivations and needs. A total of 219 Polish PVIs were surveyed using a combination of closed and open questions. About 50% of the respondents expressed interest in using TCs. The factor most closely related to the willingness to use TCs was age. The predominant reason for using TCs was to obtain a prescription or referral, and the most highlighted need was the possibility to choose between a TC and an in-person visit. The blind and poor-sighted participants differed in some regards. Our study indicates that TCs, under some conditions, may be a beneficial option for PVIs, and provides some directions for its effective implementation.

Experiences of stressful situations and mindfulness training for persons with visual impairment

The aim of this study was to explore what persons with visual impairment (VI) experienced as stressful in their daily lives and their experiences with using mindfulness training (MT) to cope with stressful situations. In order to explore this we conducted semi-structured interviews with six persons with VI after finishing an 8-week MT course. Systematic text condensation was used to analyze the interviews. This qualitative study found that the participants described three main areas of stress: (1) lack of access to information, (2) social expectations, and (3) navigating the body through one’s surroundings. The participants’ experiences with using MT to cope with stressful situations resulted in emotion-based and problem-based strategies: (1) breathing anchor, (2) awareness of and reflection upon thoughts and feelings, (3) most things are doable, (4) tackling the situation in a new way, and (5) haste makes waste. Our respondents described using MT for coping with stressful situations in all the three main areas of stress. Based upon this study we propose that there is good reason to offer MT as stress management for persons with VI, but further study is required to confirm the health-promoting benefits of MT for this group.

Post-Traumatic Stress Disorder in People with Visual Impairment Compared with the General Population

Background: People with a visual impairment appear to have an increased risk of experiencing potentially traumatizing life events and possibly also subsequently developing post-traumatic stress disorder (PTSD). This study investigated the point prevalence of PTSD in people with a visual impairment compared with the general population of Norway and examined factors associated with PTSD among people with a visual impairment. Methods: A telephone-based survey was administered to a probability sample of 1216 adults with a visual impairment. Of these, 736 (61% response rate) participated. A probability sample from the general population served as a reference (n = 1792, 36% response rate). PTSD was measured with the PTSD Checklist for the DSM-5 (PCL-5), based on the currently most bothersome event reported from the Life Events Checklist for DSM-5 (LEC-5). We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Results: The prevalence of PTSD was higher among people with a visual impairment than in the general population, both for men (9.0% vs. 3.8%) and women (13.9% vs. 8.5%). The prevalence rates of PTSD from the illness or injury that had caused the vision loss (men 3.9%, women 2.2%) accounted for a considerable part of the difference between the populations. For women, PTSD related to sexual assaults also contributed significantly to a higher PTSD prevalence in the visually impaired versus the general population (5.2% vs. 2.2%), while for men there were no other event categories which resulted in significant differences. Among people with a visual impairment, the higher risk of PTSD was associated with lower age, female gender, having acquired the vision loss, and having other impairments in addition to the vision loss. Conclusion: The higher prevalence of PTSD in people with a visual impairment suggests that vulnerability to mental health problems is associated with serious life events. The higher incidence than in the general population is partly due to the illness or injury that had led to the vision loss and partly due to people with vision loss appearing to be more vulnerable through exposure to other types of potentially traumatizing events, such as sexual abuse.

The Michigan Vision-Related Anxiety Questionnaire: A Psychosocial Outcomes Measure for Inherited Retinal Degenerations

OBJECTIVE

We sought to construct and validate a patient-reported outcome measure for screening and monitoring vision-related anxiety in patients with inherited retinal degenerations.

DESIGN

Item-response theory and graded response modeling to quantitatively validate questionnaire items generated from qualitative interviews and patient feedback.

METHODS

Patients at the Kellogg Eye Center (University of Michigan, Ann Arbor, Michigan, USA) with a clinical diagnosis of an inherited retinal degeneration (n = 128) participated in an interviewer-administered questionnaire. The questionnaire consisted of 166 items, 26 of which pertained to concepts of "worry" and "anxiety." The subset of vision-related anxiety questions was analyzed by a graded response model using the Cai Metropolis-Hastings Robbins-Monro algorithm in the R software mirt package. Item reduction was performed based on item fit, item information, and item discriminability. To assess test-retest variability, 25 participants completed the questionnaire a second time 4 to 16 days later.

RESULTS

The final questionnaire consisted of 14 items divided into 2 unidimensional domains: rod function anxiety and cone function anxiety. The questionnaire exhibited convergent validity with the Patient Health Questionnaire for symptoms of depression and anxiety. This vision-related anxiety questionnaire has high marginal reliability (0.81 for rod-function anxiety, 0.83 for cone-function anxiety) and exhibits minimal test-retest variability (ρ = 0.81 [0.64-0.91] for rod-function anxiety and ρ = 0.83 [0.68-0.92] for cone-function anxiety).

CONCLUSIONS

The Michigan Vision-Related Anxiety Questionnaire is a psychometrically validated 14-item patient-reported outcome measure to be used as a psychosocial screening and monitoring tool for patients with inherited retinal degenerations. It can be used in therapeutic clinical trials for measuring the benefit of an investigational therapy on a patient's vision-related anxiety.

Trauma in the third decade: Ruminative coping, social relationships and posttraumatic stress symptoms

BACKGROUND

Previous research suggest that rumination and poor social relationships contribute to the maintenance of posttraumatic stress symptoms (PTSS) after traumatic events. Less is known about how these factors work together. The aim of this study was to assess the association between ruminative coping style and long-term PTSS, and to determine whether perceived social support and loneliness can attenuate or potentiate this association, respectively.

METHODS

This study used cross-sectional data from survivors and bereaved (n = 185) collected 26 years after the 1990 fire on the Scandinavian Star ferry.

RESULTS

Ruminative coping style, perceived social support, and loneliness were all uniquely associated with PTSS. Social support, but not loneliness, moderated the association between ruminative coping style and PTSS.

LIMITATIONS

The 26-year interval between the traumatic event and the data collection mean that we cannot infer how a ruminative coping style, perceived social support, and loneliness could affect PTSS in the early aftermath of disaster.

CONCLUSIONS

The results suggest that perceived social support and loneliness play different roles in long-term maintenance of PTSS. Whereas loneliness seem to have a direct association with PTSS, high social support may also protect against the negative effects of a ruminative coping style on PTSS. Social relationships may play a crucial role in recovery from trauma, particularly in individuals with a ruminative coping style.