INTERVENTIONS FOR VISUAL LOSS IN NURSING HOME RESIDENTS

针对疗养院居民视力丧失的干预措施

• 批准号: 6509877
• 负责人: SHEILA K WEST
• 金额: $ 52.3万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-05-01 至 2004-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6509877
• 关键词: behavioral /social science research tag; cataract; cataract surgery; clinical depression; clinical research; clinical trials; comorbidity; eye refractometry; frail elderly; functional ability; health care cost /financing; health care service utilization; health services research tag; human subject; human therapy evaluation; mental disorder chemotherapy; nursing homes; outcomes research; quality of life; questionnaires; socializations; therapy compliance; vision aid; vision disorders; vision tests

DESCRIPTION (adapted from investigator's abstract): The burden of visual impairment among older persons is considerable, with especially high rates reported among nursing home residents. Causes of visual impairment are largely remediable with refraction and cataract surgery, or the functional impact lessened with appropriate low vision aids. Yet, no intervention trial to determine methods to improve visual status in nursing home residents has ever been carried out. Moreover, the impact of improving visual status on socialization and functional status in nursing homes is unknown. In this project the investigators propose to measure the impact on socialization, and a variety of other measures of function, of a visual impairment intervention program. Nursing homes will be randomized into a group receiving standard care and a group receiving a visual impairment intervention program, and outcomes compared at 6 and 12 months after the intervention. The intervention program consists of 3 tracks depending on the cause of vision loss: free refraction and subsidized spectacles; transportation in connection with cataract surgery; and free training and subsidized low vision aids. From 28 nursing homes on the Lower Eastern Shore of Maryland, the investigators will assess visual impairment and the causes of visual loss in the residents. They expect to identify 578 persons with presenting acuity worse than 20/40 in the better eye, and an equal sample of 578 persons with no visual loss. Baseline comparisons of difference between those with visual impairment and those with no visual loss will determine the impact of visual loss on functional status. Those with visual loss will be randomized, by nursing home, into treatment arms for prospective determination of the impact of impairment in visual status on function. The primary outcome measure is improved socialization scores, using a scale of observed resident behavior with nursing home staff respondents. Secondary outcomes include utilization of appropriate eye care services in both treatment arms, change in physical function and mobility, changes in depressive symptomatology, and changes in psychoactive drug use. Prospective change will be measured among intervention and control groups, including both visually impaired and non-impaired. The cost-effectiveness of the intervention strategy will be determined. Optimizing eye care services for nursing home residents will become increasingly important as the size of this population increases. This trial will answer timely questions of the impact on the functional status of the most frail elderly of modest, potentially sustainable inputs into improving the appropriate utilization of eye care services.

描述（根据研究者的摘要改编）：视觉的负担 老年人的损害相当大，尤其很高 报道了疗养院居民。视觉障碍的原因很大 可以通过折射和白内障手术或功能影响进行补救 使用适当的低视力辅助工具减少。但是，没有干预试验 确定改善疗养院居民视觉状态的方法 被执行。此外，改善视觉状态对 疗养院中的社会化和功能状况尚不清楚。在这个 研究人员建议衡量对社会化的影响，并 视觉障碍干预的其他功能量度多种多样 程序。疗养院将被随机分为接受标准护理的小组 以及接受视觉障碍干预计划的小组和结果 在干预后的6个月和12个月中进行了比较。干预计划 由3条曲目组成，具体取决于视力丧失的原因：自由折射和 补贴眼镜；与白内障手术有关的运输；和 免费培训和补贴的低视力辅助工具。来自28家疗养院 马里兰州的下东岸，调查人员将评估视觉 居民的障碍和视觉丧失的原因。他们期望 识别578人的敏锐度较差的敏锐度较差的眼睛， 578人的平等样本，没有视觉损失。基线比较 视觉障碍与没有视觉损失的人之间的区别 将确定视觉损失对功能状态的影响。那些与 视觉丧失将通过疗养院随机分为 预期确定视觉状态受损的影响 功能。主要结果指标是改善社会化得分，使用 与疗养院工作人员受访者观察到的居民行为的规模。 次要结果包括两者中适当的眼保健服务的利用 治疗臂，身体功能的变化和活动能力，抑郁症发生变化 症状学和精神活性药物使用的变化。潜在的变化会 在干预组和对照组之间进行测量，包括视觉 受损和不受影响。干预策略的成本效益 将确定。优化疗养院居民的眼保健服务 随着人口的规模增加，将变得越来越重要。 该审判将及时回答有关功能状况影响的问题 最谦虚的老年人，潜在的可持续投入 改善对眼保健服务的适当利用。

项目成果

Low Vision Rehabilitation in a Nursing Home Population: The SEEING Study.

疗养院人群的低视力康复：SEEING 研究。

• 发表时间: 2007
• 期刊: Journal of visual impairment & blindness
• 影响因子: 1.1
• 作者: Deremeik,James;Broman,AimeeT;Friedman,David;West,SheilaK;Massof,Robert;Park,William;Bandeen-Roche,Karen;Frick,Kevin;Muñoz,Beatriz
• 通讯作者: Muñoz,Beatriz