Intra-ocular straylight can cause decreased visual functioning, and it may cause diminished vision-related quality of life (VRQOL). This cross-sectional population-based study investigates the association between straylight and VRQOL in middle-aged and elderly individuals. Multivariable linear regression analyses were used to assess the association between straylight modeled continuously and cutoff at the recommended fitness-to-drive value, straylight ≥ 1.4 log(s), and VRQOL. The study showed that participants with normal straylight values, straylight ≤ 1.4 log(s), rated their VRQOL slightly better than those with high straylight values (straylight ≥ 1.4 log(s)). Furthermore, multivariable regression analysis revealed a borderline statistical significant association (p = .06) between intra-ocular straylight and self-reported VRQOL in middle-aged and elderly individuals. The association between straylight and self-reported VRQOL was not influenced by the status of the intra-ocular lens (natural vs. artificial intra-ocular lens after cataract extraction) or the number of (instrumental) activities of daily living that were reported as difficult for the elderly individuals.
In the Netherlands, over 40% of nursing home residents are estimated to have visual impairments. This results in the loss of basic visual abilities. The nursing home environment fits more or less to residents’ activities and social participation. This is referred to as environmental fit. To raise professional awareness of environmental fit, an Environmental Observation tool for the Visually Impaired was developed. This tool targets aspects of the nursing home environment such as ‘light’, the use of ‘colours and contrasts’ and ‘furnishing and obstacles’. Objective of this study is to validate the content of the observation tool to have a tool applicable for practice. Based on the content validity approach, we invited a total of eight experts, six eye care professionals and two building engineering researchers, to judge the relevance of the items. The Item Content Validity approach was applied to determine items to retain and reject. The content validity approach led to a decrease in the number of items from 63 to 52. The definitive tool of 52 items contains 21 for Corridors, 17 for the Common Room, and 14 for the Bathroom. All items of the definite tool received an Item-Content Validity Index of 0.875 and a Scale-Content Validity Index of 0.71. The content validity index of the scale and per item has been applied, resulting in a tool that can be applied in nursing homes. The tool might be a starting point of a discussion among professional caregivers on environmental interventions for visually impaired older adults in nursing homes
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Background: While the participation of adults with visual and severe or profound intellectual disabilities (VSPID) in society and community life is important, evidence-based interventions to improve their participation are lacking. Weconducted a process evaluation of the implementation of ‘Care for Participation+’ (CFP+), a new intervention targeting the attitudes of direct support professionals (DSPs) toward the participation of adults with VSPID, within a residential facility in the Netherlands.Methods: CFP+ was inspired by the Boston Psychiatric Rehabilitation Approach and adapted by adopting a new definition and operationalization of the concept of participation for adults with VSPID. Following systematic training, 16 DSPs of adults with VSPID were able to apply key elements of CFP+ to explore diverse roles and activities for this population, facilitating their self-management, teaching them necessary skills for participation, and organizing support. Our process evaluation entailed an investigation of the delivered dose, reach, fidelity, and adaptation of CFP+ during and after the CFP+ intervention. We also evaluated the mechanisms of impact and context using questionnaires, assignments, documentation, interviews, and a logbook.Results: The intended dose, reach, and fidelity relating to the implementation of CFP+ were not achieved. Despite this fact, an assessment of the mechanisms of impact indicated that assignments of CFP+ were well (75%) or reasonably well (17%) understood by DSPs. CFP+ was applied by DSPs to stimulate self-management (83% of DSPs), new activities (100%), enhanced involvement in existing activities (67%) and to explore new roles (50%) for adults with VSPID. A negative contextual factor mentioned by the trainer and manager was the DSPs’ lack of commitment to the training program. Another negative contextual factor mentioned by DSPs was the lack of time for implementing CFP+.Conclusions: CFP+ provides new opportunities to improve the participation of adults with VSPID. Despite the nonoptimal conditions for implementing CFP+ and the DSPs’ general reluctance to apply the new intervention, some have actively used CFP+ within the residential facility. Future studies should focus on the outcomes of CFP+ regarding attitudinal changes among DSPs relating to the participation of adults with VSPID and their quality of life.
