What explains health in persons with visual impairment?

Health and Quality of Life Outcomes

Alarcos Cieza⁴  Danny Loyola³  Stephan Froehlich²  Michaela Coenen¹  Juliane Leissner³ 

[1] ICF Research Branch in cooperation with the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland;ARIS MVZ Nuernberg, Neumeyerstr 48, Nuernberg 90411, Germany;Department of Medical Informatics, Biometry and Epidemiology – IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU) Munich, Marchioninistr 17, Munich 81377, Germany;Swiss Paraplegic Research, Guido-Zäch-Str. 4, Nottwil 6207, Switzerland

关键词: Quality of life;    Disability and Health;    International Classification of Functioning;    Health;    Functioning;    Visual impairment;   

Others  :  814863
DOI  :  10.1186/1477-7525-12-65

 received in 2013-10-25, accepted in 2014-04-30,  发布年份 2014

【 摘 要 】

Background

Visual impairment is associated with important limitations in functioning. The International Classification of Functioning, Disability and Health (ICF) adopted by the World Health Organisation (WHO) relies on a globally accepted framework for classifying problems in functioning and the influence of contextual factors. Its comprehensive perspective, including biological, individual and social aspects of health, enables the ICF to describe the whole health experience of persons with visual impairment. The objectives of this study are (1) to analyze whether the ICF can be used to comprehensively describe the problems in functioning of persons with visual impairment and the environmental factors that influence their lives and (2) to select the ICF categories that best capture self-perceived health of persons with visual impairment.

Methods

Data from 105 persons with visual impairment were collected, including socio-demographic data, vision-related data, the Extended ICF Checklist and the visual analogue scale of the EuroQoL-5D, to assess self-perceived health. Descriptive statistics and a Group Lasso regression were performed. The main outcome measures were functioning defined as impairments in Body functions and Body structures, limitations in Activities and restrictions in Participation, influencing Environmental factors and self-perceived health.

Results

In total, 120 ICF categories covering a broad range of Body functions, Body structures, aspects of Activities and Participation and Environmental factors were identified. Thirteen ICF categories that best capture self-perceived health were selected based on the Group Lasso regression. While Activities-and-Participation categories were selected most frequently, the greatest impact on self-perceived health was found in Body-functions categories. The ICF can be used as a framework to comprehensively describe the problems of persons with visual impairment and the Environmental factors which influence their lives.

Conclusions

There are plenty of ICF categories, Environmental-factors categories in particular, which are relevant to persons with visual impairment, but have hardly ever been taken into consideration in literature and visual impairment-specific patient-reported outcome measures.

【 授权许可】

   
2014 Leissner et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]World Health Organization: International Statistical Classification of Diseases and Related Health Problems. Geneva: World Health Organization; 2001.
• [2]Jette AM, Branch LG: Impairment and disability in the aged. J Chronic Dis 1985, 38:59-65.
• [3]Laforge RG, Spector WD, Sternberg J: The relationship of vision and hearing-impairment to one-year mortality and functional decline. J Aging Health 1992, 4:126-148.
• [4]Ash DD, Keegan DL, Greenough T: Factors in adjustment to blindness. Can J Ophthalmol 1978, 13:15-21.
• [5]Parrish RK II, Gedde SJ, Scott IU, Feuer WJ, Schiffman JC, Mangione CM, Montenegro-Piniella A: Visual function and quality of life among patients with glaucoma. Arch Ophthalmol 1997, 115:1447-1455.
• [6]Rakes SM, Reid WH: Psychologic management of loss of vision. Can J Ophthalmol 1982, 17:178-180.
• [7]Scott IU, Smiddy WE, Schiffman J, Feuer WJ, Papas CJ: Quality of life of low-vision patients and the impact of low-vision services. Am J Ophthalmol 1999, 128:54-62.
• [8]Scott IU, Schein OD, Feuer WJ, Folstein MF, Bandeen-Roche K: Emotional distress in patients with retinal disease. Am J Ophthalmol 2001, 131:584-589.
• [9]Swanson MW, McGwin G: Visual impairment and functional status from the 1995 National Health Interview Survey on Disability. Ophthalmic Epidemiol 2004, 11:227-239.
• [10]Wolffsohn JS, Cochrane AL: Low vision perspectives on glaucoma. Clin Exp Optom 1998, 81:280-289.
• [11]Cahill MT, Banks AD, Stinnett SS, Toth CA: Vision-related quality of life in patients with bilateral severe age-related macular degeneration. Ophthalmology 2005, 112:152-158.
• [12]Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992, 30:473-483.
• [13]The EuroQol Group: EuroQol - a new facility for the measurement of health-related quality of life. Health Policy 1990, 16:199-208.
• [14]Steinberg EP, Tielsch JM, Schein OD, Javitt JC, Sharkey P, Cassard SD, Legro MW, Diener-West M, Bass EB, Damiano AM, Steinwachs DM, Sommer A: The VF-14. An index of functional impairment in patients with cataract. Arch Ophthalmol 1994, 112:630-638.
• [15]Mangione CM, Phillips RS, Seddon JM, Lawrence MG, Cook EF, Dailey R, Goldman L: Development of the ‘Activities of Daily Vision Scale’. A measure of visual functional status. Med Care 1992, 30:1111-1126.
• [16]Hart PM, Chakravarthy U, Stevenson MR, Jamison JQ: A vision specific functional index for use in patients with age related macular degeneration. Br J Ophthalmol 1999, 83:1115-1120.
• [17]Mangione CM, Lee PP, Gutierrez PR, Spritzer K, Berry S, Hays RD: Development of the 25-item National Eye Institute Visual Function Questionnaire. Arch Ophthalmol 2001, 119:1050-1058.
• [18]Armbrecht AM, Findlay C, Kaushal S, Aspinall P, Hill AR, Dhillon B: Is cataract surgery justified in patients with age related macular degeneration? A visual function and quality of life assessment. Br J Ophthalmol 2000, 84:1343-1348.
• [19]Brown GC: Vision and quality-of-life. Trans Am Ophthalmol Soc 1999, 97:473-511.
• [20]Brown GC, Brown MM, Sharma S: Difference between ophthalmologists‘ and patients’ perceptions of quality of life associated with age-related macular degeneration. Can J Ophthalmol 2000, 35:127-133.
• [21]Brown MM, Brown GC, Sharma S, Kistler J, Brown H: Utility values associated with blindness in an adult population. Br J Ophthalmol 2001, 85:327-331.
• [22]Brown MM, Brown GC, Sharma S, Landy J, Bakal J: Quality of life with visual acuity loss from diabetic retinopathy and age-related macular degeneration. Arch Ophthalmol 2002, 120:481-484.
• [23]Clemons TE, Gillies MC, Chew EY, Bird AC, Peto T, Figueroa M, Harrington MW: The National Eye Institute Visual Function Questionnaire in the Macular Telangiectasia (MacTel) Project. Invest Ophth Vis Sci 2008, 49:4340-4346.
• [24]Mackenzie PJ, Chang TS, Scott IU, Linder M, Hay D, Feuer WJ, Chambers K: Assessment of vision-related function in patients with age-related macular degeneration. Ophthalmology 2002, 109:720-729.
• [25]Polinder S, Haagsma JA, Bonsel G, Essink-Bot ML, Toet H, Van Beek EF: The measurement of long-term health-related quality of life after injury: comparison of EQ-5D and the health utilities index. Inj Prev 2010, 16:147-153.
• [26]Submacular Surgery Trials Pilot Study Investigators: Submacular surgery trials randomized pilot trial of laser photocoagulation versus surgery for recurrent choroidal neovascularization secondary to age-related macular degeneration: II. Quality of life outcomes. Submacular Surgery Trials pilot study report number 2. Am J Ophthalmol 2000, 130:408-418.
• [27]Van Nispen RM, De Boer MR, Hoeijmakers JG, Ringens PJ, Van Rens GH: Co-morbidity and visual acuity are risk factors for health-related quality of life decline: five-month follow-up EQ-5D data of visually impaired older patients. Health Qual Life Outcomes 2009, 7:18. doi:10.1186/1477-7525-7-18 BioMed Central Full Text
• [28]Mangione CM, Gutierrez PR, Lowe G, Orav EJ, Seddon JM: Influence of age-related maculopathy on visual functioning and health-related quality of life. Am J Ophthalmol 1999, 128:45-53.
• [29]World Health Organization: International Classification of Functioning, Disability and Health: ICF. Geneva: World Health Organization; 2001.
• [30]Cieza A, Stucki G: Content comparison of health-related quality of life (HRQOL) instruments based on the international classification of functioning, disability and health (ICF). Qual Life Res 2005, 14:1225-1237.
• [31]Binns AM, Bunce C, Dickinson C, Harper R, Tudor-Edwards R, Woodhouse M, Linck P, Suttie A, Jackson J, Lindsay J, Wolffsohn J, Hughes L, Margrain TH: How effective is low vision service provision? A systematic review. Surv Ophthalmol 2012, 57:34-65.
• [32]Che Hamzah J, Burr J, Ramsay C, Azuara-Blanco A, Prior M: Choosing appropriate patient-reported outcomes instrument for glaucoma research: a systematic review of vision instruments. Qual Life Res 2011, 20:1141-1158.
• [33]Stelmack JA, Tang XC, Wei Y, Massof RW: Low-Vision Intervention Trial Study Group: The effectiveness of low-vision rehabilitation in 2 cohorts derived from the veterans affairs Low-Vision Intervention Trial. Arch Ophthalmol 2012, 130:1162-1168.
• [34]World Health Organization: How to use the ICF: A practical manual for using the International Classification of Functioning, Disability and Health (ICF). Exposure draft for comment (October 2013). Geneva: World Health Organization; 2013. http://www.who.int/classifications/drafticfpracticalmanual.pdf webcite
• [35]ICD-10 Version 2007 http://apps.who.int/classifications/apps/icd/icd10online webcite
• [36]DIMDI-ICD-10-GM Version 2010 http://www.dimdi.de/static/de/klassi/icd-10-gm/kodesuche/onlinefassungen/htmlgm2010/block-h53-h54.htm webcite
• [37]ICF Checklist http://www.who.int/classifications/icf/training/icfchecklist.pdf webcite
• [38]Longworth L, Yang Y, Young T, Mulhern B, Hernández Alava M, Mukuria C, Jonathan T, Tsuchiya A, Evans P, Keetharuth AD, Brazier J: Use of generic and condition-specific measures of health-related quality of life in NICE decision-making: a systematic review, statistical modelling and survey. Health Technol Assess 2014, 18(9):1-224.
• [39]Langelaan M, De Boer MR, Van Nispen RM, Wouters B, Moll AC, Van Rens GH: Impact of visual impairment on quality of life: a comparison with quality of life in the general population and with other chronic conditions. Ophthalmic Epidemiol 2007, 14:119-126.
• [40]Van Gestel A, Webers CA, Beckers HJ, Van Dongen MC, Severens JL, Hendrikse F, Schouten JS: The relationship between visual field loss in glaucoma and health-related quality-of-life. Eye (Lond) 2010, 24:1759-1769.
• [41]Cieza A, Brockow T, Ewert T, Amman E, Kollerits B, Chatterji S, Ustün TB, Stucki G: Linking health-status measurements to the international classification of functioning, disability and health. J Rehabil Med 2002, 34:205-210.
• [42]Cieza A, Geyh S, Chatterji S, Amman E, Kollerits B, Chatterji S, Ustün TB, Stucki G: ICF linking rules: an update based on lessons learned. J Rehabil Med 2005, 37:212-218.
• [43]Gertheiss J, Hogger S, Oberhauser C, Tutz G: Selection of ordinally scaled independent variables with applications to international classification of functioning core sets. Appl Statist 2011, 60:377-395.
• [44]Oberhauser C, Escorpizo R, Boonen A, Stucki G, Cieza A: Statistical validation of the brief International Classification of Functioning, Disability and Health Core Set for osteoarthritis based on a large international sample of patients with osteoarthritis. Arthritis Care Res (Hoboken) 2013, 65:177-186.
• [45]Algurén B, Fridlund B, Cieza A, Sunnerhagen KS, Christensson L: Factors associated with health-related quality of life after stroke: a 1-year prospective cohort study. Neurorehabil Neural Repair 2012, 26:266-274.
• [46]Lee YJ, Woo SY, Ahn JH, Cho S, Kim SR: Health-related quality of life in adults with metabolic syndrome: the Korea national health and nutrition examination survey, 2007–2008. Ann Nutr Metab 2012, 61:275-280.
• [47]Tan Z, Liang Y, Liu S, Cao W, Tu H, Guo L, Xu Y: Health-related quality of life as measured with EQ-5D among populations with and without specific chronic conditions: a population-based survey in Shaanxi Province. China PLoS One 2013, 8(7):e65958.
• [48]Gordon M, Paulsen A, Overgaard S, Garellick G, Pedersen AB, Rolfson O: Factors influencing health-related quality of life after total hip replacement - a comparison of data from the Swedish and Danish hip arthroplasty registers. BMC Musculoskelet Disord 2013, 14:316. BioMed Central Full Text
• [49]Yuan M, Lin Y: Model selection and estimation in regression with grouped variables. J Roy Stat Soc B 2006, 68:49-67.
• [50]Szende A, Williams A: Measuring self-reported population health: An international perspective based on EQ-5D. EuroQol Group; 2004. http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Books/Measuring_Self-Reported_Population_Health_-_An_International_Perspective_based_on_EQ-5D.pdf webcite
• [51]Kempen G, Ballemans J, Ranchor A, Van Rens GH, Zijlstra GA: The impact of low vision on activities of daily living, symptoms of depression, feelings of anxiety and social support in community-living older adults seeking vision rehabilitation services. Qual Life Res 2012, 21:1405-1411.
• [52]Lamoureux EL, Hassell JB, Keeffee JE: The impact of diabetic retinopathy on participation in daily living. Arch Ophthalmol 2004, 122:84-88.
• [53]Mathew RS, Delbaere K, Lord SR, Beaumont P, Vaegan , Madigan MC: Depressive symptoms and quality of life in people with age- related macular degeneration. Ophthalmic Physiol Opt 2011, 31:375-380.
• [54]Brody BL, Gamst AC, Williams RA, Smith AR, Lau PW, Dolnak D, Rapaport MH, Kaplan RM, Brown SI: Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. Ophthalmology 2001, 108:1893-1900.
• [55]Jampel HD, Frick KD, Janz NK, Wren PA, Musch DC, Rimal R, Lichter PR: Depression and mood indicators in newly diagnosed glaucoma patients. Am J Ophthalmol 2007, 144:238-244.
• [56]Rovner BW, Casten RJ: Neuroticism predicts depression and disability in age-related macular degeneration. J Am Geriatr Soc 2001, 49:1097-1100.
• [57]Casten RJ, Rovner BW: Update on depression and age-related macular degeneration. Curr Opin Ophthalmol 2013, 24:239-243.
• [58]Haymes SA, Johnston AW, Heyes AD: The development of the Melbourne Low-Vision ADL Index: a measure of vision disability. Invest Ophth Vis Sci 2001, 42:1215-1225.
• [59]Wolffsohn JS, Jackson J, Hunt OA, Cottriall C, Lindsay J, Gilmour R, Sinclair A, Harper R: An enhanced functional ability questionnaire (faVIQ) to measure the impact of rehabilitation services on the visually impaired. Int J Ophthalmol 2014, 7:77-85.
• [60]Wolffsohn JS, Cochrane AL: Design of the low vision quality-of-life questionnaire (LVQOL) and measuring the outcome of low-vision rehabilitation. Am J Ophthalmol 2000, 130:793-802.
• [61]Crews JE, Campbell VA: Vision impairment and hearing loss among community-dwelling older Americans: Implications for health and functioning. Am J Public Health 2004, 94:823-829.
• [62]Bruijning J, Van Nispen R, Verstraten P, Van Rens G: A Dutch ICF version of the Activity Inventory: results from focus groups with visually impaired persons and experts. Ophthalmic Epidemiol 2010, 17:366-377.
• [63]Renaud J, Levasseur M, Gresset J, Overbury O, Wanet-Defalque MC, Dubois MF, Témisjian K, Vincent C, Carignan M, Desrosiers J: Health-related and subjective quality of life of older adults with visual impairment. Disabil Rehabil 2010, 32:899-907.
• [64]Alexander MF, Maquire MG, Lietman TM, Snyder JR, Elman MJ, Fine SL: Assessment of visual function in patients with age-related macular degeneration and low visual acuity. Arch Ophthalmol 1988, 106:1543-1547.
• [65]Carabellese C, Appollonio I, Rozzini R, Bianchetti A, Frisoni GB, Frattola L, Trabucchi M: Sensory impairment and quality of life in a community elderly population. J Am Geriatr Soc 1993, 41:401-407.
• [66]Wang JJ, Mitchell P, Smith W, Cumming RG, Attebo K: Impact of visual impairment on use of community support services by elderly persons: the Blue Mountains Eye Study. Invest Ophth Vis Sci 1999, 40:12-19.
• [67]Froehlich S, Kirchberger I, Amann E, Cieza A, Stucki G, Hirneiss C, Kampik A: Content Comparison of Patient-Centred Health-Status Measures Used in Visual Impairment based on the International Classification of Functioning, Disability and Health (ICF). In Paper presented at: World Ophthalmology Congress WOC, XXX International Congress of Ophthalmology, XXVI Pan-American Congress of Ophthalmology, XVII Brazilian Congress of Prevention of Blindness, February 19 – 24. São Paulo; 2006.
• [68]Massof RW, Hsu CT, Baker FH, Barnett GD, Park WL, Deremeik JT, Rainey C, Epstein C: Visual disability variables. I: the importance and difficulty of activity goals for a sample of low-vision patients. Arch Phys Med Rehabil 2005, 86:946-953.
• [69]Massof RW, Hsu CT, Baker FH, Barnett GD, Park WL, Deremeik JT, Rainey C, Epstein C: Visual disability variables. II: The difficulty of tasks for a sample of low-vision patients. Arch Phys Med Rehabil 2005, 86:954-967.
• [70]Bruijning J, Van Nispen R, Van Rens G: Feasibility of the Dutch ICF Activity Inventory: a pilot study. BMC Health Serv Res 2010, 10:318. BioMed Central Full Text
• [71]Kostanjsek N, Rubinelli S, Escorpizo R, Cieza A, Kennedy C, Selb M, Stucki G, Üstün TB: Assessing the impact of health conditions using the ICF. Disabil Rehabil 2011, 33:1475-1482.
• [72]Rauch A, Cieza A, Stucki G: How to apply the International Classification of Functioning, Disability and Health (ICF) for rehabilitation management in clinical practice. Eur J Phys Rehabil Med 2008, 44:329-342.
• [73]Røe C, Sveen U, Geyh S, Cieza A, Bautz-Holter E: Construct dimensionality and properties of the categories in the ICF Core Set for low back pain. J Rehab Med 2009, 41:429-437.