Cognitive appraisals, distress and disability among persons in low vision rehabilitation

Abstract

Objective: Examined cognitive appraisals of interference and tolerance in the prediction of distress and self-reported disability among persons presenting for low vision rehabilitation.

Design: Cross-sectional; correlational and path analyses.

Methods: One-hundred and thirteen patients (mean age, 71 years; 52 men and 61 women) presenting for low vision rehabilitation at a university-based centre for low vision rehabilitation participated in an initial clinical vision examination and completed several questionnaires to evaluate cognitive appraisals, emotional distress and self-reported disability.

Results: Path analyses indicated that greater tolerance was associated with less interference imposed by vision loss. Greater tolerance was also associated with less emotional distress and symptom severity (visual acuity) was associated with self-reported disability. Cognitive appraisals (tolerance and interference) indirectly influenced self-reported disability through emotional distress.

Conclusions: The data indicate that appraisals of personal ability to tolerate vision loss and the perceived interference of vision loss on goal-directed behaviour and expected activities have greater influence on distress and are subsequently predictive of disability in comparison with objective symptoms (visual acuity). Implications for clinical interventions and further research are discussed.

Figure 1

Path Diagram of the Model Tested to Evaluate the Impact of Symptom Severity (Acuity), Appraisals of Tolerance and Interference, and Emotional Distress on Vision Related Self-Reported Disability. Note. Lower scores on tolerance indicate greater difficulty in the ability to tolerate vision related changes; higher scores for disability reflect fewer problems associated with vision-specific disability; higher scores for visual acuity indicate greater vision impairment.