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Psychosocial interventions to improve mental health in adults with vision impairment: systematic review and meta‐analysis
Author(s) -
Aa Hilde P. A.,
Margrain Tom H.,
Rens Ger H. M. B.,
Heymans Martijn W.,
van Nispen Ruth M. A.
Publication year - 2016
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1111/opo.12313
Subject(s) - randomized controlled trial , psychosocial , meta analysis , psychological intervention , anxiety , mental health , clinical psychology , medicine , population , confidence interval , loneliness , medline , psychiatry , psychology , environmental health , political science , law
Purpose To systematically assess the literature on psychosocial interventions to improve mental health (i.e. depression, anxiety, mental fatigue, loneliness, psychological stress and psychological well‐being) in visually impaired adults (≥18 years). Methods The databases Medline, Embase and Psychinfo were searched for relevant studies, which were categorised into randomised controlled trials ( RCT s), non‐ RCT s and before and after comparisons ( BA ). The Cochrane Collaboration Risk of Bias Tool was used to assess study quality. Standardised mean differences ( SMD ) were calculated to quantitatively summarise the outcomes of the RCT s and non‐ RCT s in a meta‐analysis. Meta‐regression was used to explore sources of heterogeneity in the data. Results The search identified 27 papers (published between 1981 and 2015), describing the outcomes of 22 different studies (14 RCT s, four non‐ RCT s, and four BA s). Pooled analyses showed that interventions significantly reduced depressive symptoms ( SMD −0.30, 95% confidence interval ( CI ) −0.60 to −0.01), while effects on anxiety symptoms, mental fatigue, psychological stress and psychological well‐being were non‐significant. Meta‐regression analyses showed homogeneity in effect sizes across a range of intervention, population, and study characteristics. Only a higher age of participants was associated with less effective results on depressive symptoms ( b = 0.03, 95% CI 0.01 to 0.05), psychological stress ( b = 0.07, 95% CI 0.01 to 0.13) and psychological well‐being ( b = −0.03, 95% CI −0.05 to 0.01). However, after removing a clear outlier the overall effect on depressive symptoms and the influence of age on depressive symptoms and psychological stress were no longer significant, while the influence of age on psychological well‐being remained. Conclusions There is currently only limited evidence for the effectiveness of psychosocial interventions in the field of low vision. More well‐designed trials are needed with specific attention for interventions tailored to the needs of elderly patients.