Quality of life in people with visual impairment compared with the general population

Aim The aim of the present study was to examine quality of life and its associated factors among adults with visual impairment in Norway. Subject and methods Of the 1216 adults contacted, 736 (61% response rate) participated in a cross-sectional survey. A general population probability sample served as reference (n=1792, 36% response rate). Differences between the populations were examined with independent t-tests for continuous variables and with Chi-square tests for categorical variables. Quality of life covariates were investigated with linear regression analysis. Results People with visual impairment had lower quality of life than the general Norwegian population, across all age groups (mean QOL: 6.8 versus 7.6, p<0.001) and within all age groups (all p<0.01). Compared with the general population, people with visual impairment were less likely to report the highest levels and more likely to report intermediate levels of quality of life. Higher quality of life was associated with lower onset-age of impaired vision (B=-0.11, p<0.001), having employment (B=0.36, p=0.02), lower levels of loneliness (B=-0.28, p<0.001) and higher levels of social support (B=0.40, p<0.001) and general self-efficacy (B=0.07, p<0.001). Conclusion Quality of life was lower among people with visual impairment and may be increased by promoting work participation, social inclusion, connectedness, and coping.publishedVersio

Posttraumatic stress disorder in people with visual impairment compared with the general population

Background: People with a visual impairment appear to have an increased risk of experiencing potentially traumatizing life events and possibly also subsequently developing post-traumatic stress disorder (PTSD). This study investigated the point prevalence of PTSD in people with a visual impairment compared with the general population of Norway and examined factors associated with PTSD among people with a visual impairment. Methods: A telephone-based survey was administered to a probability sample of 1216 adults with a visual impairment. Of these, 736 (61% response rate) participated. A probability sample from the general population served as a reference (n = 1792, 36% response rate). PTSD was measured with the PTSD Checklist for the DSM-5 (PCL-5), based on the currently most bothersome event reported from the Life Events Checklist for DSM-5 (LEC-5). We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Results: The prevalence of PTSD was higher among people with a visual impairment than in the general population, both for men (9.0% vs. 3.8%) and women (13.9% vs. 8.5%). The prevalence rates of PTSD from the illness or injury that had caused the vision loss (men 3.9%, women 2.2%) accounted for a considerable part of the difference between the populations. For women, PTSD related to sexual assaults also contributed significantly to a higher PTSD prevalence in the visually impaired versus the general population (5.2% vs. 2.2%), while for men there were no other event categories which resulted in significant differences. Among people with a visual impairment, the higher risk of PTSD was associated with lower age, female gender, having acquired the vision loss, and having other impairments in addition to the vision loss. Conclusion: The higher prevalence of PTSD in people with a visual impairment suggests that vulnerability to mental health problems is associated with serious life events. The higher incidence than in the general population is partly due to the illness or injury that had led to the vision loss and partly due to people with vision loss appearing to be more vulnerable through exposure to other types of potentially traumatizing events, such as sexual abuse.publishedVersio

Physical Activity, Mental Health, and Mortality among Individuals with Visual Impairment: The HUNT Study

Fysisk aktivitet, mental helse og dødelighet hos personer med synsnedsettelse: Resultater fra HUNT-studien Å fremme fysisk aktivitet i befolkningen er ansett som en av de beste strategiene for folkehelsen grunnet dens gunstige effekter på mental helse, samt i forebygging av ikke-smittsomme sykdommer og tidlig død. Allikevel, fordelene av regelmessig fysisk aktivitet kan variere mellom ulike grupper i befolkningen. Personer som lever med synstap opplever oftere problemer med å delta i fysisk aktivitet sammenlignet med personer uten synstap, samt at de har større utfordringer med helse, sosialisering og det å fungere i dagliglivet. Det er per i dag uklart hvilken betydning fysisk aktivitet har på helsen hos personer som lever med synstap. Hensikten med denne doktorgradsavhandlingen var å undersøke betydningen av fysisk aktivitet på fritiden hos personer med og uten selv-rapportert synstap i dens sammenheng med psykiske plager og dødelighet. I alle de tre studiene som er inkludert i denne avhandlingen er det blitt benyttet data fra ungdom og voksendelen av Helseundersøkelsen i Nord Trøndelag (HUNTstudien). I tillegg ble data fra Dødsårsaksregisteret benyttet i en av studiene. Resultatene fra de tre studiene viste at ukentlig fysisk aktivitet, helst i moderat til høy intensitet, reduserte risikoen for depresjonssymptomer og tidlig død hos personer med selv-rapportert synstap, og styrken på sammenhengen var tilnærmet lik eller sterkere hos denne gruppen sammenlignet med personer uten selv-rapportert synsnedsettelse. Sammenhengene varierte mellom alder, kjønn og personlighet hos personer med selv-rapportert synsnedsettelse, noe som tyder på at responsen av fysisk aktivitet kan virke ulikt innad i denne populasjonen. Fysisk aktivitet hadde ingen sammenheng med angstsymptomer. Studiene bidrar til kunnskap om fysisk aktivitet og dens sammenheng med mental helse og dødelighet hos ungdom og voksne som rapporterer å ha nedsatt syn. Funnene tyder på at fysisk aktivitet kan vurderes som et sykdomsforebyggende og helsefremmende tiltak hos denne populasjonen. Allikevel, sammenhengen ser ut til å være kompleks og videre forskning er nødvendig

The association between physical activity, mental health, and personality: The HUNT study

Background: Previous studies have suggested that physically active behavior is associated with reduced symptoms of depression and anxiety. It is uncertain whether this relationship is affected by a third underlying factor. The aim of this study is to evaluate the association between physical activity (PA), symptoms of depression and anxiety, and personality traits. Methods: During the period 2006–2008, the third phase of a population-based health survey (HUNT 3) was conducted in the county of Nord-Trøndelag in Norway. In total, 38,743 subjects aged 19 years or older completed the self-reported questionnaires on PA, mental health problems and personality in HUNT 3, of which 21,722 (56.1%) were women and 17,021 men (43.9%). The Hospital Anxiety and Depression Scale (HADS) was used to detect case-level symptoms of depression and anxiety, while the Eysenck Personality Questionnaire (EPQ) was used to measure the stable and consistent personality dimensions extroversion and neuroticism. Analysis focused on the odds of HADS-defined depression and anxiety comparing different levels of PA. Also, the linear trend between PA and personality scores was assessed. Results: The prevalence of depression and anxiety scores above 8 was 9.5% and 14.1% respectively. Distribution of HADS-defined anxiety, scored extroversion, and scored neuroticism was higher among women compared with men, while HADS-defined depression had a higher distribution among men. The results from this cross-sectional study suggest that moderately physically active individuals have significantly lower odds of symptoms of depression and anxiety compared with less physically active individuals (p < 0.05). High PA had no further effect on mental health. A lower risk of HADS-defined anxiety was found among physically active women in comparison with physically active men. In the association with personality, lower levels of PA had a significant negative linear trend than high PA in relation to extroversion score (p < 0.01) and a significant positive linear trend with lower PA than high PA in relation to neuroticism score (p < 0.01). Small and consistent effects of the association between PA and scored extroversion and neuroticism were observed among both women and men. Conclusion: Subjects reporting regular PA were less likely to report symptoms of depression, but only physically active women were associated with lower symptoms of anxiety. Personality may be an important underlying factor in explaining this association, but other possible mechanisms might be more elucidating

Social interactions, experiences with adverse life events and depressive symptoms in individuals with visual impairment: a cross-sectional study

Background Knowledge about the high rates of depression in people with visual impairment (VI) remains unclear. The study aimed to examine whether depressive symptoms in people with VI were associated with social isolation, perceived social support and lifetime exposure to bullying, physical abuse or sexual abuse. Methods An anonymous telephone survey was conducted from January to May 2017 in an age-stratified sample of adults with VI who were members of the Norwegian Association of the Blind and Partially Sighted. Participants were asked questions about social isolation, perceived social support, and past experiences with bullying and abuse. Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). We calculated unadjusted and full-adjusted exponentiated beta-values (Exp(β)) and corresponding 95% confidence intervals (CIs) using generalized linear models. Results Overall, 736 (61%) adults participated in the study. The mean depression scores were 5.24 (SD: 5.3, range: 0–27), 4.61 for men and 5.77 for women. Results from the full-adjusted model showed higher levels of depressive symptoms among participants who reported social isolation (Exp(β): 1.89, 95% CI: 1.63–2.20), lower levels of perceived social support (Exp(β): 1.55, 95% CI: 1.31–1.83), and past experiences of abuse (Exp(β): 1.41, 95% CI: 1.17–1.70). The strength of the associations between past exposure to bullying or abuse and depressive symptoms was similar for those with low and high levels of support. Conclusion Social isolation, perceived support and experiences of adverse events appear to be independently associated with depressive symptoms. Thus, social integration may be appropriate for the promotion of mental health among people with VI

Visual impairment and employment in Norway

Background Past studies have suggested lower employment of people with visual impairment. Reasons for this are less known. This study aimed to examine the employment rates among people with visual impairment, and its association with sociodemographic characteristics, vision-related factors, depression, and life satisfaction. Methods This cross-sectional study included a stratified random sample of 574 working-age adults (18–67 years) who were members of the Norwegian Association of the Blind and Partially Sighted. Data were collected by telephone interviews between January and May 2017, and included information on work status, sociodemographic factors, vision-related characteristics, depression (Patient Health Questionnaire-9), and life satisfaction (Cantril’s Ladder of Life Satisfaction). Associations with employment (full-time, part-time, or self-employment) were examined using regression analyses. Results Of the participants, 51.2% of males and 38.1% of females reported to be employed. Employment was associated with being of middle age, male gender, higher education, residing in high-income municipalities, having a moderate degree of vision loss, lower onset-age of vision loss, and having no additional impairments. Employed participants had lower levels of depression compared to others (adjusted exponentiated beta: 0.80, 95% confidence interval (CI): 0.67, 0.96). They also had a higher odds of scoring higher on life satisfaction (adjusted exponentiated beta (odds ratio): 1.85, 95% CI: 1.32, 2.59). Conclusions Employment was lower in people with visual impairment than in the general population. Inclusion of the blind and partially sighted into the workforce could promote health and thus have socio-economic benefits

Serious life events in people with visual impairment versus the general population

The present study aimed to examine the lifetime exposure to serious life events in people with visual impairment compared with the general population. Data were derived from a telephone survey including a probability sample of 736 adults with visual impairment (response rate: 61%). The lifetime prevalence of direct experiences with seventeen different categories of serious life events (Life Events Checklist for DSM-5 (LEC-5)) were compared to that obtained from the general Norwegian population (N = 1792, 36% response rate). Altogether, 68% of people with visual impairment had been directly exposed to at least one serious life event, with equal rates among males and females (p = 0.59). The prevalence of serious life events was higher than for the general population (60%, p &lt; 0.001), especially for fire or explosions, serious accidents, sexual assaults, life-threatening illness or injury, and severe human suffering. In conclusion, our results indicate that people with visual impairment are more prone to experiencing serious life events. This highlights the need for preventive strategies that reduce the risk of serious life events in this population

Sexual assaults in individuals with visual impairment: A cross-sectional study of a Norwegian sample

Objective: To examine the prevalence of sexual assaults among individuals with visual impairment (VI) compared with the general population and to investigate the association between sexual assault and outcomes of self-efficacy and life satisfaction. Design: Cross-sectional interview-based study conducted between February and May 2017. Participants: A probability sample of adults with VI (≥18 years) who were members of the Norwegian Association of the Blind and Partially Sighted. A total of 736 (61%) members participated, of whom 55% were of female gender. We obtained norm data for sexual assaults from a representative survey of the general Norwegian population. Outcome measures: Sexual assaults (Life Event Checklist for DSM-5), self-efficacy (General Self-Efficacy Scale) and life satisfaction (Cantril’s Ladder of Life Satisfaction). Results: The prevalence of sexual assaults (rape, attempted rape and forced into sexual acts) in the VI population was 17.4% (95% CI 14.0 to 21.4) among women and 2.4% (95% CI 1.2 to 4.7) among men. For women, the VI population had higher rates of sexual assaults across age strata than the general population. For men, no significant differences were found. In the population of people with VI, the risk of sexual assault was greater for those having other impairments in addition to the vision loss. Individuals with VI who experienced sexual assaults had lower levels of self-efficacy (adjusted relative risk (ARR): 0.18, 95% CI 0.05 to 0.61) and life satisfaction (ARR: 0.31, 95% CI 0.19 to 0.50) than others. Conclusions: The risk of experiencing sexual assault appears to be higher in individuals with VI than in the general population. Preventive measures as well as psychosocial care for those who have been exposed are needed

Einsamkeit bei Erwachsenen mit Sehbehinderung: Prävalenz, assoziierte Faktoren und Zusammenhang mit der Lebenszufriedenheit

Hintergrund: Bisher ist wenig darüber bekannt, ob und in welchem Maße sich Einsamkeit auf das Leben von Menschen mit Sehbehinderung (SB) auswirkt. Das Ziel dieser Studie war es daher, die Prävalenz und die assoziierten Faktoren von Einsamkeit bei Erwachsenen mit SB sowie den Zusammenhang von Einsamkeit und Lebenszufriedenheit zu untersuchen. Methoden: In diese Querschnittsstudie wurde eine Wahrscheinlichkeitsstichprobe von 736 Erwachsenen (≥18 Jahre) mit SB eingeschlossen, die Mitglieder des Norwegischen Verbandes der Sehbehinderten und Blinden waren. Die Interviews fanden zwischen Januar und Mai 2017 statt; erhoben wurden Informationen über soziodemographische Faktoren, Merkmale der SB, negative Lebenserfahrungen, Einsamkeit laut Three Item Loneliness Scale und Lebenszufriedenheit laut Cantril's Ladder of Life Satisfaction. Die Prävalenz der Einsamkeit wurde mit Daten der norwegischen Allgemeinbevölkerung (N = 14 884; Durchschnittsalter 46,4 Jahre; 50,7% Frauen) verglichen. Ergebnisse: Die Prävalenz mittelschwerer und schwerer Einsamkeit in der SB-Population betrug 28,7% (95-%-Konfidenzintervall (KI): 25,4; 32,1) bzw. 19,7% (95-%-KI: 16,9; 22,8). Die Rate war durchgängig in allen Altersgruppen und für alle Schweregrade der Einsamkeit höher als in der Allgemeinbevölkerung. Jüngeres Lebensalter, vollständige Erblindung, Vorliegen weiterer Beeinträchtigungen, Arbeitslosigkeit sowie Mobbing- und Gewalterfahrungen waren mit Einsamkeit assoziiert. Zugleich waren höhere Einsamkeits-Scores mit geringerer Lebenszufriedenheit assoziiert (vollständig angepasstes β = −0,48; 95-%-KI: −0,55; −0,41). Schlussfolgerungen: Einsamkeit ist bei Erwachsenen mit SB weit verbreitet. Strategien, die geeignet sind, die Einsamkeit zu lindern, könnten die Lebenszufriedenheit der Menschen, die mit SB oder Blindheit leben, verbessern