The Influence of Coping on Vision-Related Quality of Life in Patients With Low Vision: A Prospective Longitudinal Study.

Abstract

To determine the longitudinal impact of specific coping strategies on vision-related quality of life (VRQoL) in patients with low vision. This was a single-group, longitudinal study utilizing telephone-administered interviews conducted at baseline and at 3 and 6 months with patients (visual acuity < 6/12 in the better eye) recruited from low vision services. The Coping Strategy Indicator (CSI) assessed three strategies used specifically in relation to vision-related problems: avoidant coping, problem-solving coping, and seeking social support. Vision-related quality of life was assessed using the Impact of Vision Impairment (IVI) questionnaire, which comprises two domains: vision-related functioning and vision-related emotional well-being. We used multivariable mixed linear regression including time as an independent variable to assess change in VRQoL. The study comprised 162 patients (mean age = 69.8 years, 66% female), most with age-related macular degeneration (42%) and moderate vision impairment (41%; <6/18-6/60). Multivariable mixed linear regression showed that avoidant coping was a significant determinant of decline in vision-related functioning (β = -0.11, 95% confidence interval [CI] -0.22 to -0.01, P = 0.036) and emotional well-being (β = -0.29, 95% CI -0.45 to -0.13, P < 0.001) over a 6-month period. Our findings showed that avoidant coping has a detrimental impact on VRQoL over time. Low vision specialists should be aware of their patients' coping strategies and encourage them to engage in active rather than avoidant coping to deal with the impact of their vision impairment.