Psychosocial needs of elderly visually impaired patients: pilot study of patients' perspectives

Background: The diagnosis of severe eye disease is a traumatic event that may result in depression that, if untreated, has a poor prognosis, and can exacerbate effects of co-existing medical conditions. The perceived psychosocial needs of patients have not been well studied.Method: In this pilot study we interviewed 66 elderly (65+ years) sight-impaired patients recruited from general practitioner (GP) practices and members of a local Society for the Blind, in one-off appointments using four interviewer-administered measures. We recorded their recollections of reaction to diagnosis; support received from clinicians; and current levels of functioning and health with a view to identifying unmet needs. Thirty-six of the 66 respondents were registered blind (21) or partially sighted (15), and 30 were not registered.Results: Over 70% of the blind or partially sighted respondents had felt depressed following diagnosis, and 81% of the blind and 60% of the partially sighted were currently depressed. Mean Geriatric Depression Scale (GDS) scores for blind individuals were significantly higher (P<0.01) than for not-registered individuals. Visual Functioning Questionnaire (VFQ-25) scores indicated lower levels of social functioning for blind than partially sighted individuals. Many respondents reported difficulty in talking about their worries to their doctors and expressed a need for more information about their diagnosis.Conclusion: Severe sight loss appears to be associated with long-term emotional distress and poor social functioning, but many respondents did not perceive their doctors as sympathetic. Regular health checks in primary care of severely visually impaired older patients could both identify depression and monitor changing needs of patients with degenerative sight problems