Timing of access to low vision rehabilitation services.

Abstract

PURPOSE: Low vision rehabilitation improves the functional abilities of people with vision impairment but access to rehabilitation services remains low. This study aims to explore issues pertaining to the timing of low vision and rehabilitation services, from the patient’s perspective and translate patients’ preferences into practice. METHOD: A 2 phase qualitative study was designed. In the first phase, the views of people with visual impairment and who had accessed low vision services in Australia, were obtained through semi-structured telephone interviews. Contributions were audio-recorded, transcribed verbatim, and analysed thematically using NVivo software. This data was summarised. In Phase 2, focus groups were conducted, where the Phase 1 study was reported to low vision service providers and stakeholders with the purpose of developing an action plan to implement patient preferences. RESULTS: In Phase 1, 31 participants (median age 70 years, range 14-80, 18 females) were recruited. Participants had accessed two or more low vision rehabilitation services in all Australian states: low vision assessment, orientation and mobility, counselling, occupational therapy, peer support and library services. Participants judged the timing of their access to rehabilitation services as “good/ fine” and “useful” if it was early. Those who felt that they did not access rehabilitation services early enough held regrets and blamed it predominantly on lack of awareness of available services. Participants strongly preferred to receive information about low vision and rehabilitation services directly from their doctor at the time the diagnosis of their disease was made. In Phase 2, three focus groups with a total of 18 participants. Participants thought that eye care providers are not able to implement patient preferences in a busy clinic situation. All participants thought a consistent way of doing things across all stakeholders was required. CONCLUSION: Patients with visual impairment were most receptive to receiving information about rehabilitation services verbally, from their doctor, at the time of diagnosis of vision impairment. Low vision and eye care practitioners believed that patients preferences were not practicable in the ideal clinic consultations. A new approach that accommodates both patients and practitioner’s views was suggested.