Bl. Brody et al., Age-related macular degeneration: A randomized clinical trial of a self-management intervention, ANN BEHAV M, 21(4), 1999, pp. 322-329
The purpose of this study was to conduct a randomized clinical trial to ass
ess whether a self-management group intervention can improve mood, self-eff
icacy and activity in people with central vision loss due to age-related ma
cular degeneration (AMD). Ninety-two elderly patients with AMD (average age
= 79) from a university ophthalmology clinic were randomly assigned to the
self-management intervention (n = 44) or to a wait-list (n = 48). All pati
ents were legally blind in at least one eye. The intervention consisted of
6 weekly 2-hour group sessions providing education about the disease, group
discussion, and behavioral and cognitive skills training to address barrie
rs to independence. All participants eventually completed the intervention
allowing pre-post comparisons for all patients. The battery of measures inc
luded the Profile of Mood Stares (POMS); Quality of Well-Being Scale, and a
ssessments of self-efficacy participation in activities, and use of vision
aids. Participants' initial psychological distress was high (mean total POM
S = 59.72) and similar to distress experienced by other serious chronic ill
ness populations (e.g. cancer bone marrow transplant). Analysis of covarian
ce testing the primary hypothesis revealed that intervention participants e
xperienced significantly (p = .04) reduced psychological distress (pre (x)
over bar = 61.45; post (x) over bar = 51.14) in comparison with wait-list c
ontrols (pre (x) over bar = 57.72; post (x) over bar = 62.32). Intervention
participants also experienced improved (p = .02) self-efficacy (pre (x) ov
er bar = 70.16; post (x) over bar = 77.27) in comparison with controls (pre
(x) over bar = 67.71; post (x) over bar = 69.07). Further, intervention pa
rticipants increased their nse of vision aids (p < .001; pre (x) over bar =
3.37, post (x) over bar = 6.69). This study demonstrates that a relatively
brief behavioral intervention cart substantially reduce psychological dist
ress and increase self efficacy in elderly adults experiencing vision loss
due to macular degeneration. Self-management intervention appears to improv
e mood self-efficacy: and use of vision aids, further enhancing the lives o
f poorly sighted individuals with AMD.