Interventions in the Scope of Occupational Therapy to Improve Psychosocial Well-Being in Older Adults with Low Vision and Mental Health Concerns: A Systematic Review

Abstract

Research has found that occupational therapy practitioners focus on functional and participation outcomes in the low vision population, but overlook corresponding psychosocial outcomes in rehabilitation. The purpose of this systematic review is to answer the PICO question: “What is the evidence to support interventions within the scope of occupational therapy for improving psychosocial well-being or quality of life in adults experiencing depression or anxiety as a result of low vision?” The team conducted a search of literature published between 2008 and 2020. Inclusion criteria consisted of interventions within the scope of occupational therapy for patients with low vision, and which measured mental health or quality of life factors. Eleven articles met inclusion criteria. The majority of the evidence consisted of 1B (45%) and 2B (36%) level randomized control trials. Two studies were 3B level evidence. Mental health outcomes were measured primarily using depression rating scales, although a number of studies also utilized vision-specific quality of life questionnaires. Established intervention themes included behavioral activation plus occupational therapy low vision rehabilitation, cognitive problem-solving approaches, usual care ‘plus’ skill-based training, and group service delivery approaches. Moderate evidence supports behavioral activation plus occupational therapy low vision rehabilitation, problem-solving approaches, and group service delivery approaches for improving mental health outcomes. There is moderate evidence that does not support usual treatment ‘plus’ skill-based training to improve mental health.

Keywords:

• Low vision
• depression
• anxiety
• rehabilitation
• occupational therapy
• mental health

Acknowledgements

The research team would like to acknowledge Peter Shipman, MLIS for his contributions and guidance of appropriate search strategies in various databases.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.

Additional information

Notes on contributors

Callie Barber

Callie Barber is a 2020 graduate of Augusta University with a Master of Health Science in Occupational Therapy.

Caroline Gould

Caroline Gould is a 2020 graduate of Augusta University with a Master of Health Science in Occupational Therapy.

Gio Guillermo

Gio Guillermo is a 2020 graduate of Augusta University with a Master of Health Science in Occupational Therapy.

Julia Dupree

Julia Dupree is a 2020 graduate of Augusta University with a Master of Health Science in Occupational Therapy.

Meghan McLeer

Meghan McLeer is a 2020 graduate of Augusta University with a Master of Health Science in Occupational Therapy.

Teal Benevides

Teal Benevides is an associate professor at Augusta University Department of Occupational Therapy.

Mallory Rosche

Mallory Rosche is an assistant professor at Augusta University Department of Occupational Therapy and provides low vision rehabilitation services to individuals with vision loss.