An evaluation of visually impaired veteran characteristics influencing blind rehabilitation participation

Michael Williams, Ph.D. candidate

Rehabilitation R&D Center of Excellence, Atlanta VA Medical Center

Objectives: The goal of this study was to attempt to understand and assess help-seeking patterns of visually impaired veterans, specifically those who seek out help and assistance to mitigate the negative consequences of this disability and those who do not. The lack of valid and reliable empirical data examining help-seeking behavior patterns of visually impaired individuals who do not receive blind rehabilitation represents a significant limitation on the inclusion of persons who might benefit the most from this type of training.

Methods: Pilot data examining veteran characteristics were gathered from a random sample of 104 visually impaired veterans, (62 who have participated in some form of blind rehabilitation sometime in the past, and 42 who have not). Phone interviews were conducted on both groups of subjects using the following self-report instruments: Blind Rehabilitation Service Follow-up Outcome Survey (BRSFOutSur) measuring self-reported functional performance; Blind Rehabilitation Service Data Base (BRSDBase) recording subject characteristics; Geriatric Depression Scale (GDS 30-item); and the SF-36 Health Survey, used to ascertain multiple operational definitions of health. Additional questions probing veterans on motivating and/or deterring factors to participation in blind rehabilitation such as the perceived efficacy of rehabilitation, family caregiving responsibilities, burdens related to traveling to a distant rehabilitation program, and perceptions of overall general health were investigated.

Results: Descriptive results indicate that 81% of respondents in this sample of visually impaired veterans were white, 21% reported living alone, mean age was 68.3 (SD 4.9), and mean depression score using the GDS (30-item) was shown to be 4.65 (SD 4.9). Mean Rasch scaled functional independence score for veterans who had received blind rehabilitation was 1.23 (SD .74), while mean Rasch scaled functional independence for veterans who had not received blind rehabilitation was found to be .57 (SD 1.17). It is of interest to note that veterans who reported receiving blind rehabilitation report comparable mean functional independence scores (1.23) to current national pre/post functional change averages for veterans receiving rehabilitation in FY 2001 (1.73). Logistic regression analysis found that increased levels of depression decreased the log-odds of participation in rehabilitation by -.115 (sig.< .05). Likewise, lower functional independence reduced the log-odds of rehabilitation participation by -.682 (sig.< .01).

Conclusions: While these results are preliminary, it appears that a veteran's functional independence, levels of depression, and beliefs regarding program effectiveness all play a role in influencing participation in blind rehabilitation. Data collection and analysis further exploring help-seeking behavior and actions of visually impaired veterans are continuing through a recently funded developmental research study. Understanding help-seeking patterns of visually impaired persons will likely lead to improvements in service delivery systems targeting this population, and may facilitate the inclusion of greater numbers of persons who might benefit the most from visual impairment rehabilitation.

Funding Acknowledgment: Data collection and analysis used in this study was supported by VA Rehab R&D grants C1776R and C1894R. Current work is being supported by VA Rehab R&D grant C2269R.