Falvo (rehabilitation counselor training, Southern Illinois U.) provides the basic medical information about chronic conditions which she believes will be of valuable use to nonmedical rehabilitation professionals and students. Introductory chapters discuss psychosocial aspects of chronic illness an

Medical and psychosocial aspects of chronic illness and disability : Donna R. Falvo

Objectives To review systematically the evidence of age-related macular degeneration (AMD) affecting real-world visual ability and quality of life (QoL). To explore trends in specific topics within this body of the literature.

Design Systematic review.

Methods A systematic literature search was carried out using MEDLINE, EMBASE, CINAHL, PsycINFO, PsychARTICLES and Health and Psychosocial Instruments for articles published up to January 2015 for studies including people diagnosed with AMD, assessing real-world visual ability or QoL as an outcome. Two researchers screened studies for eligibility. Details of eligible studies including study design, characteristics of study population and outcomes measured were recorded in a data extraction table. All included studies underwent quality appraisal using the Mixed Methods Appraisal Tool 2011 Version (MMAT).

Results From 5284 studies, 123 were eligible for inclusion. A range of approaches were identified, including performance-based methods, quantitative and qualitative patient-reported outcome measures (PROMs). AMD negatively affects tasks including mobility, face recognition, perception of scenes, computer use, meal preparation, shopping, cleaning, watching TV, reading, driving and, in some cases, self-care. There is evidence for higher rates of depression among people with AMD than among community dwelling elderly. A number of adaptation strategies have been associated with AMD of varying duration. Much of the research fails to report the type of AMD studied (59% of included studies) or the duration of disease in participants (74%). Of those that do report type studied, the breakdown is as follows: wet AMD 20%, dry AMD 4% and both types 17%.

Conclusions There are many publications highlighting the negative effects of AMD in various domains of life. Future research should focus on delivering some of this research knowledge into patient management and clinical trials and differentiating between the types of AMD.

https://bmjopen.bmj.com/content/bmjopen/6/12/e011504.full.pdf

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

Schools can play an important role in adolescents’ identity development. To date, research on the role of school in adolescents’ identity development is scattered across research fields that employ different theoretical perspectives on identity. The aim of this literature review was to integrate the findings on the role of school in adolescents’ identity development from different research fields and to provide schools and teachers with insights into how adolescents’ identity development can be supported. Using constant comparative analysis, 111 studies were analyzed. We included articles on personal and social identity and on school-related identity dimensions. Three groups of studies emerged. First, studies on how schools and teachers unintentionally impact adolescents’ identity showed that, at school, messages may unintentionally be communicated to adolescents concerning who they should or can be through differentiation and selection, teaching strategies, teacher expectations, and peer norms. Second, studies on how schools and teachers can intentionally support adolescents’ identity development showed that different types of explorative learning experiences can be organized to support adolescents’ identity development: experiences aimed at exploring new identity positions (in-breadth exploration), further specifying already existing self-understandings (in-depth exploration), and reflecting on self-understandings (reflective exploration). The third group suggests that explorative learning experiences must be meaningful and situated in a supportive classroom climate in order to foster adolescents’ identity development. Together, the existing studies suggest that schools and teachers are often unaware of the many different ways in which they may significantly impact adolescents’ identity development.

https://link.springer.com/content/pdf/10.1007/s10648-018-9457-3.pdf

The Role of School in Adolescents’ Identity Development. A Literature Review

OBJECTIVES: To examine patterns of associations between a broad range of mental and physical conditions by using a large, systematically obtained pediatric registry. METHODS: The sample included 9014 youth ages 8 to 21 years (4349 males and 4665 females; 3585 aged RESULTS: There was a direct association between the severity of the physical condition and most classes of mental disorders, as well as with functional impairment. Models adjusted for sociodemographic correlates, other physical and mental disorders, and false discovery and revealed broad patterns of associations between neurodevelopmental disorders with behavior disorders (odds ratio [OR]: 1.5; 95% confidence interval [CI]: 1.3–1.8; P P P P P CONCLUSIONS: Findings show the strong overlap between physical and mental conditions and their impact on severity and functional impairment in youth. Specific patterns of comorbidity have important implications for etiology. Prospective tracking of cross-disorder morbidity will be important to establish more effective mechanisms for prevention and intervention.

http://pediatrics.aappublications.org/content/pediatrics/135/4/e927.full.pdf

Comorbidity of Physical and Mental Disorders in the Neurodevelopmental Genomics Cohort Study

Purpose: To review perceived emotional well-being in older people with visual impairment and perceived factors that inhibit/facilitate psychosocial adjustment to vision loss. Method: The databases of MEDLINE, EMBASE, PsycINFO and CINAHL were searched for studies published from January 1980 to December 2010, which recruited older people with irreversible vision loss, and used qualitative methods for both data collection and analysis. Results sections of the papers were synthesised using a thematic-style analysis to identify the emergent and dominant themes. Results: Seventeen qualitative papers were included in the review, and five main themes emerged from the synthesis: 1) the trauma of an ophthalmic diagnosis, 2) impact of vision loss on daily life, 3) negative impact of visual impairment on psychosocial well-being, 4) factors that inhibit social well-being, and 5) factors that facilitate psychological well-being. We found the response shift model useful for explaining our synthesis. Conclusions: Acquire...

Emotional well-being and adjustment to vision loss in later life: a meta-synthesis of qualitative studies.

This meta-analysis integrates the results from 198 studies that compared psychological well-being of visually impaired individuals with unimpaired control groups or population norms. On average, visually impaired people showed a strong decline of vision-specific psychological well-being. However, declines in vision-unspecific measures were only small. Furthermore, declines of psychological well-being were stronger in studies with convenience samples (rather than probability samples) and in studies that used population norms as standard for comparison (rather than control groups), in individuals with greater vision loss, in patients with age-related macular degeneration as compared to glaucoma, in adults as compared to children, and, in part, in older studies. These factors should inform researchers and practitioners for developing and implementing interventions aimed at protecting psychological well-being.

Psychological well-being in visually impaired and unimpaired individuals: A meta-analysis

This study compared the achievement of developmental tasks by 158 adolescents with visual impairments to that of 158 sighted adolescents. The groups did not differ in the fulfillment of 9 of 11 tasks. However, those with visual impairments were less successful in peer-group integration and forming intimate relationships. ********** The concept of developmental tasks assumes that human development in modern societies is characterized by a long series of tasks that individuals have to complete throughout their lives. Havighurst (1948) defined developmental tasks as biologically, socially, and individually determined tasks that must be completed before one enters a new period of life. Examples of developmental tasks of adolescence described by Havighurst (1948); Schleyer-Lindenmann (2006); Seiffge-Krenke, Silbereisen, and Otremba (1984); and others include gaining autonomy from parents, building peer relations, and preparing for a future profession. Adolescents reported that these developmental tasks were important goals in their lives (Nurmi, 1991, 1993; Wenxin, Lingling, Lingin, & Nurmi, 2006). The average level of attainment of developmental tasks increases with age (see, for example, Pinquart, Silbereisen, & Wiesner, 2004; Seiffge-Krenke & Gelhaar, 2008), and higher levels of internal locus of control promote the completion of these tasks (Schonpflug & Jansen, 1995). Adolescents with chronic illnesses or disabilities often face restrictions in everyday activities because of their functional impairments or need for medical care. For example, they may not be able to engage in age-typical leisure activities or may be obliged to spend time in hospitals or rehabilitation settings. Because of these constraints, one would expect that such adolescents would need to adjust their goals according to their difficulties. Hitherto, little was known about differences in the contents and attainment of goals by adolescents with disabilities and other adolescents. Some studies have assessed a small number of developmental goals. For example, Shepherd et al. (1990) showed that young adults with cystic fibrosis had less autonomy from their parents and more problems in making the transition from school to work than did other young adults. The only systematic quantitative study that investigated the developmental tasks of adolescents with chronic illnesses (Seiffge-Krenke, 1998; see also Roth & Seiffge-Krenke, 1996) found that 14-year-old adolescents with diabetes reported lower levels of achievement in 2 out of 12 assessed developmental tasks (perceived physical maturity and finding a personal lifestyle) than did adolescents without chronic diseases. However, the effect sizes were small to medium ([d.sub.t1] = .28 and .56 standard deviation units), and the severity of the symptoms had no effect on the level of goal attainment. Furthermore, the between-group discrepancy vanished after two years. By the end of the study, the adolescents with diabetes were even more successful than their peers without diabetes in occupational preparation ([d.sub.t4] = .55). However, the findings of Seiffge-Krenke's (1998) study may not be representative of all adolescents with disabilities, since adolescents with diabetes have few restrictions in their everyday lives if their metabolism control is adequate. In addition, Seiffge-Krenke did not test whether the observed differences in the goal attainment of the two groups could be explained by other variables, such as perceived control over the attainment of developmental tasks. Thus, the aim of the study presented here was to gather more information about the goal attainment of adolescents with disabilities. The study focused on the achievement of developmental tasks of adolescents with visual impairments because these adolescents may have more difficulty completing their developmental tasks than may young people with diabetes. There is some evidence for the delayed attainment of certain developmental tasks in adolescents with visual impairments. …

Attainment of Developmental Tasks by Adolescents with Visual Impairments and Sighted Adolescents

The present study compared psychological adjustment of 158 adolescents with vision impairment and 158 sighted adolescents with a matched-pair design using the Strengths and Difficulties Questionnaire. Adolescent self-reports and teacher reports on emotional problems, peer problems, and total difficulties showed higher scores in students with vision impairment than in sighted students. However, the size of between-group differences was small, and adolescents who are blind and their peers with low vision showed similar levels of psychological adjustment. In addition, older students reported more emotional problems than younger students. Furthermore, differences between self-reported emotional problems of students with and without vision impairment were stronger in older participants. In both groups, girls showed more emotional problems and less conduct problems than boys. We conclude that most students with vision impairment are well adjusted but a minority may benefit from psychological interventions.

Psychological Adjustment in Adolescents with Vision Impairment.

Adolescents who attend boarding schools share more time with peers than do students from day schools which, in turn, could provide more opportunities for bullying. Furthermore, some students attend...

Bullying in German boarding schools: A pilot study

We examined the development of intimate relationships in 180 adolescents with visual impairment (VI) and 533 sighted peers. Adolescents with VI reported a later age at the time of first falling in love, dating, and entering into a romantic relationship. However, between-group differences in the timing of first sexual intercourse were not significant. In addition, similar numbers of adolescents from both groups had experiences with falling in love and having romantic relations at the time of assessment. The two groups differed in the criteria for mate selection, and emotional maturity was more important for young people with VI than for their sighted peers while the reverse was found for physical attractiveness and material resources of potential partners. Finally, the two groups did not differ in the perceived quality of their present romantic relationship.

Jens P. Pfeiffer

Papers

Psychological well-being in visually impaired and unimpaired individuals: A meta-analysis

Attainment of Developmental Tasks by Adolescents with Visual Impairments and Sighted Adolescents

Psychological Adjustment in Adolescents with Vision Impairment.

Bullying in German boarding schools: A pilot study

What is Essential is Invisible to the Eye: Intimate Relationships of Adolescents with Visual Impairment