Can we address depression in vision rehabilitation settings? Professionals' perspectives on the barriers to integrating problem-solving treatment

Holloway, Edith, Sturrock, Bonnie, Lamoureux, Ecosse, Keeffe, Jill, Hegel, Mark, Casten, Robin, Mellor, David and Rees, Gwyneth 2016, Can we address depression in vision rehabilitation settings? Professionals' perspectives on the barriers to integrating problem-solving treatment, Disability and rehabilitation, pp. 1-9, doi: 10.1080/09638288.2016.1250172.

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Title Can we address depression in vision rehabilitation settings? Professionals' perspectives on the barriers to integrating problem-solving treatment
Author(s) Holloway, Edith
Sturrock, Bonnie
Lamoureux, Ecosse
Keeffe, Jill
Hegel, Mark
Casten, Robin
Mellor, DavidORCID iD for Mellor, David
Rees, Gwyneth
Journal name Disability and rehabilitation
Start page 1
End page 9
Total pages 9
Publisher Taylor & Francis
Place of publication Abingdon, Eng.
Publication date 2016-11-20
ISSN 0963-8288
Keyword(s) Rehabilitation
low vision
problem-solving treatment
Summary PURPOSE: Low vision rehabilitation (LVR) is a pertinent context for integrating early, evidence-based psychological interventions given the high prevalence of untreated depression in adults with vision impairment. This study aims to identify the perceived barriers and facilitators to staff-delivered telephone-based problem-solving treatment for primary care (PST-PC) offered as an integrated component of LVR. METHODS: Qualitative semi-structured interviews, developed using the theoretical domains framework (TDF) and Consolidated Framework for Implementation Research (CFIR), were conducted with 21 LVR professionals and a clinical psychologist involved in the delivery of PST-PC. Barriers and facilitators at the practitioner, client, intervention, and organizational level were identified with thematic analysis using a "theoretical" approach. RESULTS: Prominent barriers were a lack of role recognition for PST-PC practitioners (n = 32), unmet client expectation with PST-PC (n = 28), dissatisfaction with telephone delivery (n = 27), and limited organizational awareness of PST-PC (n = 39). Facilitating factors included a recognized need for evidence-based psychological services (n = 28), clients experiencing benefits in early sessions (n = 38), PST-PC promoting practical skills (n = 26), and comprehensive PST-PC training (n = 36). CONCLUSIONS: PST-PC may provide an accessible early intervention for LVR clients with depressive symptoms. Ongoing practitioner training, clinical support, and screening potential LVR clients for treatment suitability are likely to enhance delivery in this setting. Implications for rehabilitation Depression is highly prevalent in adults engaged in low vision rehabilitation (LVR) programs, yet few receive support. Clinical guidelines recommend integrated models of care be offered within rehabilitation settings as early intervention for mild to moderate levels of depressive symptoms. Integrated telephone-based problem-solving treatment for primary care (PST-PC) delivered by trained LVR practitioners is a practical, skills-based model that has potential to increase access to an early psychological intervention in LVR clients with depressive symptoms. LVR clients are often older in age, have multiple comorbid health conditions and a significant level of functional disability, requiring flexibility in the delivery of PST-PC and specialized staff training, and support in working with older and more complex clients.
Notes In press
Language eng
DOI 10.1080/09638288.2016.1250172
Field of Research 170199 Psychology not elsewhere classified
11 Medical And Health Sciences
Socio Economic Objective 970117 Expanding Knowledge in Psychology and Cognitive Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Informa UK Limited
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Document type: Journal Article
Collection: Faculty of Health
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