Delivering problem-solving treatment in low-vision rehabilitation: a pilot feasibility study

PURPOSE: To explore the feasibility and preliminary effectiveness of Problem-Solving Treatment for Primary Care (PST-PC) delivered by low-vision rehabilitation (LVR) practitioners to adult clients with depressive symptoms. DESIGN/METHOD: A single-group pre/postintervention study. Eighteen adult LVR clients with depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score of ≥5) received 6-8 weekly telephone sessions of PST-PC delivered by expertly trained practitioners (n = 14). Feasibility was determined via participating client and practitioner recruitment and intervention retention rates. Depressive symptoms (PHQ-9), health-related quality of life (HRQoL; Assessment of QoL Instrument-7D), and confidence in one's ability to cope using problem-solving strategies (Coping Self-Efficacy Scale) were assessed using pre/posttelephone assessments. RESULTS: Participating client recruitment and retention rates were 71% and 40%, respectively. Seventy percent of practitioners completed supervised training in PST-PC and demonstrated satisfactory levels of fidelity and competency. Postintervention, we observed a 53% improvement in depressive symptoms (p < .001), a 23% improvement in HRQoL (p = .001), and an 18% improvement in participants' confidence to use problem-focused coping strategies (p = .001). CONCLUSIONS: Telephone-PST-PC delivered by a trained LVR practitioner may be an effective intervention for clients of LVR services who exhibit depressive symptoms. A randomized controlled trial is now needed to confirm these preliminary findings and establish longer-term effectiveness.