The effects of lockdown of work and activities for adults with multiple, complex needs including sensory impairments during the pandemic in 2020

Sheltered work and leisure activities were locked down in at the Signo centre in March 2020 because of the COVID-19 pandemic. The Signo centre is a Norwegian national centre for adults with multiple, complex needs, including severe sensory loss/impairments. Tension and uncertainty rapidly spread among relatives and workers. To explore the impacts of the pandemic on residents, 24 adults living in Signo Vivo answered a semi-structured interview together with their primary worker. Additionally, reports on staff injuries and PRN medication between April and Aug of 2020 were compared to the period before the lockdown. The reports from the interviews included fewer stressful events for the participants, more rest and sleep, more time spent in their own apartments, and more time with smaller groups of workers. The reports on staff injuries and PRN medication showed decreased occurrence.

Prevalence and impact of combined vision and hearing (dual sensory) impairment: A scoping review

Hearing and vision impairments are common globally. They are often considered separately in research, and in planning and delivering services. However, they can occur concurrently, termed dual sensory impairment (DSI). The prevalence and impact of hearing and vision impairment have been well-examined, but there has been much less consideration of DSI. The aim of this scoping review was to determine the nature and extent of the evidence on prevalence and impact of DSI. Three databases were searched: MEDLINE, Embase and Global Health (April 2022). We included primary studies and systematic reviews reporting the prevalence or impact of DSI. No limits were placed on age, publication dates, or country. Only studies where the full text was available in English were included. Two reviewers independently screened titles, abstract, full texts. Data were charted by two reviewers independently using a pre-piloted form. The review identified 183 reports of 153 unique primary studies and 14 review articles. Most evidence came from high-income countries (86% of reports). Prevalence varied across reports, as did age groups of participants and definitions used. The prevalence of DSI increased with age. Impact was examined across three broad groups of outcomes-psychosocial, participation, and physical health. There was a strong trend towards poorer outcomes for people with DSI across all categories compared to people with one or neither impairment, including activities of daily living (worse for people with DSI in 78% of reports) and depression (68%). This scoping review highlights that DSI is a relatively common condition with substantial impact, particularly among older adults. There is a gap in evidence from low and middle-income countries. There is a pressing need for a consensus position on the definition(s) of DSI and standardisation of reporting age groups to enable reliable estimates to be ascertained and compared and responsive services developed.

Quality of Life in Deafblind People and Its Effect on the Processes of Educational Adaptation and Social Inclusion in Canary Islands, Spain

Deafblindness is a unique and complex disability. Research on the needs and quality of life are scarce; as well as the lack of adequate knowledge, training and lack of qualified professionals to serve this group. All this justifies the sense and interest of this study. This study is derived from the project with reference 2020EDU04. Design: The study is descriptive, cross-sectional and quantitative-qualitative research design was conducted. Objectives: Know and analyze the needs of adult deafblind people in order to contribute to improving their quality of life. Method: Sample of 16 adults with double sensory loss (hearing and vision) residing in the Autonomous Community of the Canary Islands (Spain) was used. Instruments: The FUMAT Scale was used to measure personal development; self-determination; interpersonal relationships; social inclusion; rights of deafblind people; emotional well-being; physical well-being and material well-being. In addition, a semi-structured interview is conducted. Results by dimensions: Personal development: The professionals did not have specialized training to provide an educational response. Physical well-being: 68% of the sample had other health problems associated with deafblindness. Interpersonal relationships: 100% of the sample reported communication problems in the family environment. Social inclusion: They reported difficulties in accessing educational and leisure activities. Material well-being: In general, they stated that they have the material resources necessary for their daily lives. Self-determination: they consider that they have decision-making capacity in basic aspects of daily life. Rights: Deafblind people state that they have limitations in exercising their rights. Based on the interviews, it was observed that the people with the greatest difficulties in daily life are those who presented the greatest visual commitment. Conclusion: The etiology does not determine the quality of life of deafblind people, but communication conditions interpersonal relationships and personal development, and therefore their quality of life.

A salutogenesis approach to ageing with impairment: the managing and coping experiences of older people ageing with deafblindness

An understanding of the psychosocial impact of deafblindness on older people is impoverished by a dearth of research in the field. Particularly limited are studies adopting a salutogenesis perspective, in which older deafblind people's coping capacities are explored. Much research focuses on vulnerability to unfavourable outcomes, which may perpetuate negative stereotypes of deafblind people as passive and dependent. Identifying deafblind people as a vulnerable group gives rise to misunderstanding of the impairment, perceptions of incapability and neglect of deafblind people's agency. This paper draws on data from the first United Kingdom-based study of vulnerability from the perspectives of older adults ageing with deafblindness. Findings presented here relate to participants’ experiences of managing and coping with their felt vulnerability and ageing with deafblindness. The study adopted interpretative phenomenological analysis (IPA) as its qualitative approach. In-depth semi-structured interviews were undertaken between October 2014 and July 2016 with eight participants, aged between 48 and 83 years. Data were analysed using an iterative six-step IPA process. Three superordinate themes were identified: taking action to protect self; psychological coping strategies; and accessing and using care and support. Participants’ managing and coping strategies, and the care and support they value, respond to elements identified as generating felt vulnerability. Professionals should seek to bolster coping capacity and provide support in ways valued by those ageing with deafblindness.

Visual, hearing, and dual sensory impairment are associated with higher depression and anxiety in women

OBJECTIVE

We investigated cross-sectional gender-specific associations with vision, hearing, and both (dual) impairment with depression and chronic anxiety using a large representative sample of Spanish adults.

METHODS

The present study utilized data from the Spanish National Health Survey 2017. A total of 23,089 adults (15-103 years, 45.9% men) participated in this survey. Participants self-reported whether they had suffered depression and/or anxiety, and also whether they experience vision, hearing and both vision/hearing (dual) impairment. Multivariable logistic regression analyses were conducted to assess the associations between the three types of sensory impairment and anxiety or depression, in men and women.

RESULTS

Across the whole sample (n = 23,089) the prevalence of depression and anxiety was between 2.00 and 2.56 times higher in women compared to men. Dual sensory impairment (hearing and vision) was associated with higher levels of depression (odds ratio [OR] = 2.980, 95% confidence interval [CI]: 2.170-4.091) and anxiety (OR = 2.636, 95% CI: 1.902-3.653) compared to single sensory impairment. Stratified associations by gender showed higher odd ratios for women with dual sensory loss (3.488 for depression and 3.478 for anxiety) compared to men (2.773 for depression and 1.803 for anxiety).

CONCLUSIONS

Dual sensory impairment (hearing and seeing) is are associated with increased depression and anxiety. Women with dual sensory impairment showed stronger associations compared to men among adults in Spain. Interventions are needed to address vision and/or hearing impairment in order to reduce anxiety and depression especially in women.

Similarities and Differences in Health, Social Trust, and Financial Situation in People With Usher Syndrome, a Bio-Psychosocial Perspective

Purpose

The primary aim was to describe the similarities and differences among the general health, physical health, psychological health, social trust, and financial situations of people with Usher syndrome (USH) types 1, 2, and 3. A second aim was to explore whether age, gender, clinical diagnosis, visual field, visual acuity, and degree of hearing impairment were associated with the general health, physical health, psychological health, social trust, and financial situations of people with USH.

Methods

In this study, 162 people with USH living in Sweden were included, and all three types of the disease were represented. Data concerning vision, hearing, and genetics were retrieved from the Swedish Usher database. Group comparison using frequencies, χ²-tests and Kruskal-Wallis tests for group comparison were used. To examine the effect of independent variables on poor health outcomes, a logistic regression analysis was conducted.

Results

Problems with poor health, social trust, and finances were found for all three types; however, more similarities than differences were found. The results of the regression model were ambiguous; it is not clear which independent measures contributed the most to poor outcomes. People with USH3 tended to report the most problems regarding the dependent outcome measures.

Conclusion

The observations of the associations between the independent variables and poor health, social trust and finances made in the present study are important to bear in mind in a rehabilitation setting; however, they do not fully explain how people with USH actually feel or rate their health. More research is needed to confirm the knowledge that exists within the clinical setting and the life stories told by the people with USH to merge existing knowledge into a rehabilitation setting based on evidence.

Effects of Senior Simulation Suit Programme on nursing students' attitudes towards older adults: A randomized controlled trial

BACKGROUND

As populations age worldwide, nursing educational institutions need to train nurses not only to provide health care services specific to the elderly, but also to have a positive attitude as they work. The present study aimed to investigate the efficacy of a Senior Simulation Suit Programme (SSSP). The SSSP, which focused on mimicking the physiological experiences of an 80 year-old person, was hypothesized to increase the wearer's positive attitude towards older adult care.

METHODS

A single-blinded, randomized controlled trial was used to evaluate the efficacies of SSSP. One hundred and thirty-nine (139) nursing students were randomly assigned to either SSSP group (n = 69) or to a control group (n = 70) with "placebo clothing", i.e. clothing that mimicked old age but did not actually impair faculties. Two instruments-Kogan Attitudes Towards Old People Scale (KAOP) and a 1-item scale on Willingness To Care for Older People Scale (WCOP)-were used for data collection at baseline and at completion of SSSP. A Chinese version of Palmore's Facts Aging Quiz (C-FAQ) was used to assess nursing students' knowledge about adult care, and a questionnaire was developed to collect demographic information at baseline.

RESULTS

No significant difference between the two groups was found. A significant increase of positive attitudes and of willingness to serve older adults was found in both the control group and the group wearing SSSP.

CONCLUSION

Both the SSSP and control intervention could improve the attitudes of nursing students towards older adult care. This study suggests that wearing whatever the nursing students associate with being old, will improve their attitude towards older adult care.

Life strategies of people with deafblindness due to Usher syndrome type 2a - a qualitative study

Purpose: To explore life strategies in people with Usher syndrome type 2a. Background: There are no studies on life strategies in people with Usher syndrome. People with deafblindness are often described in terms of poor health and low quality of life, or as being vulnerable. From a clinical point of view, it is of importance to balance this picture, with an increased knowledge of life strategies. Methods: The study had a qualitative explorative design. Fourteen people aged 20-64 years (4 women, 10 men) with USH2a in Sweden participated in focus group interviews, which were transcribed and analysed by qualitative content analysis. Results: The content analysis resulted in seven categories; remaining active, using devices, using support, sharing knowledge, appreciating the present, maintaining a positive image and alleviating emotional pain. Two sub-themes: resolve or prevent challenges and comforting oneself was abstracted forming a theme "being at the helm". Conclusion: The findings show that people with USH2a have a variety of life strategies that can be interpreted as highlighting different aspects of psychological flexibility in a life adjustment process. The study demonstrates that people with USH2a manage in many ways, and metaphorically, by "taking the helm", they strive to actively navigate towards their own chosen values.

Using the ICF to Identify Contextual Factors That Influence Participation of Persons With Deafblindness

OBJECTIVE

To identify and describe the contextual factors that influence the participation of people with deafblindness in India.

DESIGN

Qualitative study, using directed content analysis approach and the International Classification of Functioning, Disability and Health (ICF) as a framework to analyze the data.

SETTING

Community and social participation settings.

PARTICIPANTS

Community-dwelling individuals with deafblindness (N=16). Age ranges from 18-45 years.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Personal and environmental factors that influence the participation of individuals with deafblindness using the ICF framework.

RESULTS

Results indicate that the age of onset and nature of impairment (deafblindness) and willingness to explain the condition (functional consequences of deafblindness) emerged as important personal factors. Access to resources such as assistive technology, social support, and deafblind-specific services were found to be enablers of participation. Lack of services, systems, and policies specific to deafblindness along with negative societal attitude toward disability were highly perceived environmental barriers that influence participation of people with deafblindness in India.

CONCLUSIONS

Professionals must acknowledge aspects of the environment in conducting assessments and delivering interventions and understand the dynamic interactions between environment of the individual and his/her concurrent vision and hearing impairments. Approaches to enable participation require rehabilitation professionals to work with those with deafblindness to advocate for removal of environmental barriers and ensure provision of appropriate resources from the government to facilitate their participation. Social policy and government must ensure emphasis on awareness about deafblindness, access to deafblind-specific services, positive societal attitude, and opportunities for full participation for people with deafblindness in society.

Participation experiences of people with deafblindness or dual sensory loss: A scoping review of global deafblind literature

Background

Deafblindness, also known as dual sensory loss, is a varying combination of visual and hearing impairment in the same individual. Interest in this topic has increased recently due to evidence suggesting an increase in prevalence of this condition among older adults. Persons with deafblindness frequently experience participation barriers and social isolation. Developing an understanding of their experiences can inform the design of programs and policies to enhance participation of people with deafblindness in society.

Objective

To identify and summarize available research literature on participation experiences of people with deafblindness or dual sensory loss.

Methods

A comprehensive literature search of eight databases (CINAHL/EBSCO, Embase, ERIC, Global Health, MEDLINE, ProQuest, PsycINFO, PubMed) was performed in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) during January 2017 and last updated in June 2017. In addition, non-peer reviewed (grey) literature was also retrieved in the form of online published reports of research projects by 16 deafblind-specific organizations across the globe. To be included, sources had to be published after 1990, had persons with deafblindness as the focal population, and focused on their participation experiences.

Results

A total 1172 sources were identified of which 54 studies were included. The findings reveal that persons with deafblindness, regardless of origin of their impairment, experience difficulty in communication, mobility, daily living functioning, and social interactions. While these experiences may vary between individuals with congenital versus acquired conditions, they generally feel socially isolated, insecure and uncertain about their future.

Conclusion

Participation experiences of persons with deafblindness are shaped by dynamic interactions between personal factors (such as onset and type of impairments) and environmental influences (such as attitude, technology, and supports). A better understanding of participation experiences may help professionals in placing emphasis on affected participation domains to design services to enhance participation of people with deafblindness.

Health, work, social trust, and financial situation in persons with Usher syndrome type 1

BACKGROUND

Research has demonstrated that persons with Usher syndrome type 1 (USH1) have significantly poorer physical and psychological health compared to a reference group.

PURPOSE

To explore the relation between work, health, social trust, and financial situation in USH1 compared to a reference group.

MATERIAL

Sixty-six persons (18-65 y) from the Swedish Usher database received a questionnaire and 47 were included, 23 working and 24 non-working. The reference group comprised 3,049 working and 198 non-working persons.

METHODS

The Swedish Health on Equal Terms questionnaire was used and statistical analysis with multiple logistic regression was conducted.

RESULTS

The USH1 non-work group had a higher Odds ratio (95% CI) in poor psychological and physical health, social trust, and financial situation compared to the USH1 work group and reference groups. Age, gender, hearing, and vision impairment did not explain the differences. The relation between the USH1 work and non-work groups showed the same pattern as the reference groups, but the magnitude of problems was significantly higher.

CONCLUSIONS

Both disability and unemployment increased the risk of poor health, social trust and financial situation in persons with USH1, but having an employment seemed to counteract the risks related to disability.

Assessing Autism Spectrum Disorder in People with Sensory Impairments Combined with Intellectual Disabilities

People with sensory impairments combined with intellectual disabilities show behaviours that are similar to Autism Spectrum Disorder (ASD). The instrument Observation of Autism in people with Sensory and Intellectual Disabilities (OASID) was developed to diagnose ASD in this target group. The current study focuses on the psychometric properties of OASID. Sixty individuals with intellectual disabilities in combination with visual impairments and/or deafblindness participated in this study. The OASID assessment was administered and rated by three independent observers. By means of expert consensus cut-off scores for OASID were created. To determine the concurrent validity OASID was compared with the Pervasive Developmental Disorder for People with Mental Retardation (PDD-MRS) and the Childhood Autism Rating Scale second edition (CARS-2). The intra-rater reliability, the inter-rater reliability, internal consistency and concurrent validity of OASID were good to excellent. Cut-off scores were established based on criteria from the DSM-5. OASID was able to differentiate between four severity levels of ASD.

Availability of Mental Health Services for Individuals Who Are Deaf or Deaf-Blind

A survey of state mental health agencies found that a majority have no specific policy or procedure regarding how to provide mental health services to persons who are deaf or who are deaf-blind. Agency representatives report that staff lack knowledge of how to provide mental health services to persons who are deaf-blind and the agencies lack qualified interpreters. They recommend training for social workers and counselors to address best practices in working with people who are deaf-blind concerning communication methods and strategies, physical interaction, cultural issues, everyday life, sensory deprivation, ethics, use of an interpreter, and other general issues.

One of society's most vulnerable groups? A systematically conducted literature review exploring the vulnerability of deafblind people

The vulnerability of deafblind people is considered axiomatic; they are seen not only as a vulnerable group but also as one of the most vulnerable. This paper aims to synthesise existing knowledge to determine what is known about such vulnerability. A comprehensive literature search was undertaken between April 2013 and May 2014. The review method was informed by systematic review principles. An approach based on a 'hierarchy of evidence' would have reduced the amount of literature reviewed significantly, to the point where synthesis would not be possible. Included material was appraised and an interpretative rather than aggregative approach to synthesis adopted. Drawing on principles of critical interpretive synthesis, rather than being a determiner of whether material should be included or excluded, a critique of the literature is offered within the synthesis. Twenty-eight references were identified for inclusion, originating from the UK, USA, Australia, Continental Europe and the Nordic Countries. No empirical studies specifically examining the experience of vulnerability of deafblind people were found. However, deafblind people describe feelings of vulnerability in studies exploring their experiences more generally, and in personal accounts of living with the impairment. Literature produced by practitioners and specialist organisations also explores the topic. Deafblind people are identified as a population 'at risk' of various adverse outcomes, particularly when compared to the non-deafblind majority, and deafblind people describe being and feeling vulnerable in various situations. The literature largely relates to negative outcomes and includes significantly less exploration of positive risk taking, coping capacity and resilience. Deafblind people do not appear to describe themselves as being vulnerable as a permanent state, suggesting a need for greater exploration of the experience among all sections of this heterogeneous population, with consideration of the concepts of resilience and coping capacity.

Late life acquired dual-sensory impairment: A systematic review of its impact on everyday competence

The literature on the relationship between late acquired dual-sensory impairment (DSI) in older adults and the ability to remain independent is limited. A systematic search of the literature was conducted to assess the impact that late life acquired DSI in older adults has on their ability to remain independent within their homes. Exclusion and inclusion criteria were applied to the papers identified and eight qualified for inclusion in the review. Each selected paper was assessed using a quality rating scale. Country of origin, population studied, age, vision, and hearing criteria all varied between papers. They provide evidence that DSI affects everyday competence, and this effect is complicated by physical comorbidities, mental health, and social factors.

Ageing with a unique impairment: a systematically conducted review of older deafblind people's experiences

Little is known about the experiences of people ageing with impairments; social gerontology has largely focused on those ageing into disability rather than those ageing with disability. This paper synthesises existing knowledge to determine what is known about the experiences of those ageing with deafblindness. A comprehensive literature search was undertaken between April 2013 and May 2014. The review method was informed by systematic review principles. A total of 24 references were identified for inclusion. No studies examining deafblind people's experience of ageing and old age specifically were found, suggesting that those ageing with deafblindness are an under-studied sub-group within the deafblind population. However, deafblind people describe ageing experiences in studies exploring their lives generally, and in personal accounts of living with the impairment. Practitioner-authored material also explores the topic. Similarities in experience were identified between those ageing with deafblindness and those ageing with other impairments: ongoing change and consequent need for adaptation; a particular relationship between ageing and impairment; a sense that whilst one can learn adaptive strategies having lived with impairment for many years, it does not necessarily get easier; and a particular relationship with care and support services. These experiences illustrate the unique nature of ageing with impairment, and challenge gerontologists to engage in further research and theorising in the field of disability in later life.

Implications of Deafblindness: The Physical and Mental Health and Social Trust of Persons with Usher Syndrome Type 3

Introduction

The aim of this study was to describe health and social trust in persons with Usher syndrome type 3 (USH3) in relation to hearing and visual impairment.

Methods

Participants were recruited from the Swedish Usher database. Twenty-one persons with USH3 received two questionnaires, which covered a wide range of domains related to health and social trust. Fifteen individuals, 4 men and 11 women aged 19–71 years, responded. Each outcome measure within every domain reported by the individual was structured into a matrix, which included auditory and visual findings.

Results

Severe problems with health and social trust were apparent for persons with USH3. Differences in the number of reported problems were suggested. Three persons had cochlear implants, and they reported far fewer problems with physical health, mental health, and social trust than the others.

Discussion

Three major patterns emerged. The first was that the group was heterogeneous with regard to the problems reported in the biopsychosocial dimensions; that is, general health, physical health, and mental health, as well as social trust. The second was that none of the biopsychosocial dimensions could be disregarded when describing health among persons with USH3. The third major pattern was that a cochlear implant might benefit the health of persons with USH3.

Implications for practitioners

The results suggested poor physical and mental health and severe social trust problems for people with USH3. Interdisciplinary strategies are required to facilitate the rehabilitation of persons with USH3 throughout their lifespan.

Physical and psychological health, social trust, and financial situation for persons with Usher syndrome type 1

The article describes physical health, psychological health, social trust, and financial situation in persons with deafblindness due to Usher syndrome type 1 (USH1) in comparison with a cross-section of the Swedish population. Persons with USH1 were recruited through the Swedish Usher database. Totally, 87 adults received the Health on Equal Terms (HET) questionnaire. The HET was adjusted, thus the questions were translated into Swedish sign language, and a large font size, better contrast, and a structure compatible with the Braille script reader were also provided. The questionnaire comprises a wide range of domains related to health and wellbeing. In all, 60 persons responded (60% women, mean age: 49 years, range: 21–79 years). The persons with USH1 were compared to a cross section of the Swedish population that included 5738 individuals (56% women, mean age: 49 years, range: 16–84  years). Significant differences in physical health, psychological health, social trust, and financial situation as well as the odds ratio adjusted for sex and age, and its 95% confidence interval are reported. The psychological health, social trust, and financial situation of persons with USH1 were significantly poorer compared to the reference group although this was not the case for physical health. Persons with USH1 only expressed significantly more problems with headache compared to the cross section of the Swedish population. The respondents revealed major problems with fatigue, loss of confidence, and suicide thoughts and attempts. Major social trust and financial problems were reported in terms of refraining going out alone, not receiving help, having no one with whom to share thoughts, and confide in and being unable to obtain 15.000 SEK (approximately US$1.724 or €1.544) in the case of an unforeseen situation. To identify factors associated with physical health, psychological health, social trust, and financial situation is important in the design of future rehabilitation strategies for persons with USH1. The high level of psychological distress and lack of social trust reported could be related to ontological insecurity, as well as lack of recognition from others. Special attention must be devoted to suicide behavior.

Psychological Stress in People with Dual Sensory Impairment through Usher Syndrome Type II

Introduction

Due to their dual, sensory impairment, people with Usher syndrome are assumed to have a high risk of stress. The purpose of this study was to assess stress in people with Usher syndrome type II (USH2) and the influence of personal variables such as age, gender, and employment on stress.

Methods

Two questionnaires were used: A self-developed questionnaire (SQ) to investigate the frequency and intensity of stress by external stressors within six life domains and the German standardized stress questionnaire Trierer Inventory of Chronic Stress (TICS) to compare frequency of stress between the USH2 sample group and a reference group ( n = 604). The questionnaires were filled in by an ad hoc sample of 262 persons with USH2 (response rate: 93%), mainly recruited from self-help groups (ages 17–79, mean age = 51; 53% female; 32% employed). Differences were determined by using methods of classical test theory.

Results

The evaluated SQ shows good indices in terms of item and factor analysis. The greatest stress was seen in the factor “Orientation and Mobility”; in TICS it was in the scale “Chronic Worry.” In TICS the USH2 sample showed significantly higher stress on scales that indicate a lack of social-emotional need fulfillment and less stress in those with high expectations ( p = .05). In both questionnaires, stress was dependent on personal variables.

Discussion

The results indicate the need for rehabilitation arrangements to reduce stress in people with USH2, especially in the areas of orientation and mobility, chronic worry, and social isolation. In intervention, particular attention should be paid to older, female, and unemployed people.

Implications for practitioners

Internal and external resources for people with dual sensory impairment need to be strengthened and systematic programs for learning how to cope with stress need to be established in order to provide clients with successful problem- and emotion-focused coping strategies.

Screening for hearing, visual and dual sensory impairment in older adults using behavioural cues: a validation study

OBJECTIVE

This study investigated the psychometric properties of the Severe Dual Sensory Loss screening tool, a tool designed to help nurses and care assistants to identify hearing, visual and dual sensory impairment in older adults.

DESIGN

Construct validity of the Severe Dual Sensory Loss screening tool was evaluated using Crohnbach's alpha and factor analysis. Interrater reliability was calculated using Kappa statistics. To evaluate the predictive validity, sensitivity and specificity were calculated by comparison with the criterion standard assessment for hearing and vision. The criterion used for hearing impairment was a hearing loss of ≥40 decibel measured by pure-tone audiometry, and the criterion for visual impairment was a visual acuity of ≤0.3 diopter or a visual field of ≤0.3°. Feasibility was evaluated by the time needed to fill in the screening tool and the clarity of the instruction and items. Prevalence of dual sensory impairment was calculated.

RESULTS

A total of 56 older adults receiving aged care and 12 of their nurses and care assistants participated in the study. Crohnbach's alpha was 0.81 for the hearing subscale and 0.84 for the visual subscale. Factor analysis showed two constructs for hearing and two for vision. Kappa was 0.71 for the hearing subscale and 0.74 for the visual subscale. The predictive validity showed a sensitivity of 0.71 and a specificity of 0.72 for the hearing subscale; and a sensitivity of 0.69 and a specificity of 0.78 for the visual subscale. The optimum cut-off point for each subscale was score 1. The nurses and care assistants reported that the Severe Dual Sensory Loss screening tool was easy to use. The prevalence of hearing and vision impairment was 55% and 29%, respectively, and that of dual sensory impairment was 20%.

CONCLUSIONS

The Severe Dual Sensory Loss screening tool was compared with the criterion standards for hearing and visual impairment and was found a valid and reliable tool, enabling nurses and care assistants to identify hearing, visual and dual sensory impairment among older adults.

Deafblind people, communication, independence, and isolation

This paper discusses issues related to communication, independence, and isolation for an understudied group of deaf people who also have visual impairments. The discussion is based on the experiences of 28 deafblind people in 6 different countries, obtained from interviews that were carried out as part of a larger research project on travel issues. However, the similarities in experiences between countries were stronger than the differences. In particular, barriers to communication and inadequate support, with resulting problems of isolation and depression, were found in all the countries. Equally, deafblind people in all the countries were interested in being involved in and contributing to society and supporting other people, particularly through organizations of blind and deafblind people. This runs counter to the tendency to present deafblind and other disabled people purely as recipients of support rather than also as active participants in society. However, there were some differences in the support available in the different countries.

Characteristics of a Danish population of adults with acquired deafblindness receiving rehabilitation services

The aim of this study is to report on the characteristics of a population of 916 individuals with acquired deafblindness receiving national Danish counselling and rehabilitation services. Age, gender, prevalence, social status, and communication mode are some of the data included in this study. Results show that 70% of the population was older than 79 years, 15% was between 65 and 79 years, and 15% of the population was younger than 65 years. Oral speech was used by 86%, sign language by 10%, and tactile sign language by 4%. Among individuals younger than 65 years, less than 50% was employed or in education. Results are discussed with respect to the organization of the Danish counselling and rehabilitation service system.

Helping persons with Usher syndrome type II adapt to deafblindness: An intervention program centered on managing personal goals

Difficulties adapting to changes in Usher syndrome type II leading to deafblindness are well known. One of the factors that may affect the adaptation process is the ability to redirect one’s life and set new goals for oneself. This article presents the results of a group intervention program centered on managing personal goals. The results of a double-multivariate repeated-measures multivariate analysis of variance (MANOVA) point to a significant partial effect on the variable “meaning of life,” while no significant change was found for the feeling of “serenity,” “self-determination,” and the “ability to set, plan, and pursue a goal.” The results of this pilot project warrant continuing the research since the intervention seems to have a positive impact on psychological well-being.

Stress in adults with congenital deafblindness and an intellectual disability: Information from their cortisol curves

Adults with congenital deafblindness and an intellectual disability are at high risk for exposure to chronic and severe stress. Sensory deprivation, separations from primary caregivers, and difficulties in communication, from birth on, make daily life stressful for them. Chronic and high stress can lead to deviancies in the cortisol curve. This, in turn, can have negative effects on mental and physical health. Nothing is known yet about the cortisol curve of adults with congenital deafblindness and an intellectual disability, but our hypothesis is that it will be deviant.

In this study, the cortisol curve of six participants with congenital deafblindness was compared to the curve of 40 typical controls. Remarkably, in spite of all past and present stress factors, the cortisol curve of the participants was rather normal. Possible explanations for this finding are discussed, amongst others individual differences in experiencing stress. Implications for further research are discussed.