Fatigue, visual impaired, blind, determinants
Fatigue is a symptom with high impact for patients with irreversible visual impairment. The first study of this project explored the patient perspective on fatigue in visually impaired adults and indicated that low vision related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience in other patient populations.
As a next step we meta-analyzed studies in this population and a visually healthy comparison group with fatigue as a primary research outcome and concluded that visually impaired patients experience clearly greater fatigue severity. Next, we aimed to clarify how fatigue is precisely associated with fatigue and strived to identify underlying mechanisms by developing a multidimensional path model. In both populations, depression appeared to be the strongest mediating determinant of fatigue. Also, effects of perceived health and self-efficacy were generic in participants with and without vision loss. In contrast, somatic comorbidity, sleep disorders and accommodative coping seem to be disease-specific determinants of vision-related fatigue. Currently this multidimensional path model is broadened by vision specific factors to predict fatigue more precisely for people with visual impairment.
In addition, the burden of fatigue in visual impairment was investigated and results revealed an interaction between visual impairment and high impact of fatigue for total societal costs, meaning additional economic burden of fatigue The presence of high fatigue impact was associated with a double fold increase of the societal costs for a person with visual impairment.
VU Medical Department of Ophthalmology, ZonMw, Koninklijke Visio, Bartimeus
2015 - 2020