Vision-Related Quality of Life and Mental Health Outcomes of Children and Young People with Visual Impairment and Their Carers

OBJECTIVES: To investigate the associations between vision-related quality of life (VQoL) and mental health outcomes of children and young people with visual impairment (CYP-VI) and their parents/carers, as a first step towards development of family-centred intervention.

METHODS: Cross-sectional study included 68 CYP-VI aged 8-18 years (visual acuity of logMAR 0.50 or worse, comprising moderate and severe visual impairment and blindness in ICD-11) and their carers. Families were recruited through two paediatric ophthalmology departments and relevant vision loss charities in the United Kingdom. Children’s outcomes included the overall scores on Vision-Related Quality of Life Questionnaire for Children and Young People (VQoL_CYP) as reported by the CYP-VI themselves, and Strengths and Difficulties Questionnaire (SDQ) as reported by their carers. Carers’ outcomes were overall scores on Satisfaction With Life Scale (SWLS), Patient Health Questionnaire (PHQ-9), General Anxiety Disorder Assessment (GAD-7), and Parental Stress Scale (PSS). Associations between children’s and carers’ outcomes were analysed using Spearman’s correlation coefficient.

RESULTS: Lower VQoL was associated with more overall behavioural and emotional difficulties on SDQ (r=–0.485, p<0.001), lower carer’s satisfaction with life (r=0.395, p=0.002), worse carer’s depression (r=–0.390, p=0.002) and anxiety symptoms (r=–0.315, p=0.015). VQoL was not significantly associated with parental stress levels (r=–0.196, p=0.140). More overall child’s behavioural and emotional difficulties significantly correlated with higher parental stress (r=0.363, p=0.004), worse carer’s depression (r=0.436, p<0.001) and anxiety symptoms (r=0.422, p<0.001), but not with their satisfaction with life (r=–0.159, p=0.224). Visual acuity and gender were not related with any of the measured outcomes. Older age was associated with lower VQoL (r=–0.320, p=0.010).

CONCLUSIONS: Our findings show moderate correlations between mental health of CYP-VI and their carers, and indicate both should be considered when assessing VQoL outcomes of CYP-VI. Interventions targeting mental health of these families may promote better VQoL of CYP-VI.