Efficacy of Problem-Solving Therapy on Patient-Reported Outcomes in Visually Impaired Patients: A Comprehensive Review
Rikta Paul, Mohammad Nooruz Zaman, Lokesh GuptaIntroduction
Visual impairment is increasingly recognized as a significant risk factor for depression, anxiety, and diminished quality of life. Although various interventions aim to address these psychosocial challenges, problem-solving therapy has shown promise in helping individuals adapt to vision-related limitations by enhancing coping strategies and self-efficacy. This review evaluates the potential of problem-solving therapy as a standalone intervention to improve mental health outcomes in visually impaired adults.
Methods
A systematic search was conducted across PubMed, Medline-OVID, Embase, the Cochrane Library, and Google Scholar, covering literature from January 2001 to April 2024. Eligible studies included randomized controlled trials, nonrandomized studies, and single-group interventions involving adults with visual impairment. The primary outcomes examined were depression, anxiety, psychological well-being, and vision-related quality of life. Five studies were included—four randomized controlled trials and one pre–post intervention study.
Results
Evidence suggests that problem-solving therapy contributes to meaningful reductions in depressive symptoms among visually impaired individuals. One study reported a 50% lower incidence of depressive disorders among participants with age-related macular degeneration who received problem-solving therapy. Additional improvements were noted in psychological well-being and vision-related quality of life. While objective visual acuity did not change, perceived functional ability improved significantly. However, challenges related to participant adherence—such as dropout due to social isolation—were observed.
Conclusion
Problem-solving therapy appears to be a valuable psychological intervention for visually impaired patients, offering measurable improvements in emotional well-being and perceived functionality. Adaptations may be necessary to increase accessibility and engagement.
Implications for Practitioners
Practitioners can incorporate problem-solving therapy into comprehensive low-vision rehabilitation programs to address mental health concerns. Tailoring interventions to patient needs, offering remote or hybrid delivery options, and including structured follow-up or booster sessions can enhance adherence and efficacy. Future research should focus on long-term outcomes, diverse patient populations, and standardized delivery models to establish problem-solving therapy as an evidence-based approach in vision care.