Dr Trefor Aspden
Problem Solving Treatment in Visual Impairment (POSITIVE)
"People who lose their vision can have a difficult time adjusting to their condition, especially
in the early stages after their diagnosis. This can have an impact on their psychological
well-being and their motivation and confidence to continue with their day-to-day activities.
We hope that helping people to develop their problem-solving skills after their initial
diagnosis will increase their level of confidence and wellbeing.
Once problem-solving skills are learnt, they can also be applied to a range of problems that
individuals may encounter as a person living with vision loss. We propose to test an
established intervention called Problem-Solving Treatment (PST) among 120 people with
an early diagnosis of vision loss. A trial will be conducted where approximately half of
participants will be randomly allocated to receive the intervention, and half will receive usual
care. The intervention group will be split into those with severe and those with moderate to
slight vision loss. We will examine whether the intervention has a positive impact on
psychological wellbeing, quality of life and mobility, and if any changes are related to
severity of vision loss. If there is evidence that PST is a useful intervention for people with
vision loss, we will consider how it can be incorporated into usual care after their
Randomised; Interventional; Design type: Treatment
Primary study design
Secondary study design
Randomised controlled trial
Patient information sheet
Topic: Eye; Subtopic: Eye (all Subtopics); Disease: Ophthalmology
Problem Solving Treatment, Six sessions of Problem Solving Treatment conducted over 8 weeks, and also a telephone booster session approximately three months after the last session.
Primary outcome measures
Warwick-Edinburgh Mental Well-being Scale; Timepoint(s): Baseline, 3 months, 6 months, 9 months
Secondary outcome measures
1. Generalized Self-efficacy Scale; Timepoint(s): Baseline, 3 months, 6 months, 9 months
2. Hospital Anxiety and Depression Scale; Timepoint(s): Baseline, 3 months, 6 months, 9 months
3. Impact of Vision Impairment Questionnaire; Timepoint(s): Baseline, 3 months, 6 months, 9 months
4. Life Spaces Questionnaire; Timepoint(s): Baseline, 3 months, 6 months, 9 months
5. Self-assessed Instrument for Perceived Visual Ability for Independent Mobility; Timepoint(s): Baseline, 3 months, 6 months, 9 months
6. Social Problem Solving Inventory Revised; Timepoint(s): Baseline, 3 months, 6 months, 9 months
7. Vision Quality of Life Index; Timepoint(s): Baseline, 3 months, 6 months, 9 months
Overall trial start date
Overall trial end date
Participant inclusion criteria
A diagnosis of severe, irreversible sight loss, or registration as blind or partially sighted within the last 3 months.
Target Gender: Male & Female ; Lower Age Limit 18 years
Target number of participants
Planned Sample Size: 120; UK Sample Size: 120
Participant exclusion criteria
1. Already participating in psychiatric/psychological assessment or intervention within the previous 3 months.
2. Having significant cognitive impairment (screened by Six-item Cognitive Impairment Test (6-CIT; Katzman et al., 1983) whereby score of =10 will result in exclusion).
3. Having insufficient proficiency in English to participate.
4. Residing in a care home.
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Royal Holloway, Egham Hill
Guide Dogs for the Blind Association, UK. Ref: RFT056/10
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting