The "In It Together" digital intervention to treat distress among older adults with sensory loss and their spouses: Study protocol for a randomized controlled trial study.

Sensory impairment is common in older age and may be associated with intra- and interpersonal struggles. Treatment and intervention efforts may be hampered by functional difficulties or unwillingness to receive face-to-face mental health services. The current study seeks to assess the efficacy of an online psychological intervention for older adults with sensory loss and their spouses in Denmark, using a two-arm, parallel-group, randomized controlled trial study design. Participants will be randomly assigned to the intervention group or waiting list control group. The intervention consists of four digital, sequential modules that contain psychoeducation and Acceptance and Commitment Therapy inspired therapeutic activities. Individuals will be assessed at baseline, 6 weeks, and 10 weeks post-baseline, and for the intervention group only, at 18-weeks. The outcomes are well-being (primary), relationship satisfaction (secondary), and depressive symptoms (tertiary). The data will be analyzed using multilevel modeling to account for non-independence of data (nesting within participant and within couple). This is the first randomized controlled trial study of an online psychological intervention for older adults with sensory loss and their spouses and it will provide valuable knowledge regarding whether internet-delivered intervention is effective for this population group.

What couples say about living and coping with sensory loss: a qualitative analysis of open-ended survey responses.

The current study reports the results of open-ended questions from a follow-up survey of adults with sensory loss and their spouses who had previously taken part in an online study. In total, 111 participants completed the survey (72 adults with a sensory loss and 39 spouses). Open-ended questions asked about the overall experience of living with sensory loss, sensory loss-related challenges, and support and coping mechanisms. Thematic analysis was used to identify dominant themes in participants' responses. Three core themes capturing their overall experience emerged: (1) sensory loss-related challenges, (2) support and coping, and (3) adjustment and readjustment. Sensory loss was characterized as a challenging experience, causing communication and emotional disturbances. Coping strategies reported by both partners included the use of assistive technology, positive re-appraisal, acceptance and/or denial of the loss, while support strategies were mostly derived from the comments of spouses (for AWSLs), family members and peer networks (for both partners). Finally, respondents described sensory loss as an adventurous learning experience. Our findings underscore the significance of considering sensory loss from a social relational/family perspective and highlight the importance of addressing the needs of both adults with sensory loss and their partners in treatment and rehabilitation.Implications for rehabilitationStudy highlights the need to consider sensory loss from a relational/family perspective.Healthcare professionals should try to increase the involvement of significant others and close family members (e.g., spouses, parents, children) into the rehabilitation process.Greater emphasis should be placed on exploring and reinforcing positive experiences and attitudes associated with sensory loss during counselling/rehabilitation sessions.Improved education about sensory loss for both the general public and health care professionals could minimize the adverse outcomes associated with sensory loss.

Intra- and interpersonal effects of coping on the psychological well-being of adults with sensory loss and their spouses.

PURPOSE: The aim of the current study was to examine the associations between coping and psychological well-being among adults with sensory loss and their spouses. METHODS: A total of 183 adults with sensory loss and 133 spouses participated in an online survey and were followed up six months later. Coping and well-being were measured using the Brief Coping Orientation to Problems Experienced Scale (Brief COPE) and the five-item World Health Organization Well-Being Index (WHO-5), respectively. Cross-sectional and longitudinal intra- and interpersonal effects of coping on psychological well-being were analyzed using a structural equation modeling approach. RESULTS: Results showed that a significant portion of adults with sensory loss (32.4%) and spouses (23.8%) had poor well-being, and this remained stable over the six-month period. Coping styles associated with the well-being of adults with sensory loss included active coping, avoidance, distraction, venting and spouse support seeking. Coping styles associated with the well-being of spouses included support seeking, distraction, venting, avoidance (by partner) and humor (by partner). CONCLUSION: The results highlight the need to support the well-being of adults with sensory loss and their spouses in rehabilitation, and the importance of both intra- and interpersonal coping in the adjustment process. Implications for rehabilitation Rehabilitation specialists and social workers working with adults with sensory loss should, where possible, incorporate family members into support plans. Rehabilitation specialists and social workers working in sensory rehabilitation should be mindful of how the coping styles of one partner can impact the well-being of their significant other. In addition to promoting positive coping behaviors, such as planning and support seeking, rehabilitation specialists and social workers should also take care to identify and reduce maladaptive coping behaviors such as avoidance and distraction. Online and print information for spouses on how to cope with a partner's sensory loss should be available and accessible for couples attending sensory rehabilitation clinics.

Couples coping with sensory loss: A dyadic study of the roles of self- and perceived partner acceptance.

OBJECTIVES: Hearing-, vision-, and dual-sensory loss have been linked to relational and psychological distress among adults with sensory loss (AWSLs) and their spouses. Regardless, research on factors associated with couples' adjustment is lacking. This study examined the stability and strength of associations between self-acceptance of sensory loss, perceived partner acceptance of sensory loss, and relationship satisfaction and psychological distress among AWSLs and their spouses over time. DESIGN: A total of 122 AWSLs and their spouses completed an online survey at two time points over a 6-month period. METHODS: A multigroup (i.e., time 1 and time 2) actor-partner interdependence model assessed the stability and strength of actor and partner effects of self-acceptance and perceived partner acceptance on each partner's relationship satisfaction and psychological distress over time. RESULTS: No moderation by time was identified, indicating stability in associations over the 6-month period. Overall, both actor and partner effects were evident. Specifically, self-acceptance among AWSLs was inversely associated with own psychological distress and the relationship satisfaction of spouses. Self-acceptance by spouses was inversely associated with the psychological distress of AWSLs and spouses. Perception of spouse acceptance by AWSLs was positively associated with own and spouse relationship satisfaction. CONCLUSIONS: Interventions targeting acceptance that incorporate a family systems perspective may be beneficial in alleviating psychological and relational distress among couples coping with sensory loss. Statement of contribution What is already known on this subject? The experience of hearing and/or vision loss has been linked to heightened distress both psychologically and within intimate relationships. Prior research has demonstrated a link between an individual's ability to accept their sensory loss and healthier well-being. What does this study add? This is the first dyadic study of sensory loss acceptance and its link to relationship satisfaction and distress. Acceptance operates interpersonally protecting against distress for those with sensory loss and their spouses. Perceiving that one's spouse accepts the sensory loss is important for both partner's relationship satisfaction.

Mental Health and Spouse Support Among Older Couples Living With Sensory Loss.

OBJECTIVES: The current study examined the mental health of couples living with and without sensory loss; compared the mental health of couples living with hearing, vision, or dual-sensory loss; and investigated the association between spouse support and the mental health of couples living with sensory loss. METHOD: The study included 513 couples with sensory loss and 1,079 couples without sensory loss. Actor-Partner Interdependence Models were used to examine associations between spouse support and mental health. RESULTS: Controlling for potential covariates, individuals with sensory loss and their spouses were at a greater risk of mental health problems. Sensory loss modality (hearing and/or vision) did not explain any differences. Both actor and partner effects of spouse support on anxiety and depression were found. DISCUSSION: The findings highlight the need to support the mental health of couples living with sensory loss and indicate the importance of considering the intimate relationship in future studies.

A relationship-focused investigation of spousal psychological adjustment to dual-sensory loss.

OBJECTIVES: The relationship intimacy model of psychosocial adjustment to illness indicates that a patient's willingness to communicate about their illness, as perceived by the spouse, is a strong predictor of spouse relational and psychological well-being. Inspired by the relationship intimacy model, the current study examined the psychological adjustment of spouses of individuals with dual-sensory loss (DSL), a disability where interpersonal communication is of particular concern. METHOD: Surveys were sent to all known individuals and their partners who were 50 years of age or older and were enrolled in services for acquired DSL in Denmark. A total of 65 spouses met the inclusion criteria of which 45 (69%) returned a partner survey. RESULTS: Results showed a significant association between couples' sensory loss-related communication, relationship satisfaction, perceived support and psychological well-being. Perceived support significantly mediated the association between couples' sensory loss communication and spouse psychological well-being. CONCLUSION: The current study's findings provide support for a relationship-focused perspective of spousal psychological adjustment in the context of DSL. Further, couples' sensory loss-related communication is presented as a potential intervention target to enhance spouse perceived support and psychological well-being.

Sensory loss and its consequences for couples' psychosocial and relational wellbeing: an integrative review.

OBJECTIVES: Previous research has shown that marital communication is key to couples' successful illness adjustment. However, little is known about couples' experiences of health conditions characterised by communication difficulties such as acquired hearing, vision, and dual-sensory loss. The aim of this review was to identify the effect of sensory loss, and associated communication difficulties, on couples' relational and psychosocial adjustment. METHOD: A systematic search was conducted to identify studies investigating the social, psychological, and relational impact of sensory loss on couples. RESULTS: Twenty-four articles met the criteria for inclusion in the review. Significant heterogeneity in the measurements and design of the quantitative studies prevented statistical data synthesis. All but two studies reported some effect of sensory loss on couples' psychosocial or relational wellbeing. Higher levels of marital satisfaction were found to buffer against adverse psychological outcomes. Results of quantitative and qualitative studies were synthesised to form an integrative model illustrating the associations between sensory loss and couples' relational and psychosocial wellbeing. CONCLUSIONS: Although this review reports an association between sensory loss and couples' relational and psychosocial wellbeing, the results should be viewed with caution given that relatively few studies on couples' experiences of acquired sensory loss exist, and many have methodological limitations.

Therapeutic horse riding improves cognition, mood arousal, and ambulation in children with dyspraxia.

OBJECTIVES: The objectives of this study were to evaluate the effects of the physical motion of a horse (riding therapy) combined with the audiovisual perception of this motion on a group of children with dyspraxia in terms of cognition, mood arousal, and gait variability. DESIGN: The study design was a pretest/post-test. SETTINGS/LOCATION: The study was conducted at the Fettercairn Youth Horse Project, Fettercairn, Tallaght, Dublin. SUBJECTS: Forty (40) children ranging from 6 to 15 years of age with a primary diagnosis of dyspraxia were the study subjects. INTERVENTIONS: Children meeting inclusion criteria participated in six 30-minute horse-riding sessions and two 30-minute audiovisual screening sessions. OUTCOME MEASURES: A Standard Progressive Matrices test (also known as the Ravens test) was used to measure aspects of general intelligence. A Childhood Depression Inventory (CDI) questionnaire was used to assess cognitive, affective, and behavioral signs of depression. A GAITRite Pressure Mapping System analyzed foot function and gait variability by measuring single and double support, cycle time, cadence, toe in/out, and stride length. RESULTS: Significant improvements were evident on the Ravens test and the CDI by the end of the study period. The amount of both single and double support required while completing the walking task also was significantly reduced. Improvements were visible on toe in/out values, cycle time, and cadence. Changes in stride length did not reach statistical significance. CONCLUSIONS: These findings support the theory that riding therapy and/or the perception of beat-based rhythms, as experienced by the rider on the horse, stimulates cognition, mood, and gait parameters. In addition, the data also pointed to the potential value of an audiovisual approach to equine therapy.