Support for Older People With Vision Impairment: A Rapid Realist Review

Abstract

Background: Vision impairment among older adults is a significant public health issue impacting their physical and mental health and overall quality of life. However, access and navigation of support services are inconsistent and lacking. Recognising the need to gain insight to improve access to services in this population, this review aimed to understand how, why, for whom, to what extent and in what context the provisions for care and support for older people with vision impairment worked.

Methods: A rapid Realist review was undertaken. Six databases (Cinahl, Cochrane Library, PubMed, Social Services Abstracts, Sociological Abstracts and Sociology Collection) were searched. The review followed the RAMESES Quality Standards for Realist Synthesis and retrieved documents were screened systematically to identify relevant papers. The papers were analysed through iterative and simultaneous use of coding, consolidating and conceptual mapping process to develop a Realist programme theory. Project Advisory Group members contributed to the processes. The Realist review was conducted from July 2023 to July 2024.

Results: Ninety-one documents were reviewed and analysed. Novel insights into the provisions of care and support for older people with vision impairment were presented through seven interconnected components: Developing condition literacy, acceptance of the condition and readiness for help, timeliness, access to services, relationships, positive care trajectory and professional knowledge. All contributed to the development of the Programme Theory.

Conclusion: The Programme Theory explained why and for whom the services worked, while limited information was found in terms of how and when the services were accessed. The key components identified around the Programme Theory were complex and interconnected in nature, underscoring the importance of a systems approach to effective service provision for older adults with vision impairment. Literature gaps were identified for further exploration in a Realist evaluation.