1. AER International Conference 2010 Amy R. McKenzie, Ed.D. & Susan Miller Smedema, Ph.D., CRC Florida State University 1

2.  Terminology  Prior Research  Methodology  Results  Implications & Recommendations The authors kindly request that attendees not distribute the contents of this presentation, as a manuscript based on the study has been submitted for publication. 2

3. Quality of Life  is “individuals’ perceptions of their position in the context of the culture and value systems in which they love and in relation to their goals, expectations, standards, and concerns” (World Health Organization, 1995, p. 1405)  is one of the most important outcomes related to disability service provision (Bishop, Chapin, & Miller, 2008) 3

4. Subjective Quality of Life  is the measure of one’s feelings about his or her life situation; overall and in various life domains  often includes the measurement of sense of well-being, life satisfaction, and depressive symptoms  matches the subjective nature of the WHO’s definition of QOL 4

5. In the field of visual impairments, social support and well-being have been investigated with focus on their relationship with:  perceived overprotection (Cimarolli, 2006; Cimarolli, Reinhardt, & Horowitz, 2006; Cimarolli & Wang, 2006)  employment (Cimarolli & Wang, 2006)  life goals (Boerner & Cimarolli, 2005)  life changes (Boerner, Wang, & Cimarolli, 2006),  adaptation of vision loss (McIlvane & Reinhardt, 2001; Reinhardt, 1996; Cimarolli, Reinhardt, & Horowitz, 2006)  frequency and type of internet use (Smedema & McKenzie, 2010) 5

6. The current study is a partial replication of Cimarolli & Boerner’s (2005) investigation of the link between psychological well-being of 86 adults with visual impairments in the New York metropolitan area and positive and negative social support. However, differences include national recruitment, larger number of participants, the use of regression analysis, measurement of percieved social support on a continuum (rather than positive vs. negative) and the measurement of specific sense of well-being factors through an additional scale. 6

7.  191 adults with visual impairments  Mean age – 46.1 years (SD = 14.8)  38.7% male and 61.3% male  85.9% Caucasian, 4.0% African American, 5.5% Latino/Latina, 1% Native American, 3.5% Asian American  48.7% married, 35.2% single, 11.6% committed but unmarried, 4.7% divorced  17.1 average hours of employment; 45.2% unemployed; 15.1% attending school 7

8. Visual Acuities  49.7% - NLP  10.1% - LP  3.5% - CF  8.0% - 20/600-20/800  11.0% - 20/400-20/600  17.6% - 20/80-20/200 8

9. Etiology  27.1% - Retinopathy of Prematurity  14.6% - Retinal Disorders  Retinal detachment, retinoblastoma, and Lebers  10.1% - Neurological Conditions  ONH, Septo-optic dysplasia 59.8% were congenitally visually impaired 9

10. Lubben Social Network Scale – 6 (LSNS – 6)  Measures perceived social support received by family and friends  Participants are asked questions such as “How many of your friends do you see or hear from once a month?”; responses are on a 5-point scale  Cronbach’s alpha:  LSNS-6 authors -.83; Current study -.85 10

11. Center for Epidemiologic Studies Depression Scale – 10 (CES-D-10)  Measures depressive symptoms; higher scores indicate greater levels of depression  Participants indicate how often in the previous week they experience each of 10 symptoms using a 4-point Likert scale  Cronbach’s alpha:  CES-D-6 authors -.84; Current study -.92 11

12. Satisfaction with Life Scale (SWLS)  Measures global life satisfaction; higher scores indicate greater life satisfaction  Participants are asked to use a 7-point scale to indicate the extent to which they agree with five items – “In most ways my life is close to ideal.”  Cronbach’s alpha  SWLS authors -.87; Current study -.91 12

13. Sense of Well-Being Inventory (SWBI)  Measures subjective well-being in individuals with disabilities  Participants are asked to rate their level of agreement with 36 items using a 4-point Likert scale – “I get frustrated about my disability” – in five different subscales  Physical, psychological, financial, family and social, and medical 13

14. Sense of Well-Being Inventory (SWBI)  Cronbach’s alpha:  SWBI authors:.88,.83,.72,.79, and.62  Current study:.88,.83,..82,.77, and.76 14

15.  FSU IRB approval was obtained  Participant recruitment occurred via listserv and online forums used by adults with visual impairments (46) as well as an announcement placed in an online newsletter  The study was conducted through the use of an online survey, for which accessibility of screen reading programs was tested prior to distribution 15

16.  Bivariate correlations for all measures in the study were calculated using Pearson’s r values.  Hierarchical regression analysis was used to calculate the relationship of perceived social support and well-being variables (depression, life satisfaction, sense of well-being factors), controlling for demographic and disability variables (age, employment, visual acuity, visual field restriction, and age of disability onset), 16

17.  Overall, it is interesting to note that disability characteristics, such as visual acuity, were not significantly associated with levels of depression, life satisfaction, total sense of well-being, or social support.  Social support was significantly associated at the p<.001 level with all well-being variables in the predicted directions (negatively with depression, positively with life satisfaction and total sense of well-being) 17

18. CES-D  Overall model was significant (R² =.25, p<.001)  Age – Significant negative association (β=-.22, p<.01) ▪ As age increased, depressive symptoms decreased  Social Supports - Significant negative association (β=-.44, p<.001) ▪ Lower levels of social support were associated with higher levels of depressive symptoms 18

19. Comparison of Results  Comparative to McIlvan & Reinhardt, 2001; Reinhardt, 1996  Cimarolli & Boerner (2005) found individuals with the least amount of social support have higher levels of depressive symptoms  Like Cimarolli & Wang (2006), no significant associations were found with employment 19

20. SWLS  Overall model was significant (R² =.21, p <.001)  Age – Significant positive association (β=.13, p<.05) ▪ As age increased, life satisfaction increased  Employment – Significant positive association (β=.17, p<.05) ▪ As employment levels increased, life satisfaction increased  Social Support - Significant positive association (β=.40, p<.001) ▪ As levels of social support increases, life satisfaction increased 20

21. Comparison of Results  Cimarolli & Wang (2006)  Association between employment and SWL  McIlvan & Reinhardt (2001) and Reinhardt (1996)  Association between social supports and SWL  Cimarolli & Boerner (2005)  Lowest levels of SWL were found in participants with only negative social support 21

22. SWBI  Medical well-being was the only domain in which the model was not significnat  After Bonferroni correction, p=.19 22

23.  Physical Well-Being  Model was significant (R 2 =.25, p <.001)  Significant positive associations were found with employment (β=.16, p<.05) and social support (β=.46, p<.001)  Psychological Well-Being  Model was significant (R 2 =.18, p <.001)  Significant positive associations were found with age (β=.16, p<.05) and social support (β=.38, p<.001)  McIlvane & Reinhardt (2001) found a similar association with social support 23

24.  Economical Well-Being  Model was significant (R 2 =.27, p <.001)  Significant positive associations were found with age (β=.14, p<.05), employment (β=.40, p<.001), and social support (β=.26, p<.001)  Family and Social Well-Being  Model was significant (R 2 =.42, p <.001)  Significant positive associations were found with age (β=.14, p<.05), employment (β=.14,p<.05), and social support (β=.61, p<.001) 24

25.  Due to the correlational nature of the study, it is not possible to determine causality  Population of participants did not reflect the general population of adults with visual impairments  WHO: 14.2% of individuals with VI are blind  Similar participant characteristics were found by Smedema & McKenzie (2010) when using similar participant recruitment methods for a different study 25

26. Online method of data collection  Advantages  Expanded participant pool and automated data collection  Studies have cited similar results when comparing web-based and paper-pencil test format (specifically the CES-D)  Weaknesses  Self-reporting of demographics and data  Individuals who choose to participate may be inherently different than those who did not 26

27. Implications for Future Research  Investigation of the relationship between the number of individuals who are blind, e- mail/Internet use, and online studies  Inclusion of open-ended data collection to evaluation of the quality of social supports  Expand the population of participants in the study  Recruitment through non-Internet based resources 27

28. Implications for Practice TVIs and O&M Specialists Working with Children  Focus on social skills instruction to ensure that adults have the skills to achieve adequate social support 28

29. Implications for Practice VRTs and O&M Specialists Working with Adults  Focus on social skills training that assists in developing and improving interpersonal skills  Assists in making and keeping friends and romantic partners  Ability to take advantage of resources with in the community 29

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