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Assistive Device Use in Visually Impaired Older Adults: Role of Control Beliefs

Correspondence: Address correspondence to Hans-Werner Wahl, PhD, German Center for Research on Ageing at the University of Heidelberg, Bergheimer Str. 20, D-69115 Heidelberg. E-mail: wahl{at}dzfa.uni-heidelberg.de

Purpose: We investigate whether psychological control, conceptually framed within the life-span theory of control by Heckhausen and Schulz, drives assistive device use in visually impaired elders. In particular, we expect the two primary control modes differentiated in the life-span theory of control (i.e., selective primary and compensatory primary control) to be positively related to assistive device use. We present cross-sectional as well as repeated measures analyses. Design and Methods: We assessed a sample of 71 participants (age, M = 79.5 years) suffering from age-related macular degeneration at two measurement occasions covering a 1-year interval. In addition to the application of a standardized control questionnaire based on the life-span theory of control distinctions of different control modes, we measured assistive device use as the reported number of devices used, based on a given list. Results: On the bivariate level, we could find the theoretically expected relation between selective primary control and selective compensatory control only for the analyses at Time 1. We used multiple regression models to acknowledge overlapping variance beneath the different control modes; we did this separately for both measurement occasions. Consistent with our expectation, we found selective primary control to be a significant predictor of assistive device use at Time 1, whereas after a 1-year period of disease progression, compensatory primary control took over at Time 2. Implications: Findings provide empirical support for the assumption that educational programs related to assistive device use in visually impaired elders also should take psychological control issues more strongly into consideration.

Key Words: Age-related low vision • Age-related macular degeneration • Assistive device use • Control theory • Psychological factors