Keywords

1 Introduction

Visual impairment can be a hindrance to learning and participation in education and working life. This might lead to major personal problems and prevent people from becoming fully fledged members of society and working life. It is important to gain knowledge about how to facilitate participation for the visually impaired in various communities of practice during the life course. Communities of practice are defined as:

groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. (Wenger 2011)

The aim of the following study was to explore experiences of participation. One of the authors has a visual impairment and thus provides a unique experience on the topic. At the same time, he is a researcher, a politician, and an engaged family father. He has contributed with data to this study, while also being a co-researcher. Being an active partner in the study may represent challenges that will be thoroughly discussed in the method section (Shippee et al. 2013; Kylberg et al. 2018). We have chosen a narrative approach because this methodology is appropriate for studying the life course perspective where the researchers are co-creators (Patton 2015).

2 Background

Visual impairment often results in significant disability and is associated with a substantial economic burden, reduced quality of life, medical issues, and loneliness (Gordois et al. 2012; Khorrami-Nejad et al. 2016; Dhital et al. 2010; Brunes et al. 2019). A review from 2020 concludes that considerable data indicate a high prevalence of depression and anxiety among people with visual impairments (Demmin and Silverstein 2020). Visually impaired individuals’ experiences of unpleasant social situations or exclusion often result in insecurity, worry, avoidance, inactivity and social withdrawal, and depression (The Norwegian Association of the Blind 2023).

Access to text, literature, and e-books is important in order for the visually impaired to become full members of the community of practice. The national coordinator of accessibility of higher education in Norway and the Norwegian Library of Talking Books and Braille (NLB) have pointed to the fact that a large proportion of students have a disability that makes it difficult to read printed text or text presented in the form of images. Despite the increasing degree of digitalisation, there is very limited access to available digital versions of study literature that these students can make use of (The Norwegian Library of Talking Books and Braille 2017).

In a survey, carried out by the Swedish Council for Higher Education (2015), 17% of Swedish university students reported that they had a disability. Two-thirds of these students believed that the disability had hindered them in their studies. Among the students reporting impaired sight or hearing as their disability, half of the students found their disability to be an obstacle in their studies (Swedish Council for Higher Education 2015).

The Swedish Agency for Accessible Media (MTM) is responsible for supplying academic literature to college and university students with a reading impairment. University libraries are the link between MTM and the student. All students with a reading disability can contact their university library, order an adapted version of their course literature, and borrow it in the form of a talking book, braille book, or e-textbook (The Norwegian Library of Talking Books and Braille 2017).

In Norway, only students with visual impairment have the right to order adapted study literature from the library service, NLB, provided by the National Library of Norway. Students with other reading disabilities can only lend adapted literature that already exists in the library. A Norwegian research report shows challenges in the requirement for a universal design of digital teaching aids in the university sector. Legal, economic, practical, and knowledge challenges are described (Proba Research 2019).

Research has shown that study fields such as chemistry, physics, engineering, biology, and mathematics have not been made easily accessible to blind and visually impaired students (Sahin and Yorek 2009). To learn science and mathematics, other senses such as touching and hearing are needed. The researchers concluded that classrooms should be adapted, and instruction should be adjusted for better science teaching to visually impaired students. They needed more tactile and audio experiences than visual instruction.

Access to English curriculum literature is important in education in Nordic countries. The agreement through the Accessible Books Consortium (2023) enables the exchange of adapted literature between countries. This means that a book produced in an adapted version in one country can be used by people in the target group in another country. The agreement is based on the owner of the rights agreeing that a title can be exchanged. The owner of the rights could say no to exchange without providing any reason. This situation is resolved through the Marrakesh Treaty (2013). The treaty states that a person who, due to functional impairment, has difficulty reading printed text has right to access adapted literature from all countries that have ratified the treaty.

A systematic review on the effect of assistive technology on the employment of individuals with visual impairment found that access to, and utilization of, assistive technology can help break down barriers and enable employment for blind and visually impaired workers (Ganz et al. 2020).

A British researcher, French (2017), has provided a deeper understanding of visually impaired people, their working lives, and their experiences of employment. She interviewed those who have worked in traditional jobs such as telephony, physiotherapy and piano tuning, and those who had pursued more unusual occupations. She grouped them according to occupation and framed them in a broader political, economic, ideological, and cultural context. The stories became an important part of policy work to facilitate participation in work in a group with high rates of unemployment. The user perspective is important for developing health services in accordance with user preferences.

Knowledge about visually impaired people’s experiences of participation in education and working life is crucial to facilitate a health-literate environment. Health literacy is often defined on two levels: personal and organisational (Centers for Disease Control and Prevention 2020). Emphasis on health literacy at the individual and organisational level is of great importance for the visually impaired as the literature review shows that they have major challenges in participation in education and working life. Health literacy at both levels is paramount to reach the Sustainability Development Goal of good health and well-being (SDG 3), quality education (SDG 4), and reduced inequalities (SDG 10).

3 Theoretical Perspective

Theory about participation in the community of practice may give insight into visually impaired individuals’ experiences of education and working life regarding learning, meaning, and identity.

The importance of revealing the researchers’ underpinning thoughts and theoretical assumptions in narrative inquiry has been emphasized by Chase (2018). In this study, we considered a social constructivist approach to methodology and learning to be appropriate (Patton 2015; Wenger 2004), and a narrative approach was chosen (Patton 2015).

3.1 Learning

We have chosen “learning in communities of practice” as a theoretical framework in the interpretation of the storyline (Wenger 2004). Engagement in social practice is the fundamental process by which we know what we know and by which we become who we are. The theory explores the intersection of issues of community, social practice, meaning, and identity. Learning is a process of social participation and an encompassing process of being active participants in the practices of social communities and constructing identities. The communities of practice to which we belong change over the course of our lives.

Wenger (2004) states that in communities of practices, there are various types of trajectories: peripheral trajectories, inbound trajectories, insider trajectories, boundary trajectories, and outbound trajectories. Some trajectories lead away from communities, while others lead to becoming full participants in its practice. The trajectory has a coherence through time that connects the past, the present, and the future. A historical approach gives us ways of sorting out what is important, what contributes to our identity, and what is not important. Building identity is an ongoing process produced within a rich and complex set of relations of practice. Wenger (2004) describes identity as lived, negotiated, social, a learning process, a nexus, and a local-global interplay. The link between individual engagement and the formation of communities of practice is, according to Wenger, essential to a basic understanding of identity.

4 Aim

The aim of the study was to explore the visually impaired people’s experiences of learning and participation in education and working life by creating a narrative representing experiences from different phases of their life course.

4.1 Method

We used a qualitative design (Patton 2015) with a narrative approach (Brinkmann and Kvale 2015). According to Brinkmann and Kvale (2015), a narrative can be based on stories from one or more persons. In this study, we have chosen to use one participant. The purposive sampling was based on the participants’ unique experiences and insights in the field that was studied. His age, profession, and engagement in society gave rich and thick data. He had a position in the study both as interviewee and as co-author (Shippee et al. 2013; Kylberg et al. 2018).

4.2 Ethical Considerations

This study does not require ethical approval from the Swedish Ethics Authority because the interviewee is a co-author, but it requires informed consent (The Swedish Code of Statutes 2003:460 2005). We emphasized the building of reciprocal relationships and discussed our roles during the research process (Shippee et al. 2013). The interviewee has been involved in all parts of the research process—from the planning of the study to the published chapter. He has given a written consent to share his life story and experiences and to the use of personal data in the study and raised no objections from an ethical point of view. He has also given a written consent for the picture used in the analyses to be published. The interviewee was informed about his option to withdraw from the study without giving reasons.

The interviewee has generously shared his personal experiences, and we are aware that it can be perceived as burdensome (Kylberg et al. 2018). We have had a good dialogue about this throughout the research process, and he has expressed his satisfaction at being able to share his experiences and being a co-author. He has also expressed that he sees this contribution as very important for developing knowledge about a topic that is sparsely researched.

The project was carried out with the help of ethical guidelines according to the Declaration of Helsinki. This is a statement of ethical principles for medical research involving human subjects, including research on identifiable human material and data (World Medical Association 2013). The data were stored according to the Swedish Act on Ethical Review of Research Involving Humans (The Swedish Code of Statutes 2003:460 2005).

5 Data Material

We used different data sources to construct the narrative: a recorded radio interview, a private photograph, and individual interviews.

Radio Interview

The radio interview was conducted with the Interviewee in December 2012 at the International Disability Day where he talked about the exclusion disabled people have lived with throughout history (Swedish Radio—P4 Halland 2012). The interview was 4 min and 15 s long and is available online as an open-access resource.

Photograph

We used a photograph from 1998 taken in Berlin where the first author and the interviewee met at a conference on rehabilitation medicine. The photograph is from an evening event on the first day of the conference, in the beautiful ballroom in Das Rote Rathaus (the Town Hall). The event was held as an official welcome to the conference and a “get-together” for all the participants attending the conference. One common intention with these gatherings is that the participants meet in a relaxed manner and hopefully find new “research friends”—and thus expand their networks (Fig. 9.1).

Fig. 9.1
A photograph captures Larsson and Landstad holding wine glasses in their hands with several people in the background.

Larsson and Landstad, Berlin 1998. (Photo: Author’s own)

Full size image

Individual Interview

We interviewed one participant, Stig Larsson, three times in Spring 2023. He was born in 1943 with severe myopia (near-sightedness) but became increasingly visually impaired in his teens when he suffered from additional eye diseases. He is now almost completely blind and can only see (some) contours in the landscape. He is qualified as a professional social worker and qualified as a Doctor in Sociology in 1983. In 1992, he became a Professor in Social development and in 1997, Director of a Centre for Disability and Rehabilitation Research at Lund University in Sweden. When conducting this study, he was Professor Emeritus at the Department of Social Medicine and Global Health at Lund University.

We conducted three interviews via Teams in February and March 2023. The first two interviews were 2 h long, respectively, and the third was 1 h long. The first two interviews were carried out by the first and the second authors and, the third interview by the second author. All interviews were videotaped.

We used an interview guide with open-ended questions on childhood, adolescence, education, working life, and the future. The questions were about how visually impairment impacted participation in social life, education, and working life.

5.1 Analyses

When analysing the data, we used an inductive approach, with a focus on the narrative plot (Holloway and Freshwater 2007). First, we gained a holistic impression when looking at the photograph and listening to the radio interview and the informant interviews several times (Brinkmann and Kvale 2015). Meaningful units were identified and coded in relation to childhood and the period of adolescence, study time, working life, and plans for the future, all guided by narrative theory. By using a narrative approach (Holloway and Freshwater 2007), focusing on content, form, and context in the storyline of the interview, themes were identified for each phase, and the story was subsequently organized into a chronological structure (Patton 2015). Themes were created by organising the data into increasingly more abstract units. When analysing, we worked back and forth between the data and the themes until we had a comprehensive understanding of the data (Creswell and Creswell 2018). The interviewee, who also was a co-author, made significant contributions throughout the entire research process. Different professional backgrounds were important in the research group when interpreting relevant themes. Discussions between researchers were significant in developing an understanding of the narrative itself (Wertz et al. 2011).

6 Results

The narrative explains learning and participation during the life course: learning in communities of practices during childhood and youth, and outsiderness in education and working life. The narrative also contains findings about challenges and how to strengthen learning and participation in education and working life in the future.

6.1 Learning in Communities of Practice During Childhood and Youth

Stig enjoyed school and had a good relationship with his teachers. “One trick was to sit at the front of the classroom … It made it easier to follow the lessons”. He also had lots of friends and did not identify himself as being visually impaired—that came a lot later in life. “I have always had a positive self-image and never felt that my parents have treated me differently from my siblings. My lack of sight was not a topic ...”.

Stig said that during his early school years, he wore very strong reading glasses and could see quite well with them. The biggest concern was around whether he might accidentally break the spectacles because they were expensive, as it would take a long time to procure a new pair. He participated in various sports and was strongly committed. However, he said, laughing, “I was not the first to be selected for the football team—I had no idea where the ball was”. This did not bother him at all, as he was able to assert himself in other sports. He also started a sport club together with other boys in his hometown.

At the age of 15 to 16, a blind consultant employed by the regional authority visited his family after he had undergone acute eye surgery on three separate occasions. The blind consultant suggested that he should start adaptation courses at a special school for the blind to prepare for possible blindness in the future. He was sent to boarding school, which was almost 500 km from home, at the age of 17. Eight boys started in a class together and Stig reported that he enjoyed being in this small group together with the others. At boarding school, he learned braille. Stig stated that he has used braille to a small extent during his life, but that he is considering retraining as his residual vision has now disappeared.

At the school for the blind, Stig explained that visually impaired students were required to participate in an aptitude test. It was common at the time to train the visually impaired to become metal workers. It was, however, suggested that he should study at university to become a social worker. Against this background, the choice of profession seemed to be rather random. It transpired that a teacher at the school happened to know a blind person who had become a social worker. “We are talking about coincidences here ..., but it turned out well for me. I enjoyed myself at university, and my later work as a social worker was perceived as meaningful”. Stig confided that he always has had a huge interest for mathematics and statistics, but that it was almost impossible for him to read literature that included formulae, tables, and figures because speech synthesis did not support these formats. “Not that I have regretted anything, but had the opportunity been there, I would have probably chosen differently and become a natural scientist ...”.

6.2 Outsiderness in Education and Working Life

Outsiderness was a recurrent theme in Stig’s experiences of participation in various social communities. He talked about existential issues in relation to family life, experience of nature, participation in education and working life, and participation in society.

One should not forget that vision is the dominant sense for obtaining information from the environment. In many respects one is outside if blind. This is difficult for a sighted person to understand. The emptiness that one might feel as blind ... I haven’t dared to take this on yet. Just think what I’m missing out on. The grandchildren’s smiles ….

He stated that visual impairment has affected him in a number of ways. He was hindered from participating in following his children’s interests, as well as housework, gardening, watching art and movies. He said that he became dependent on his wife regarding practical work and participating in working life. It was a great loss that eventually, he could no longer experience nature. “I would like to be a botanist—to be out in nature much more, but it is difficult”.

Stig stated that there was a lack of adapted literature for blind and visually impaired available for both studying and working life. For a long time, he relied on his strong glasses and helped himself by using a magnifying glass. Later on, he got help through speech synthesis on the computer when reading scientific books and papers. He said that his visual impairment probably meant that he tried to adapt early by using the computer as an aid—much earlier than most of his seeing student mates and colleagues did, or indeed, needed to.

Stig reported that he always has been engaged in different organisations related to politic, history, culture, sport, environment, international development, and with questions related to user participation in the health services and in society at large. He is strongly involved in the National Association of the Visually Impaired in Sweden at regional and national levels. Laughing, he said: “More than 40 memberships in different groups and organisations might be a bit too much—and quite expensive”.

Stig told that he has a high level of social awareness, working for equal conditions, and with issues that deal with sustainability and peace. Moving these issues forward through research has been important for him. After working 10 years as a social worker, he explained that he and his department took the initiative for a development project that resulted in a book. The book had great impact and shed light on various black businesses in society (prostitution, money laundering, and illegal alcohol sales). It rolled on with various projects, and then he was offered a position as a doctoral student in sociology.

Stig’s experience is that no provision has been made for his visual impairment in working life. He became a project manager in various projects and used project money to hire a secretary who took care of the administrative work. “This has come at the expense of not having the money to employ doctoral students within my projects. I have not been given the opportunity to supervise doctoral students as much as I would like. I had to choose between employing administrative help or doctoral students”. The only arrangement he can recall having from the employer was that he was allowed to be accompanied by his wife when attending international conferences.

Stig experienced problems in specially prepared books for the visually impaired in the dissemination of statistics and tables. Statistics and tables are often presented in an unsatisfactory manner. He stated that this makes it difficult to understand the data, as you must get an overview of certain areas of information only found in tables. He described it like this:

It takes an enormous amount of concentration and energy to get through a table, so I often give up. In other words, it is not just about reading the contents of a table—the reader must ‘understand’ the data and the analyses that the table tries to convey.

Stig considered this as a serious obstacle for visually impaired individuals when trying to participate in science and statistics.

At some conferences, however, he told that he had been offered an on-site companion at the conference. These were usually conferences aimed at research on disabled people. Digital conferences and meetings are extremely difficult to attend. He explained it like this:

You can’t listen to a presenter, at the same time as the presenter is showing power points, and these are read through speech synthesis, at the same time that there is a moderator, and at the same time that there is a chat function that you should use if you want to ask questions ... Then you have to have a screen reader for the power points and a screen reader for the chat function—as well as to hear the presentation from the lecturer and the moderator. This can be compared to a digital cacophony of voices talking at once ... There are no good solutions for this so far.

He reflected that people with disabilities have always been outside society and unable to participate in various activities. “Nowadays, exclusion is mostly on a symbolic level”. He said that he often experiences outsiderness—also as an academic—especially when attending an international research conference and participating in various social settings. Before the photograph was taken (see Sect. 9.5), the first author found Stig standing alone in a corner. “When you’re standing alone as an outsider in a crowd of people—with a glass of wine, I can’t mingle like I’m supposed to at a reception at a research conference. I don’t recognize anyone”.

The photograph was taken after Stig and the first author met. The image expressed experiences of mutual engagement, joy, and cohesion between research colleagues. “This is what acknowledgement and participation in a community of research-practice is about”.

Stig has contributed to developing many research fields in both Sweden and internationally. His large production of books and articles documents this. He stated that his research has led to changes in the legislation in Sweden.

6.3 Challenges and Opportunities for Participation in Education and Working Life

Stig stated that, paradoxically, the IT revolution has given people with visual impairments access to lots of material previously hidden from them. Despite that, this information explosion has made it difficult for them to find information quickly. The wide range of information and resources and the difficulty in finding the right information is perceived as problematic. “There are so many clicks and little boxes to deal with …”. He continued:

We can access information online but navigating all these systems is hugely time-consuming. The problem with the screen reader is that it reads everything out. To find a link, for example, you have to listen to the entire text before you get to the information you are looking for. This can take an infinite amount of time.

Stig stated that changes happen so quickly that it is often not worth taking the time to learn how to navigate different systems and webpages. Social media can be difficult to use. Much of the content alludes to images, and Stig said that it is difficult to get good illustrations from visual interpretation of images, not human nor AI interpretation. “Much has happened in the last 10 years, but there is still a long way to go”.

Stig reported that lack of individual guidance of various resources and systems is pervasive. There is a need for organisational health literacy to facilitate learning and participation in study and working life. This to enable visually impaired individuals to find, understand, and use information to be active participants in their community of practices. Stig conveyed that there is a need for individual guidance at different levels. This applies to both use and access to digital learning resources and study materials. Follow-up over time and, especially when new solutions are presented, is crucial.

Stig reported that there is a need for adaptation in study literature in books that are read aloud, for example, with regard to page numbers in books and journals. The user needs to be able to navigate the text and also refer to page numbers. Stig told that another problem is that a book which is read aloud has page numbers which do not always correspond exactly with the printed book. In research, it is essential that you can state exactly where you have taken citations from. In e-pub production, page numbers are also often missing, and this is problematic too. It is usually specialist libraries that produce adapted literature. Many books are read by commercial publishers who do not use editable audio files.

Scarce resources in specialist libraries can lead to them using books from commercial publishers rather than producing specially adapted literature for the blind and visually impaired. This can, in turn, lead to a reduced supply of adapted literature which is specifically designed for the end user, rather than books produced for profit.

Various ways of gaining access to adapted literature were mentioned. He could submit a request to a library to have certain literature adapted. He reported that this often takes a long time—up to several months. This impacts his work as a researcher, being able to write a manuscript and meet deadlines. A lack of communication between the library and the users was experienced. Information about if, and when, the book or article would be read was missing. Stig reported that this could be an obstacle to the process of studying and carrying out research. He often contacted the researchers directly and asked for access in Word format. Doing so enables him to then use speech synthesis.

7 Discussion

The study provides new and valuable insights into visually impaired individuals’ experiences with learning and participation in education and working life. Rich and thick data were obtained. Stories from childhood, youth and education, and working life gave unique findings about learning and participation in different communities of practices for the visually impaired. The interviewees’ knowledge and commitment contributed to him being able to convey his own and others’ experiences on the topic. A research group with different professional backgrounds was important in the analytical process to create the narrative. This was important for validating the findings (Brinkmann and Kvale 2015). We consider the findings to have transferability to other visually impaired in other countries that have similar educational systems.

The findings show different forms of learning and participation and ways of coping in school and working life. During childhood and youth, good relationships with teachers and fellow pupils were of great significance for positive learning outcomes. Inadequate arrangements in education and working life were described, which resulted in a feeling of outsiderness. Participation in science was particularly challenging, and the choice of profession became limited and random. Individual guidance in the use of digital resources is paramount when attempting to improve full participation in education and working life. There is a need to strengthen specialist competence in the provision of learning resources in order to eliminate barriers to reduce inequalities (SDG 10) and to promote good health and well-being (SDG 3) for the visually impaired.

The interviewee talked about participation in inbound trajectories in childhood and youth. That means that newcomers are joining the community of practice with the prospect of becoming a full participant in a sociocultural practice (Wenger 2004). With the help of strong glasses and good relationships with the teachers and other students, the learning environment was beneficial. His participation in social contexts gave him self-confidence, and he experienced belonging to a community of practice. School was meaningful, and he experienced a mutual engagement in actions. These are, according to Wenger (2004), important elements in becoming a full participant in the community of practice.

The narrative shows that lack of learning resources might prevent visually impaired from choosing education within science. Earlier research has shown that adopted literature in science has not been accessible to blind and visually impaired students (Sahin and Yorek 2009). This may vary between countries, but it is worrying if visually impaired are excluded and discriminated in participation in science. The lack of adapted learning resources and specialist literature for the visually impaired may lead to outbound trajectories towards another community of practice (Wenger 2004).

In education and working life, we found that the environment had a great impact on choices regarding education and working life. Our study shows that the environment may influence what to study and career choices. New relationships and interests may be developed. The interviewee had an interest in science but found another position with respect to the community of practice, changing his identity when becoming a social worker. By becoming a researcher, the interviewee fulfilled his academic ambitions. Wenger (2004) points out that this could be due to various types of trajectories. The study shows coherence through time and connects the past, the present, and the future.

Difficulties in attending digital conferences and meetings were revealed. Attending a digital conference could be experienced as a digital cacophony for the visually impaired as the tools employed were not well coordinated. A study has found that technical systems, such as professional and office systems, are not universally designed (Halbach et al. 2022). Digitalisation opens for increased accessibility if the digitalisation is carried out with a universal design. It seems that a universal design is deficient in both universities and workplaces. Young students who are introduced to new subjects are particularly vulnerable when it comes to insufficient learning resources and a lack of adapted literature. This may lead to outbound trajectories. Participation is a complex process that combines doing, talking, thinking, feeling, and belonging (Wenger 2004). It involves the whole person: it is an active process. It may pose enormous problems when different digital resources are not coordinated.

The narrative demonstrates that the interviewee’s participation in education and working life was hindered by obstacles which had major consequences. He experienced outsiderness in a range of different situations. This is in line with earlier research from the United Kingdom (Bishop and Rhind 2011). The interviewee had to make different career choices than those he originally wanted. His participation and “belonging” in social relations also became limited. His academic life was therefore limited, and he had to adjust his academic plans. This came with a personal price. He had to use family and private resources to assist him to be able to participate in academic activities normally expected of a professor.

The narrative highlights discrimination and inequality which can occur in education and working life for visually impaired. Reduced inequalities (SDG 10) and decent work and economic growth (SDG 8) for all are important Sustainability Development Goals. It seems that there is a lack of quality in education (SDG 4) for the visually impaired. Health-literate environment has to be strengthened throughout the life course to obtain good health and well-being (SDG 3). Ensuring environmental support throughout the life course is paramount. Individual and organisational health literacy must be developed on the user’s own terms in education and working life.

7.1 Strengths and Limitations

The narrative is a construction of events and activities (Flick 2017). The authors have been co-creators in constructing the narrative. Wenger’s theory about learning in a community of practices (2004) has been an underpinning framework. The interviewee has been an active participant in the research process and has given suggestions for how to analyse the narratives. He added in-depth knowledge that influenced the design of the interview guide, and he influenced us to choose a user perspective in the study. His last comment on the result section was as follows: “I am impressed by your ability to summarize and to catch important perspectives of my narrative during the interviews” (E-mail correspondence May 27th, 2023). His feedback is a kind of validation of the findings (Brinkmann and Kvale 2015).

The researchers have different academic positions such as social science, health science, sociology, and language and linguistic with special competence in the preparation of literature and learning resources for the visually impaired. These different competences were important in the analyses of the different data sources as well as the presentation of the results.

In this study, we chose to interview one, sole, interviewee. The data were rich and thick (Flick 2017) throughout their lifespan. The narratives can be understood as a historical and biographical narrative; however, we created a narrative about learning and participating in education and working life. The interviewee, of course, has his own historical perspective; he is still an internationally recommended researcher at Lund University.

It may be seen as a weakness that we only have one interviewee. In this study, we consider it as a strength because it presented an opportunity to gain in-depth knowledge about learning and participation. The interviewee’s age, knowledge, experience, and commitment provided unique data from a life course perspective. In the discussion section, we compare the interviewee’s narrative with earlier research in the field. This was the way in which we validated our findings.

8 Conclusion and Relevance to Clinical Practice

The study provides new insights into the visually impaired people’s experiences of learning and participation in education and working life. It appears that the visually impaired are often discriminated against, and experience inequalities in the important spheres of education and working life. Visually impaired individuals do not have access to the adapted resources which they need to be fully integrated in society and to live full, and fulfilling, lives.

Implications for Practice

  • Coping and participation in school and working life is important for good health and well-being.

  • It is crucial to improve participation and increased access to learning resources for the visually impaired.

  • Visually impaired individuals’ health literacy needs to be developed at individual and organisational levels on their own terms.

  • Access to personal guidance is vital for coping with rapid development in digitalisation and preventing outsiderness.

  • There is a need to strengthen expertise in special libraries in adapting literature for education and research.

  • Universal design in digital resources globally is paramount.

  • Global partnerships are important in adapting learning resources for the visually impaired in an effective and sustainable way.