Exploring the perceptions and stigmatizing experiences of Israeli family caregivers of people with Parkinson's disease

Exploring stigma in people living with Parkinson's disease and their caregivers: A review of qualitative studies

Background: Stigma deeply affects individuals living with Parkinson's disease (PD), increasing the challenges of this frequent progressive neurodegenerative disorder. Objective: This systematic review synthesized qualitative studies to explore how stigma is experienced by people living with PD and their caregivers. Methods: A systematic search from four databases identified international qualitative literature on different dimensions and impact of stigma in PD. Results: Following abstracts and full papers screening, 22 studies published between 2004 and 2024 were included. Using thematic synthesis approach, the review revealed three primary themes: (1) living with self-stigma, characterized by feelings of vulnerability, shame and efforts to conceal symptoms, (2) living with public stigma, marked by societal exclusion, misconceptions, and stereotyping, particularly regarding visible symptoms and age, and (3) living with structural stigma, involving discrimination in workplaces and inadequate institutional support. Conclusions: These findings provide a comprehensive understanding of stigma's multifaceted impact, offering insights to design effective strategies that foster awareness, challenge misconceptions, and create a more supportive and inclusive environments for individuals living with PD.

Impact of general population stigmatization toward marriage in patients diagnosed with multiple sclerosis: a cross-sectional study

BACKGROUND

Multiple Sclerosis (MS) is a long-term condition affecting the central nervous system that typically manifests in young adults. Stigma poses significant psychosocial challenges for patients with MS, negatively impacting their personal and social lives. However, limited research has examined how MS-related stigmatization influences marriage. This study focused on unmarried individuals aged 20-40 years in Iran to determine the prevalence of societal stigma and their willingness to marry someone with MS.

METHODS

A researcher-designed questionnaire was used to collect data from 343 unmarried individuals in a cross-sectional study. In-person interviews were conducted to assess participants' overall understanding of MS and their views on marrying someone with the condition. The questionnaire measured sociodemographic variables and the degree of stigmatization toward MS by including concerns related to marriage with MS patients and their families.

RESULTS

Data were collected from 343 participants (53% female), with a mean age of 25.96 ± 6.05 years. Overall, 77.6% expressed reluctance to marry someone diagnosed with MS-primarily due to concerns about physical disabilities. Additionally, 47.2% were hesitant if a potential spouse's parent had MS, while 46.6% and 28.4% reported similar reservations regarding siblings and second-degree relatives, respectively. Participants employed in healthcare fields demonstrated significantly lower levels of stigma (p = 0.031). Younger individuals tended to hold more stigmatizing views (p = 0.04), and significant variations were also observed across different ethnic groups (p < 0.001).

CONCLUSIONS

This study contributes to a more nuanced understanding of the social consequences of MS by providing valuable insights that can inform the development of strategies aimed at mitigating societal stigma. By enhancing awareness and promoting supportive interventions, it is possible to cultivate an inclusive environment that not only improves the quality of life for those affected by MS but also reduces stigma across various social contexts, including interpersonal relationships and marital dynamics.

Concealment of Parkinsons disease prevalence and impact on health and quality of life

Concealment of diagnosis in chronic conditions has proven benefits as a coping strategy to avoid stigmatization and discrimination and allows people to be treated "normally" by society. However, concealment is related to negative health, physical, quality of life outcomes, exhaustion and loneliness. In addition, diagnosis concealment has a detrimental impact on self-management behaviors. In Parkinson's disease (PD), information regarding the aspects related to concealment is limited. A better understanding of the contributors and consequences of concealment in PD may facilitate the development of strategies to support patients who conceal. We conducted a cross-sectional study to explore concealment in PD by examining rates of diagnosis concealment and associations of concealment with socio-demographic factors, self-management behaviors, stigma, social support, and quality of life. The study was conducted at an outpatient movement disorders clinic or at the participant's home, at the participant's preference. One hundred and fifty people with PD completed questionnaires assessing disclosure of their diagnosis,  socio-demographic variables, disease severity, self-management behaviors (knowledge, activation, exercise), stigma, social support, and health-related quality of life (HRQoL). Differences between disclosers and concealers were analyzed and associations between disclosure, stigma, social support and emotional aspects of HRQoL were tested using mediation models. Close to one-quarter (22.7%) conceal their PD diagnosis from their family. Concealers were more often women, Muslim, religious, and lacking academic degrees compared to disclosers. Concealers also had lower patient activation, and less social support. They engaged less in physical activity and experienced greater stigma. Concealment had a significant total effect on lower emotional aspects of HRQoL, mediated by greater stigma but not by social support. Healthcare providers should be attuned to both the prevalence of PD diagnosis concealment and its detrimental impacts on patients' emotional support needs and facilitation of health behaviors. Moreover, treating neurologists should deliver diagnoses carefully, discuss disclosure consequences, maintain open dialogue on concealment, and advise informing family. Interventions targeting stigma reduction in this population may have downstream benefits for emotional aspects of HRQoL.Trial registration: NCT05209698; Registration Date: 23/1/2022.

Exploring the stigma experienced by people affected by Parkinson's disease: a systematic review

BACKGROUND

Stigma significantly impacts individuals with Parkinson's disease (PD) and their caregivers, exacerbating social isolation, psychological distress, and reducing quality of life (QoL). Although considerable research has been conducted on PD's clinical aspects, the social and emotional challenges, like stigma, remain underexplored. Addressing stigma is crucial for enhancing well-being, fostering inclusivity and improving access to care and support. The review aims to fill this knowledge gap by synthesising existing literature on PD stigma, examining its effects on individuals and families affected, and identifying areas where interventions could reduce stigma's impact.

METHODS

This systematic review was conducted following Joanna Briggs Institute guidance. Studies were identified through searches in six databases, relevant websites, and reference lists. Covidence was used for duplicate removal, screening, and data extraction. Thematic analysis identified key themes from qualitative data, while narrative synthesis integrated findings from qualitative and quantitative studies. The review protocol was registered on PROSPERO (CRD42023399343).

RESULTS

This review included 22 studies published between 2002 and 2024, using both qualitative and quantitative methodologies. Five key themes emerged. The first highlighted stereotypes in PD, such as misconceptions about symptoms, age stereotyping, and supernatural beliefs. The second explored drivers and facilitators of stigma, identifying factors like duration since diagnosis, disease severity, lack of public education, and media representation. The third theme revealed stigma's impact on mental health and well-being, exacerbating feelings of shame, embarrassment, and social isolation. The fourth, responses and consequences of stigma, detailed strategies employed by individuals with PD to manage stigma, including seeking social support and adopting coping mechanisms. The fifth theme, beyond stigma, explored positive aspects of living with PD, highlighting resilience, positive interactions, and advocacy efforts.

CONCLUSION

This systematic review underscores the significant impact of stigma on individuals with PD and their caregivers, manifesting as social isolation, diminished QoL, and psychological distress. Key drivers include public misconceptions, cultural biases, and limited awareness and addressing these challenges requires targeted interventions. Recommendations include education to dispel myths, public awareness campaigns and advocacy efforts to reduce stigma, enhance support, and improve QoL.

Enhancements in Parkinson's Disease Management: Leveraging Levodopa Optimization and Surgical Breakthroughs

Parkinson's disease (PD) is a complex neurological condition caused due to inheritance, environment, and behavior among various other parameters. The onset, diagnosis, course of therapy, and future of PD are thoroughly examined in this comprehensive review. This review also presents insights into pathogenic mechanisms of reactive microgliosis, Lewy bodies, and their functions in the evolution of PD. It addresses interaction complexity with genetic mutations, especially in genes such as UCH-L1, parkin, and α-synuclein, which illuminates changes in the manner dopaminergic cells handle proteins and use proteases. This raises the improved outcomes and life quality for those with PD. Potential treatments for severe PD include new surgical methods like Deep Brain Stimulation (DBS). Further, exploration of non-motor manifestations, such as cognitive impairment, autonomic dysfunction, and others, is covered in this review article. These symptoms have a significant impact on patients' quality of life. Furthermore, one of the emerging therapeutic routes that are being investigated is neuroprotective medicines that aim to prevent the aggregation of α-synuclein and interventions that modify the progression of diseases. The review concludes by stressing the dynamic nature of PD research and the potential game-changing impact of precision medicines on current approaches to therapy.

The antecedents and consequences of stereotype threat in Parkinson's disease

OBJECTIVE

The aim of this study was to examine what factors make people with Parkinson's disease more susceptible to stereotype threat (i.e., the concern of being evaluated in line with negative group-based stereotypes) and the clinical consequences of this.

METHOD

Forty-nine people with Parkinson's disease completed a measure of stereotype threat, as well as measures that indexed potential antecedents and clinical consequences of stereotype threat.

RESULTS

Younger age and greater communication difficulties emerged as significant predictors of stereotype threat. Higher stereotype threat was also associated with increased emotional distress.

CONCLUSIONS

These findings are an important first step in understanding stereotype threat in Parkinson's disease and may help to guide the development of intervention and educational efforts aimed at countering its effects.