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White DR, Palmieri PA. There is 'no cure for caregiving': the experience of women caring for husbands living with Parkinson's disease. Int J Qual Stud Health Well-being 2024; 19:2341989. [PMID: 38657183 PMCID: PMC11044767 DOI: 10.1080/17482631.2024.2341989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Parkinson's disease is a progressive neurodegenerative disorder. The majority of the nearly 9 million people living with Parkinson's disease are men. As such, caregiving is often assumed by wives as the disease progresses. However, there is little research about the lived experience of wives as they transition to caregivers. OBJECTIVE To describe the lived experience of wife caregivers of male spouses living at home with Parkinson's disease. METHODS A descriptive phenomenological study. Semi-structured interviews were recorded and transcribed for analysis in Atlas.ti using Colaizzi's method. RESULTS Thirteen women, aged 50 to 83 years, were interviewed. Five themes emerged from the analysis, (1) caregiver who? (2) taking it day by day, (3) not sure what to do next, (4) just too much, and (5) caring is your soul's growth, to support the central theme "there is no cure for caregiving." CONCLUSION Transitioning from wife to caregiver was a gradual but difficult process. Although the wife caregivers wanted to be part of the health care team, they remained outsiders. Clinicians need to recognize the wives as care coordinators linking medical management with home care. Policy makers need to develop reimbursement models that provide wife caregivers with support groups, education programs, and telemental health services.
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Affiliation(s)
- Dawn R. White
- College of Graduate Health Studies, A. T. Still University, Kirksville, MO, USA
- Benerd College, University of the Pacific, Stockton, CA, USA
- South American Center for Qualitative Research, Universidad Norbert Wiener, Lima, Peru
- EBHC South America: A JBI Affiliated Group, Escuela Posgrado, Universidad Nortbert Wiener, Lima, Peru
| | - Patrick A. Palmieri
- College of Graduate Health Studies, A. T. Still University, Kirksville, MO, USA
- South American Center for Qualitative Research, Universidad Norbert Wiener, Lima, Peru
- College of Nursing and Health Sciences, Excelsior University, Albany, NY, USA
- EBHC South America: A JBI Affiliated Group, Escuela Posgrado, Universidad Nortbert Wiener, Lima, Peru
- Center for Global Nursing, Texas Woman’s University, Houston, TX, USA
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Ferrusola-Pastrana A, Fullerton CL, Meadows SN. Group-based exercise for Parkinson's: a qualitative study of participants and partners' perceptions of an exercise class delivered through a community-university collaboration. BMC Geriatr 2024; 24:488. [PMID: 38834963 DOI: 10.1186/s12877-024-05061-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/09/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Community-based exercise programmes (CBEPs) offer a practical and viable approach to providing people with Parkinson's disease (PwP) the opportunity to exercise as an ancillary therapeutic benefit to pharmacological management. This study explores the perceptions of exercising participants (PwP) and non-participating partners involved in an exercise class delivered through a community-university partnership. METHODS Two separate focus group discussions were conducted: one with class participants (PwP: n = 7, H&Y scale I to III), and the other with non-participating partners of PwP (n = 4). RESULTS Thematic analysis of the data identified that a range of physical, psychological and social factors were perceived to influence engagement: (1) actively taking control, (2) exercise is medicine for the mind and body, and (3) a community working together to promote exercise for parkinson's. Participants and partners felt that the support from the group, including the instructors and student volunteers, empowered and supported PwP to proactively self-manage their health, enjoy exercise in an inclusive group setting, and develop strong social connections with others in the local Parkinson's community. Support to exercise from healthcare professionals was identified as both an enabler and barrier to participation. CONCLUSIONS This study underscores the significance of a community-university partnership as a complementary therapeutic approach for PwP. It also provides critical reflections on its sustainability, including implications for how exercise is considered as medicine for PwP. Additionally, it offers practical recommendations to galvanise community participation and provide inclusive and viable exercise opportunities for PwP.
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Affiliation(s)
- Anna Ferrusola-Pastrana
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
- University School of Health and Sport (EUSES), University of Girona, Salt, Spain
| | - Christopher L Fullerton
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK.
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 7LA, UK.
| | - Stephen N Meadows
- School of Sport and Exercise Sciences, University of Kent, Canterbury, UK
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Aamodt WW, Kluger BM, Mirham M, Job A, Lettenberger SE, Mosley PE, Seshadri S. Caregiver Burden in Parkinson Disease: A Scoping Review of the Literature from 2017-2022. J Geriatr Psychiatry Neurol 2024; 37:96-113. [PMID: 37551798 PMCID: PMC10802092 DOI: 10.1177/08919887231195219] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Caregiver burden is a term that refers to the adverse effect of caregiving on the physical, emotional, social, spiritual, and financial well-being of the caregiver. Caregiver burden is associated with providing care to an individual with a chronic illness or disability, and the unique symptoms of Parkinson disease (PD) can amplify a patient's needs and reliance on others, leading to adverse outcomes for patients and their caregivers. In this scoping review of the literature from January 2017 through April 2022 that included 114 studies, we provide an updated, evidence-based summary of patient and caregiver-related factors that contribute to caregiver burden in PD. We also describe the impact of caregiver stress and burden on caregivers based on qualitative research studies and review recent interventions to mitigate burden. By providing clinical updates for practitioners, this review is designed to improve recognition of caregiver burden in the post-pandemic era and foster the development of targeted interventions to reduce caregiver burden in PD.
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Affiliation(s)
- Whitley W. Aamodt
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
- Translational Center of Excellence for Neuroepidemiology and Neurology Outcomes Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Benzi M. Kluger
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Miray Mirham
- School of Medicine, University of Rochester, Rochester, NY, USA
| | - Anna Job
- University of Rochester, Rochester, NY, USA
| | | | - Philip E. Mosley
- School of Medicine, University of Queensland, Herston, QLD, Australia
| | - Sandhya Seshadri
- Department of Neurology, University of Rochester, Rochester, NY, USA
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Fekonja Z, Irgolič N, Vrbnjak D. Family members' experiences of everyday caregiving for a family member living with Parkinson's disease: a qualitative thematic analysis study. BMC Nurs 2024; 23:98. [PMID: 38321424 PMCID: PMC10845758 DOI: 10.1186/s12912-024-01767-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/25/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND In the daily life of individuals living with Parkinson's disease, their loved ones are crucial. Adapting family members to the patient's condition, support in providing care, and psychosocial adaptations is essential. AIM To explore family members' perception of everyday caregiving for a family member living with Parkinson's disease and to describe their role in the care and everyday life. METHODS In a descriptive, qualitative thematic analysis study, semi-structured interviews were conducted with ten people between the ages of 20 and 70, the closest family members of people living with Parkinson's disease. The analysis of the collected data was carried out using thematic analysis. RESULTS We generated the main theme: "Living with a family member with Parkinson's disease", with associated secondary-level sub-themes: "Response", "Change", "Care", and "Support". Family members of individuals living with Parkinson's disease frequently encounter similar life situations. The most notable transformation in their daily lives primarily revolves around adapting to various activities. CONCLUSIONS Family members are the ones who most often take on the role of caregiver and provide help to their loved ones. Many of them accept the disease as a part of everyday life and learn to live with it. It is of fundamental importance that we offer family members the necessary support, knowledge, and involvement in holistic treatment and care.
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Affiliation(s)
- Zvonka Fekonja
- Faculty of Health Sciences, University of Maribor, Žitna Ulica 15, 2000, Maribor, SI, Slovenia.
| | - Nadja Irgolič
- Dom Danice Vogrinec Maribor, Unit Tabor, Čufarjeva Cesta 9, 2000, Maribor, SI, Slovenia
| | - Dominika Vrbnjak
- Faculty of Health Sciences, University of Maribor, Žitna Ulica 15, 2000, Maribor, SI, Slovenia
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Perepezko KM, Gallo JJ, Pontone GM, Hinkle JT, Mills KA. Association of caregiver strain with the trajectory of quality of life in Parkinson's disease. Parkinsonism Relat Disord 2023; 108:105292. [PMID: 36702071 PMCID: PMC9992162 DOI: 10.1016/j.parkreldis.2023.105292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/08/2023] [Accepted: 01/16/2023] [Indexed: 01/24/2023]
Abstract
We aimed to identify caregiver characteristics associated with the trajectory of quality of life (QoL) in Parkinson's disease (PD). We fit a growth mixture model to longitudinal data from the Parkinson Foundation Parkinson's Outcomes Project (POP) to identify the heterogeneity of QOL trajectories in PD. We then used multinomial logistic regression to model baseline factors that predicted class membership. Baseline growth models were fit to QOL scores measured over 4 disease duration time points. A random intercept and slope model was determined to best fit the data. Next, growth mixture models (1, 2, 3, 4, and 5-class) were fit with covariates (Hoehn & Yahr, sex, and depression) and a three-class model was found to provide the best fit. Class 1 (problematic class (10.0%)) represented individuals with poor QOL at baseline and minor improvement over time. Class 2 (moderate class (32.6%)) represented individuals with moderate QOL at baseline with slight worsening over time. Class 3 (favorable class (56.9%)) represented individuals with good QOL at baseline and slight worsening over time. Multinomial regression revealed that lower caregiver strain, better mobility, and better verbal fluency at baseline predicted membership in the favorable compared to the moderate class. Worse mobility and younger age predicted membership in the problematic compared to the moderate class. While previous studies have reported on the association between mobility and cognition, the novel finding of an association between caregiver strain and PD QOL trajectory suggests caregiver strain is important to measure and address in future research and practice.
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Affiliation(s)
- Kate M Perepezko
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - Joseph J Gallo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Jared T Hinkle
- Medical Scientist Training Program, Johns Hopkins School of Medicine, Baltimore, MD, United States; Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Kelly A Mills
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States; Parkinson's and Movement Disorder Center of Maryland, Baltimore, MD, United States
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The Lived Experience of Caregiving and Perception of Service Provision among Family-Caregivers of People with Late-Stage Parkinson's: A Qualitative Study. PARKINSON'S DISEASE 2023; 2023:4483517. [PMID: 36776984 PMCID: PMC9918353 DOI: 10.1155/2023/4483517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 10/20/2022] [Accepted: 11/29/2022] [Indexed: 02/05/2023]
Abstract
Background The complex nature of late-stage Parkinson's requires multiagency support and leads to an increased burden on family members who assume a multiplicity of responsibilities. The aim of this study is to further understand the lived experiences of family-caregivers and their perception of, and satisfaction with, service provision. Methods This qualitative substudy was a part of the European multicentre Care of Late-Stage Parkinsonism (CLaSP) project. Purposive sampling resulted in a sample of eleven family-caregivers of people with late-stage Parkinson's, who were interviewed using semistructured open-ended questions. Thematic analysis followed. Findings. Three overarching themes were developed from the data: ensuring continuous support is vital to providing care at home, perceiving unmet service provision needs, and advocating and co-ordinating all aspects of care take their toll. These themes include not only experience of services that caregivers find supportive in order to deliver care but also of disjointed care between multiple agencies, a perceived lack of Parkinson's expertise, and there was a lack of anticipatory future planning. The constancy and scope of the family-caregiver role is described, including the need to project manage multiple aspects of care with multiple agencies, to be an advocate, and to assume new roles such as managing finances. Multiple losses were reported, which in part was mitigated by gaining expertise through information and support from professionals and organised and informal support. Conclusion The intricacies and consequences of the family-caregivers' role and their experience of service provision indicate the need to acknowledge and consider their role and needs, fully involve them in consultations and provide information and joined-up support to improve their well-being, and ensure their continuous significant contribution to the ongoing care of the person with Parkinson's.
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Abstract
BACKGROUND Multiple system atrophy (MSA) is a rare Parkinson-plus syndrome with rapid progression and a high symptom burden. The experience of caregivers of people with MSA has not been closely examined. We therefore sought to document the impact of MSA on caregivers using a mixed methods approach. METHODS Patients and caregivers were recruited from a movement disorders program in Edmonton, Canada. Participants completed the following survey instruments based on their own or their loved one's symptoms: 36-Item Short-Form Health Survey (SF-36), Multiple System Atrophy health-related Quality of Life scale (MSA-QoL), and Hospital Anxiety and Depression Scale (HADS). Caregivers also completed the Zarit Burden Interview and HADS based on their own experience. Qualitative data were obtained through semi-structured interviews. RESULTS Nine people with MSA (PwMSA) (age range: 48-78 years) and 11 caregivers (49-76 years) participated. All completed surveys; 7 PwMSA and 10 caregivers were interviewed. Eight PwMSA had the parkinsonian type of MSA (MSA-P) and one a mixed type. Caregivers had on average mild-moderate caregiver burden and mild anxiety. Caregiver burden and anxiety were correlated. Qualitative subthemes under the caregiving theme included keeping the patient safe, caregivers' own health, and communication symptoms cause frustration. The rapid progression of illness was bewildering to caregivers and increased their workload. Public home care services were invaluable to caregivers' maintaining their loved ones at home. Caregivers were inventive in finding sources of hope and quality of life for their loved ones. CONCLUSION Publicly funded home care was essential for caregivers of PwMSA in this study. Caregiver support is needed to provide this unrecognized workforce with information and resources to face this challenging condition.
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8
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Perepezko K, Hinkle JT, Forbes EJ, Pontone GM, Mills KA, Gallo JJ. The impact of caregiving on quality of life in Parkinson's disease: A systematic review. Int J Geriatr Psychiatry 2023; 38:e5870. [PMID: 36703272 PMCID: PMC10214089 DOI: 10.1002/gps.5870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Parkinson's disease (PD) is a progressive neurodegenerative disease that can reduce quality of life (QOL). Previous research has explored patient specific factors that influence QOL; but understanding external factors that may also affect patient QOL, such as caregiver characteristics, can provide additional intervention targets that may improve QOL for both the person with PD and their caregiver. METHODS We conducted a systematic review of existing literature on caregiver factors that are related to QOL for the person with PD. We developed a tailored search strategy in six databases and performed a screening procedure according to PRISMA guidelines. We synthesized findings from articles that met inclusion criteria using a narrative approach and identified themes categorizing caregiver factors associated with PD QOL. RESULTS We found 32 full-text articles that fulfilled the inclusion criteria and passed the quality appraisal. Seven themes were identified, including: (1) burden, (2) strain, (3) QOL and satisfaction, (4) demographic factors, (5) psychological factors, (6) relationship factors, and (7) caregiver input. CONCLUSIONS Our review presents critical insights into the role of the caregiver in the QOL of a person with PD. Findings reveal several targets for intervention to improve QOL in this population.
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Affiliation(s)
- Kate Perepezko
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | | | - Kelly A. Mills
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Joseph J. Gallo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Sprajcer M, Owen PJ, Crowther ME, Harper K, Gupta CC, Ferguson SA, Gibson RH, Vincent GE. Sleep disturbance in caregivers of individuals with Parkinsonism: a systematic review and meta-analysis. BMJ Open 2022; 12:e062089. [PMID: 36379644 PMCID: PMC9668020 DOI: 10.1136/bmjopen-2022-062089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The global prevalence of Parkinsonism continues to rise given ageing populations. Individuals with Parkinsonism who have moderate or severe symptoms typically require a high level of care, including assistance with activities of daily living. This care is often provided across the 24-hour period by a family member or friend. It is likely that providing care significantly impacts the sleep duration and quality of the caregiver given overnight caring responsibilities, in addition to worry and stress associated with the caregiving role. The aim of this systematic review and meta-analysis was to investigate whether providing care to an individual with Parkinsonism was associated with disturbed caregiver sleep, and to identify associated factors that may contribute to disturbed sleep in this population. SETTING Five databases were electronically searched on 30 June 2021 including CINAHL, PubMed, PsycINFO, CENTRAL and EMBASE. PARTICIPANTS Eligibility criteria included a population of caregivers whose care recipient has a form of Parkinsonism. PRIMARY AND SECONDARY OUTCOME MEASURES To be included in this systematic review, outcome measures of caregiver sleep (eg, sleep duration, sleep quality) were required. RESULTS Eighteen studies (n=1998) were included. Findings indicated that caregivers of individuals with Parkinsonism typically experience poor sleep quality (mean (95% CI): 5.6 (4.8 to 6.4) points on the Pittsburgh Sleep Quality Index), increased sleep latency and poor sleep efficiency. CONCLUSIONS The degree of poor sleep quality was clinically significant. However, further investigation of sleep outcomes is required using sleep measurement tools tailored for this population (eg, measures that capture overnight sleep disruption by care recipient/s). Additionally, there is a need for appropriate individual and societal-level interventions to improve caregiver sleep. PROSPERO REGISTRATION NUMBER CRD42021274529.
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Affiliation(s)
- Madeline Sprajcer
- Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
| | - Patrick J Owen
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Meagan E Crowther
- Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
| | - Kirsty Harper
- Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
| | | | - Sally A Ferguson
- Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
| | - Rosemary H Gibson
- Sleep Wake Research Centre, School of Health Sciences, Massey University, Wellington, New Zealand
| | - Grace E Vincent
- Appleton Institute, Central Queensland University, Wayville, South Australia, Australia
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Ressler I, Gershfeld-Litvin A. Living with Parkinson’s disease: A qualitative study of spousal perspectives. J Health Psychol 2022; 28:541-553. [PMID: 36337043 PMCID: PMC10119893 DOI: 10.1177/13591053221134740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Research has demonstrated that Parkinson’s disease can have adverse psychological effects on caregivers. Very few studies have focused on the experiences of spouses who are not primary caregivers or who do not identify as primary caregivers. The aim of this study was to explore the experiences of spouses who are not primary caregivers or do not identify as primary caregivers. Twelve Israeli women, spouses of men with Parkinson’s disease, were interviewed using a semi-structured in-depth approach. Thematic analysis revealed five themes: before diagnosis, at diagnosis, after diagnosis, interpersonal ways of coping, and intrapersonal ways of coping. A dynamic of oscillation between confronting and avoiding losses was indicated. Non-death losses were mostly unacknowledged among spouses’ social circles. Results were interpreted in the context of grieving processes after diagnosis. Findings suggest a need for psychological interventions aimed at creating safe spaces for spouses to engage in a grieving process after diagnosis.
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Rippon D, Hand A, Dismore L, Caiazza R. The Impact of the COVID-19 Pandemic on Informal Caregivers of People With Parkinson's Disease Residing in the UK: A Qualitative Study. J Geriatr Psychiatry Neurol 2022; 36:233-245. [PMID: 36268777 PMCID: PMC9596687 DOI: 10.1177/08919887221135555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Informal caregivers can experience various demands when providing care and support for People with Parkinson's disease (PwP) in their own homes. The outbreak of SARS-CoV-2 and public health strategies employed to mitigate the spread of COVID-19 have presented challenges to the general populace on a global basis. The present study used a qualitative research design to explore how the COVID-19 pandemic has impacted informal caregivers in their role of providing care for PwP in their own homes. A series of 1:1 semi-structured interviews were conducted with 11 informal caregivers of PwP (M age = 72.64 years, SD = 8.94 years). A thematic analysis indicated that 1) vulnerabilities to COVID-19, 2) home maintenance & activities of daily living and 3) engagement with healthcare services were 3 themes that provided indications on how the COVID-19 pandemic impacted informal caregivers of PwP. The present study provides illustrations of how being an informal caregiver of PwP and being identified as high risk to COVID-19 can present challenges to the process of caring for loved ones who are also vulnerable to SARS-CoV-2. The results of the present study highlights the necessity to develop strategies to ensure that informal caregivers have the necessary resources to provide care for PwP in their homes and also maintain their own well-being in the post COVID-19 era.
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Affiliation(s)
- Daniel Rippon
- Northumbria University, Newcastle Upon Tyne, UK,Daniel Rippon, Northumbria University,
Northumberland Building, Newcastle Upon Tyne NE1 8ST, UK.
| | - Annette Hand
- Northumbria University, Newcastle Upon Tyne, UK,Northumbria Healthcare, NHS Foundation Trust, North Shields, UK
| | - Lorelle Dismore
- Northumbria Healthcare, NHS Foundation Trust, North Shields, UK
| | - Roberta Caiazza
- Northumbria Healthcare, NHS Foundation Trust, North Shields, UK
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Read J, Frost R, Walters K, Tuijt R, Manthorpe J, Maydon B, Pigott J, Schrag A, Davies N. Transitions and challenges for people with Parkinson's and their family members: A qualitative study. PLoS One 2022; 17:e0268588. [PMID: 35849560 PMCID: PMC9292070 DOI: 10.1371/journal.pone.0268588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/02/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To explore the experiences and challenges of people with Parkinson's and their family members living in the community through the lens of their transitions to better understand the phases and changes in their lives. DESIGN Qualitative study using semi-structured interviews and analysed using codebook thematic analysis. SETTING/PARTICIPANTS Purposive sampling was used in primary and secondary healthcare services across Southern England in 2019 to recruit 21 people with Parkinson's (aged between 45-89 years) and 17 family members (13 spouses and 4 adult children, aged between 26-79 years). RESULTS Participants' descriptions were classified in three main phases of transition from a place of health towards greater dependency on others: 1) 'Being told you are a person with Parkinson's' (early), 2) 'Living with Parkinson's' (mid), and 3) 'Increasing dependency' (decline). Seven sub-themes were identified to describe the transitions within these three phases: phase 1: receiving and accepting a diagnosis; navigating reactions; phase 2: changing social interactions and maintaining sense of self; information: wanting to know but not wanting to know; finding a place within the healthcare system; and 3: changes in roles and relationships; and increasingly dependent. CONCLUSION This study has identified points of change and means of supporting key transitions such as diagnosis, changes in social connections, and increased use of secondary healthcare services so that comprehensive, holistic, individualised and well-timed support can be put in place to maintain well-being.
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Affiliation(s)
- Joy Read
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Rachael Frost
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Kate Walters
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Remco Tuijt
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London, London, United Kingdom
| | - Bev Maydon
- Member of Patient and Public Involvement (PPI Group), London, United Kingdom
| | - Jennifer Pigott
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Nathan Davies
- Research Department of Primary Care and Population Health, University College London, London, United Kingdom
- * E-mail:
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Fidder H, Jaski JJ, Elbertse E, van Loon AM, Monnier AA, de Boer ME, de Groot AJ. Parkinson rehabilitation in nursing homes: a qualitative exploration of the experiences of patients and caregivers. Eur Geriatr Med 2022; 13:1197-1210. [PMID: 35543902 PMCID: PMC9092320 DOI: 10.1007/s41999-022-00647-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/07/2022] [Indexed: 10/27/2022]
Abstract
PURPOSE Worldwide, an increasing number of people are diagnosed with atypical Parkinsonism or idiopathic Parkinson's disease (PD). Periods of acute functional decline, triggered by acute disease, are common. Rehabilitation is often necessary to restore functioning. Skilled nursing facilities (SNFs) in the Netherlands have developed evidence-based geriatric rehabilitation for Parkinson (GR-P) programs. However, data on the experiences and needs of patients and their caregivers are lacking. This study aims to address these, in order to propose recommendations for improvement. METHODS We performed a qualitative study, using semi-structured interviews in two Dutch SNFs offering GR-P. Nine patients with PD and six informal caregivers were included. We subjected verbatim transcripts of 15 interviews to qualitative analysis. RESULTS Data saturation was reached after 15 interviews. Three overarching themes emerged: (1) autonomy, (2) sharing information and (3) contact with others. Loss of autonomy was linked to the underlying disease and the rehabilitation environment itself. Patients and caregivers felt overwhelmed by events before and during rehabilitation, expressing a need to receive information and discuss prior experiences. They considered communication between hospitals and SNFs to be poor. Patients did not always appreciate contact with peers. Both patients and caregivers appreciated empathic healthcare personnel with a firm knowledge on PD. CONCLUSIONS Autonomy, sharing information and contact with others are central themes for patients and caregivers during GR-P in SNFs. We recommend actively exploring these three central themes with every patient and caregiver entering a GR-P program and offering staff continuing education on PD, in order to improve care.
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Affiliation(s)
- Hester Fidder
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands. .,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands.
| | - Joannina J Jaski
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands.,Beweging 3.0, Geriatric Rehabilitation Center De Pol, Nijkerk, The Netherlands
| | - Eskeline Elbertse
- Vivium Naarderheem Geriatric Rehabilitaton Center, Naarden, The Netherlands
| | - Anouk M van Loon
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands
| | - Annelie A Monnier
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands
| | - Marike E de Boer
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands
| | - Aafke J de Groot
- Department of Medicine for Older People, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, The Netherlands.,Amsterdam Public Health, Aging and Later Life, Amsterdam, The Netherlands.,Vivium Naarderheem Geriatric Rehabilitaton Center, Naarden, The Netherlands
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14
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Tenison E, Lithander FE, Smith MD, Pendry-Brazier D, Ben-Shlomo Y, Henderson EJ. Needs of patients with parkinsonism and their caregivers: a protocol for the PRIME-UK cross-sectional study. BMJ Open 2022; 12:e057947. [PMID: 35545401 PMCID: PMC9096540 DOI: 10.1136/bmjopen-2021-057947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION People with parkinsonism are a highly heterogeneous group and the disease encompasses a spectrum of motor and non-motor symptoms which variably emerge and manifest across the disease course, fluctuate over time and negatively impact quality of life. While parkinsonism is not directly the result of ageing, it is a condition that mostly affects older people, who may also be living with frailty and multimorbidity. This study aims to describe the broad range of health needs for people with parkinsonism and their carers in relation to their symptomatology, disability, disease stage, comorbidities and sociodemographic characteristics. METHODS AND ANALYSIS In this single site cross-sectional study, people with parkinsonism will be sent a study information pack for themselves and their primary informal caregiver, if relevant. Data are collected via questionnaire, with additional support, if required, to maximise participation. A specific strategy has been developed to target and proactively recruit patients lacking capacity to consent, including those in residential care settings, with input from a personal consultee prior to completion of a bespoke questionnaire by a representative. Caregivers are also recruited to look at various health outcomes. Results will be displayed as descriptive statistics and regression models will be used to test simple associations and interactions. ETHICS AND DISSEMINATION This protocol was approved by the London-Brighton & Sussex Research Ethics Committee (REC reference 20/LO/0890). The results of this protocol will be disseminated through publication in an international peer-reviewed journal; presentation at academic meetings and conferences; and a lay summary uploaded to the PRIME-Parkinson website. TRIAL REGISTRATION NUMBER ISRCTN11452969; Pre-results.
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Affiliation(s)
- Emma Tenison
- Population Health Sciences, University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Fiona E Lithander
- Population Health Sciences, University of Bristol Faculty of Health Sciences, Bristol, UK
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Matthew D Smith
- Population Health Sciences, University of Bristol Faculty of Health Sciences, Bristol, UK
| | | | - Yoav Ben-Shlomo
- Population Health Sciences, University of Bristol Faculty of Health Sciences, Bristol, UK
| | - Emily J Henderson
- Population Health Sciences, University of Bristol Faculty of Health Sciences, Bristol, UK
- Older People's Unit, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
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15
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Hand A, Oates LL, Gray WK, Dismore LL, Baker K, Naisby J, Walker RW. Understanding Caregiver Strain in Parkinsonism-A Mixed Methods Approach. J Geriatr Psychiatry Neurol 2022; 35:363-373. [PMID: 33648358 DOI: 10.1177/0891988721996819] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Parkinsonism, including Parkinson's disease (PD) are progressive neurological conditions. As these condition progress, individuals will need more support with their care needs to maintain independent community-living. Care needs are mainly met by unpaid, informal caregivers, usually close family members or friends. Caregiver strain is thought to lead to the need for care home placement when the caregiver can no longer cope. OBJECTIVE To understand predictors of caregiver strain and its influence on care home placement for people with moderate to advanced Parkinsonism. METHODS This is a convergent mixed methods study. Quantitative data, following an adapted stress-appraisal model, were collected on caregiver profile, tasks performed and causes of caregiver strain. Semi-structured, in-depth interviews were conducted with caregivers of people with PD (PwP) who went into a care home during the study period, to develop a deeper understanding of the caregiver role and the factors influencing caregiver strain. RESULTS Quantitative data were collected from 115 patient caregiver dyads. Interviews were conducted with 10 caregivers. A model to predict caregiver strain was developed and predictors of caregiver strain were identified, such as functional disability and poor caregiver sleep. CONCLUSION Our findings further demonstrate the complexity of carer strain. Particular dimensions are identified that need to be addressed within clinical practice to reduce carer strain and support people with Parkinsonism to remain within their own home for as long as possible.
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Affiliation(s)
- Annette Hand
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK.,Department of Nursing, Midwifery and Health, Northumbria University, Newcastle-upon-Tyne, UK
| | - Lloyd L Oates
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK
| | - William K Gray
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK
| | - Lorelle L Dismore
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK
| | - Katherine Baker
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK
| | - Jenni Naisby
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK
| | - Richard W Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK.,Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, UK
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16
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Muente C, Folkerts AK, Kalbe E, Thieken F, Assmann LE, Widritzki M, Eggers C, Pedrosa D, Wilhelm M. Supporting Relatives Prior to Caregiver Burden—Preventive E-Mental Health Short Intervention for Family Members of Individuals with Parkinsonism in an Early Phase of the Disease: Protocol for a Feasibility Study. Brain Sci 2022; 12:brainsci12040442. [PMID: 35447974 PMCID: PMC9024797 DOI: 10.3390/brainsci12040442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 12/10/2022] Open
Abstract
Research on support for relatives of patients with Parkinsonism has mainly focused on caregivers, while preventive offers for non-caregiving relatives are lacking. Thus, the aim of this multicenter pilot study is to develop and assess the feasibility of a preventive psychosocial support program for relatives of patients with Parkinsonism. It specifically focuses on family members of patients who are in an early phase of the disease, are not currently caregiving, and have not yet developed distress symptoms. It includes a telemedicine-based, 6-week preventive psychological short intervention (PPSI). The main objective of this feasibility mixed-methods study is to specify the demand for an early, low-threshold, and low-cost short intervention and to collect feedback based on qualitative and quantitative data of N = 20 relatives. Secondary objectives are an evaluation of the effects of the intervention and an analysis of the study design. Future directions are to further develop the PPSI using these data. This study can serve as a basis for future randomized controlled studies on this intervention, which might fill an important gap in clinical supply.
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Affiliation(s)
- Catharina Muente
- Department of Neurology, University Hospital Marburg, 35043 Marburg, Germany; (F.T.); (M.W.); (C.E.); (D.P.)
- Correspondence: ; Tel.: +49-64-215-865-895
| | - Ann-Kristin Folkerts
- Department of Medical Psychology Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.-K.F.); (E.K.)
| | - Elke Kalbe
- Department of Medical Psychology Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, 50937 Cologne, Germany; (A.-K.F.); (E.K.)
| | - Franziska Thieken
- Department of Neurology, University Hospital Marburg, 35043 Marburg, Germany; (F.T.); (M.W.); (C.E.); (D.P.)
| | - Laura-Elisa Assmann
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, 35032 Marburg, Germany; (L.-E.A.); (M.W.)
| | - Maria Widritzki
- Department of Neurology, University Hospital Marburg, 35043 Marburg, Germany; (F.T.); (M.W.); (C.E.); (D.P.)
| | - Carsten Eggers
- Department of Neurology, University Hospital Marburg, 35043 Marburg, Germany; (F.T.); (M.W.); (C.E.); (D.P.)
- Center for Mind, Brain and Behavior (CMBB), Universities of Giessen and Marburg, 35032 Marburg, Germany
| | - David Pedrosa
- Department of Neurology, University Hospital Marburg, 35043 Marburg, Germany; (F.T.); (M.W.); (C.E.); (D.P.)
- Center for Mind, Brain and Behavior (CMBB), Universities of Giessen and Marburg, 35032 Marburg, Germany
| | - Marcel Wilhelm
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, 35032 Marburg, Germany; (L.-E.A.); (M.W.)
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17
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Hand A, Hill B. Exploring sexual dysfunction in care homes. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:135-170. [PMID: 35397784 DOI: 10.1016/bs.irn.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sexual needs and sexuality in older adults continues to be a neglected area of clinical intervention, particularly in longer term care settings. This is often due to older adults in long term care beds presenting with increased frailty, and often with significant neurocognitive disorders, making it difficult for care staff to evaluate the capacity of an older adult resident to participate in sexual activities or a sexual relationship. Talking about sexuality, intimacy and sexual health can be embarrassing at any age and sex is often still considered taboo for people who live in care homes. The World Health Organization recently declared that sexual health is a central aspect of life and that each individual has the right to love and be loved, to receive appropriate information and treatment, and to enable intimate relationships and personal control over sexual behavior. This chapter explores sexual behaviors, and barriers to this, in later life, and focuses on the sexual behavior of care home residents with Parkinson's disease. Reasons for sexual dysfunction, potential age-related changes to sexual functioning, along with issues such as changes to body image, intimacy and hyper sexuality, are examined for people with Parkinson's disease. Recommendations for practice are given, and acknowledge that older people may still want to be sexually active or intimate is the first step to addressing the issues and overcoming any barriers.
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Affiliation(s)
- Annette Hand
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom; Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
| | - Barry Hill
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom
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18
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Kalampokini S, Hommel ALAJ, Lorenzl S, Ferreira JJ, Meissner WG, Odin P, Bloem BR, Dodel R, Schrag AE. Caregiver Burden in Late-Stage Parkinsonism and Its Associations. J Geriatr Psychiatry Neurol 2022; 35:110-120. [PMID: 33094677 DOI: 10.1177/0891988720968263] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Patients in the late stages of parkinsonism are highly dependent on others in their self-care and activities of daily living. However, few studies have assessed the physical, psychological and social consequences of caring for a person with late-stage parkinsonism. PATIENTS AND METHODS Five hundred and six patients and their caregivers from the Care of Late Stage Parkinsonism (CLaSP) study were included. Patients' motor and non-motor symptoms were assessed using the UPDRS and Non-motor symptom scale (NMSS), Neuropsychiatric inventory (NPI-12), and caregivers' health status using the EQ-5D-3 L. Caregiver burden was assessed by the Zarit Burden Interview (ZBI). RESULTS The majority of caregivers were the spouse or life partner (71.2%), and were living with the patient at home (67%). Approximately half of caregivers reported anxiety/depression and pain/discomfort (45% and 59% respectively). The factors most strongly associated with caregiver burden were patients' neuropsychiatric features on the total NPI score (r = 0.38, p < 0.0001), total NMSS score (r = 0.28, p < 0.0001), caring for male patients and patients living at home. Being the spouse, the hours per day assisting and supervising the patient as well as caregivers' EQ-5D mood and pain scores were also associated with higher ZBI scores (all p < 0.001). CONCLUSION The care of patients with late stage parkinsonism is associated with significant caregiver burden, particularly when patients manifest many neuropsychiatric and non-motor features and when caring for a male patient at home.
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Affiliation(s)
- Stefania Kalampokini
- UCL Queen Square Institute of Neurology, 61554University College London, United Kingdom
| | - Adrianus L A J Hommel
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, 6029Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Stefan Lorenzl
- Institute of Nursing Science and Practice, 162199Paracelsus Medical University, Salzburg, Austria.,Interdisziplinäres Zentrum für Palliativmedizin und Klinik für Neurologie Universität München-Klinikum Großhadern, Munich, Germany.,Department of Neurology, Agatharied Hospital, Hausham, Germany
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular 37809Universidade di Lisboa, Lisboa, Portugal
| | - Wassilios G Meissner
- Service de Neurologie, CHU de Bordeaux, Bordeaux, France.,Institut des Maladies Neurodégénératives, 27086University de Bordeaux, Bordeaux, France.,Department of Medicine, University of Otago, Christchurch, New Zealand.,New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Per Odin
- Department of Neurology, 59568Lund University Hospital, Sweden
| | - Bastiaan R Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, 6029Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Richard Dodel
- Department of Geriatric Medicine, University Duisburg-Essen, Germany.,Department of Neurology, Philipps-University Marburg, Germany
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19
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Scharfenort M, Timpka J, Sahlström T, Henriksen T, Nyholm D, Odin P. Close relationships in Parkinson´s disease patients with device-aided therapy. Brain Behav 2021; 11:e02102. [PMID: 33949144 PMCID: PMC8213651 DOI: 10.1002/brb3.2102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 01/31/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Deep brain stimulation, continuous subcutaneous apomorphine infusion, and levodopa-carbidopa intestinal gel infusion, together called device-aided therapies (DAT), are introduced when oral and transdermal pharmacotherapy are not enough for a satisfactory control of Parkinson's disease (PD) symptoms. Solid relationships are central to an individual's well-being, but the impact of close relationships in advanced PD remains underexplored. The aim of this study was to investigate the development of close relationships between PD patients and their partners following the initiation of DAT and to examine the relationship structures in these relationships. MATERIALS AND METHODS This was a retrospective quantitative multicenter pilot study wherein 41 couples, patients with advanced PD and their partners, retrospectively rated their relationship satisfaction before the start of DAT, after one year of DAT and at the time of the interview. The couples also answered the Experiences in Close Relationships-Questionnaire of Relational Structures (ECR-RS). RESULTS Partners more often report changes in relationship satisfaction than patients between baseline and both 1 year after start of DAT (p = .049) and last evaluation (p = .041). The ECR-RS data reported significantly higher avoidance score for partners (p = .005) and significantly higher anxiety score for patients (p = .024). CONCLUSIONS The close relationship wherein one part has PD and receives DAT has a high risk of being unequal. Prospective studies are needed for further clarification of the interplay between advanced PD, DAT, and close relationships, this in order to improve pre- and postinterventional support for PD patients receiving DAT, as well as their partners.
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Affiliation(s)
- Monica Scharfenort
- Division of Neurology, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Jonathan Timpka
- Division of Neurology, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | | | - Tove Henriksen
- Department of Neurology, University Hospital of Bispebjerg, Copenhagen, Denmark
| | - Dag Nyholm
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Per Odin
- Division of Neurology, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
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20
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Champagne ER, Muise A. Responsiveness and Relationship Satisfaction in Couples Coping With Parkinson's Disease: A Pilot Study. Psychol Rep 2021; 125:804-821. [PMID: 33626979 PMCID: PMC9003747 DOI: 10.1177/0033294121998032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Parkinson’s disease (PD) is a neurodegenerative disorder which impacts the person’s physical, psychological and relational well-being, and the well-being of their romantic partner, who is often in a caregiving role. People with PD may struggle to empathize with and respond to their partner’s emotional states, which can hinder relationship satisfaction for both partners. Care partners, who may feel burnt out from caring for their partner’s physical and cognitive needs, may be limited in their ability to be responsive to their spouse’s relational needs, which can hinder satisfaction. Despite the challenges faced by couples coping with PD, little work has considered the interpersonal factors associated with relationship satisfaction for affected couples. In the current study, we investigated individual differences in the motivation to be responsive to a partner’s needs (i.e., communal strength), as well as perceptions of a partner’s responsiveness (i.e., the extent to which a person perceives their partner to care for, validate, and understand them). We recruited 20 couples in which one partner was diagnosed with PD and their romantic partner self-identified as a full-time caregiver, in order to examine how responsiveness is associated with both partners’ relationship satisfaction. When partners with PD reported higher communal strength, they reported higher relationship satisfaction and so did their care partner. When partners with PD perceived their care partner to be more responsive, they reported higher relationship satisfaction. These findings provide some preliminary evidence for responsiveness as one interpersonal factor worthy of further consideration for helping couples cope with PD.
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Affiliation(s)
| | - Amy Muise
- Department of Psychology, York University, Ontario, Canada
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21
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Management, Levels of Support, Quality of Life, and Social Inclusion in Parkinson’s Disease: Interventions, Innovation, and Practice Development. PARKINSON'S DISEASE 2021; 2021:4681251. [PMID: 33628414 PMCID: PMC7889352 DOI: 10.1155/2021/4681251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 09/20/2020] [Indexed: 11/18/2022]
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22
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Oates LL, Moghaddam N, Evangelou N, das Nair R. Behavioural activation treatment for depression in individuals with neurological conditions: a systematic review. Clin Rehabil 2019; 34:310-319. [PMID: 31875690 DOI: 10.1177/0269215519896404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of behavioural activation interventions for people with neurological conditions with comorbid depression, and explore content and adaptations. DATA SOURCES PsycINFO, MEDLINE, CINAHL, AMED, and EMBASE databases were searched on the 19 November 2019. Reference lists of selected full-texts were screened by title. REVIEW METHODS We included peer-reviewed studies published in English that used behavioural activation for treatment of depression in adults with a neurological condition. Single-case reports, reviews, and grey literature were excluded. Methodological quality was assessed by two authors independently, and quality was appraised using Critical Appraisal Skills Programme checklists. RESULTS From 2714 citations, 10 articles were included comprising 590 participants. Behavioural activation was used to treat depression in people with dementia (n = 4), stroke (n = 3), epilepsy (n = 1), Parkinson's disease (n = 1), and brain injury (n = 1). Sample size ranged from 4 to 105 participants. There were seven randomized controlled studies; however, no studies compared behavioural activation to an alternative psychological therapy. The effect sizes varied between small and large in the studies where effect size could be calculated (d = 0.24-1.7). Methodological quality of the included studies was variable. Intervention components were identifying and engaging in pleasurable activities, psychoeducation, and problem-solving. Adaptations included delivering sessions via telephone, delivering interventions via primary caregivers, and giving psychoeducation to caregivers. CONCLUSION The effectiveness of behavioural activation in randomized controlled trials varied from small to large (d = 0.24-1.7) in reducing depression. The content of behavioural activation was comparable to established treatment manuals. Adaptations appeared to support individuals to engage in therapy. REVIEW REGISTRATION PROSPERO 2018, CRD42018102604.
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Affiliation(s)
- Lloyd L Oates
- University of Lincoln, Lincoln, UK.,Lincolnshire Partnership NHS Foundation Trust, Lincoln, UK
| | | | - Nikos Evangelou
- Division of Neurosciences, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Institute of Mental Health, University of Nottingham, Nottingham, UK.,Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK
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23
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Hand A, Oates LL, Gray WK, Walker RW. Understanding the Care Needs and Profile of People Living at Home With Moderate to Advanced Stage Parkinson Disease. J Geriatr Psychiatry Neurol 2018; 31:237-247. [PMID: 30012028 DOI: 10.1177/0891988718788680] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In the United Kingdom, people with Parkinson disease (PD) and atypical parkinsonism will require more support with their care needs as the condition progresses. There are few data on the nature of care input required and the amount of informal and formal care needed by people with PD to enable them to remain within their own home. METHOD All people with moderate to advanced stage (Hoehn and Yahr III-V) idiopathic PD and atypical parkinsonism under the care of the Northumbria Healthcare NHS Foundation Trust PD service and living in their own home were invited to take part in The Northumbria Care Needs Project, a 10-year prospective longitudinal study. At baseline, data regarding formal (paid) personal and domestic care input and use of respite care, sitting services, and day centers were collected. We also collected data on patient cognitive disability, functional disability, and disease severity and informal carer tasks. RESULTS Of 162 people with PD included in the study, only 25.2% accessed formal domestic care and the same proportion formal personal care. In contrast, 80.2% identified an informal carer who helped with these tasks. Despite greater level of functional disability in those with an informal carer, levels of formal personal care input were similar to those with and without a formal carer. Levels of formal domestic carer input were higher in those without an informal carer. CONCLUSIONS Use of formal care services was relatively uncommon in our cohort and much of the burden of caring appears to be being met by informal carers.
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Affiliation(s)
- Annette Hand
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, United Kingdom.,2 Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Lloyd L Oates
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, United Kingdom
| | - William K Gray
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, United Kingdom
| | - Richard W Walker
- 1 Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, United Kingdom.,3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
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24
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Klaptocz J, Gray WK, Marwood S, Agarwal M, Ziegler J, Webb Z, Prabhakar M, Hand A, Oates L, McDonald C, Walker RW. The Pattern of Hospital Admissions Prior to Care Home Placement in People With Parkinson’s Disease: Evidence of a Period of Crisis for Patients and Carers. J Aging Health 2018; 31:1616-1630. [DOI: 10.1177/0898264318786125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: We hypothesized that the number and length of hospital admissions in people with Parkinson’s disease (PD) would increase immediately prior to admission to a care home relative to those who were able to continue living at home or who died. Method: PD patients at Hoehn and Yahr Stages III to V were followed-up over two and a half years with deaths and care home placements recorded. Hospital admissions data were collected over this period. Results: Of 286 patients included in the study, 7.3% entered a care home and 28.3% died. In the final 120 days prior to the study exit point (care home placement, death, or continued living at home), longer hospital stay was significantly associated with care home placement, after adjusting for the competing risk of death. Conclusion: Our data provide evidence that, for many people with PD, a period of crisis is reached immediately prior to care home placement.
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Affiliation(s)
- Joanna Klaptocz
- Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
| | - William K. Gray
- Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
| | | | | | | | - Zoszka Webb
- Newcastle University, Newcastle upon Tyne, UK
| | | | - Annette Hand
- Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
- Northumbria University, Newcastle upon Tyne, UK
| | - Lloyd Oates
- Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
| | - Claire McDonald
- Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
| | - Richard W. Walker
- Northumbria Healthcare NHS Foundation Trust, Tyne and Wear, UK
- Newcastle University, Newcastle upon Tyne, UK
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