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Cavallieri F, Ghirotto L, Sireci F, Parmeggiani M, Pedroni C, Mardones FA, Bassi MC, Fioravanti V, Fraix V, Moro E, Valzania F. Caregivers' burden and deep brain stimulation for Parkinson disease: A systematic review of qualitative studies. Eur J Neurol 2024; 31:e16149. [PMID: 37975788 DOI: 10.1111/ene.16149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND AND PURPOSE The impact of subthalamic nucleus deep brain stimulation (STN-DBS) on caregivers' burden is understudied. We perform a systematic review and meta-synthesis aggregating qualitative studies involving partners of people with Parkinson disease (PwP) to explore their experiences and unmet needs. METHODS A systematic review for retrieving qualitative studies included six databases: MEDLINE, Embase, CINAHL, Cochrane, PsycInfo, and Scopus. Inclusion criteria were as follows: (i) studies on the experience of caregivers of PwP in the context of STN-DBS, (ii) English peer-reviewed articles, and (iii) qualitative or mixed methods studies reporting caregivers' quotations. After the appraisal of included studies, we performed meta-synthesis of qualitative findings. Descriptive themes and conceptual elements related to PwP partners' experiences and unmet needs were generated. RESULTS A total of 1108 articles were screened, and nine articles were included. Three categories were identified: (i) dealing with Parkinson disease (PD) every day (the starting situation characterized by the impact of PD on ordinary life; the limitations to partners' socialization; partners' efforts in stepping aside for love and care activities), (ii) facing life changes with STN-DBS (the feeling of being unprepared for changes; the fear and concern due to loved ones' behavioral changes; struggling to find an explanation for those changes), and (iii) rebuilding the role of caregiver and partner after STN-DBS. CONCLUSIONS This meta-synthesis elucidates concerns, challenges, and unmet needs of partners of PwP who underwent STN-DBS. It is important to provide them with information, education, and adequate support to face these challenges. Professionals need to involve partners in the care and decision process, because STN-DBS-related outcomes do not depend solely on the well-being of PwP but also on the well-being of individuals surrounding them.
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Affiliation(s)
- Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Sireci
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Margherita Parmeggiani
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cristina Pedroni
- Direzione delle Professioni Sanitarie Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valentina Fioravanti
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valérie Fraix
- Division of Neurology, Centre Hospitalier Universitaire de Grenoble, Grenoble Institute of Neuroscience, Grenoble Alpes University, Grenoble, France
| | - Elena Moro
- Division of Neurology, Centre Hospitalier Universitaire de Grenoble, Grenoble Institute of Neuroscience, Grenoble Alpes University, Grenoble, France
| | - Franco Valzania
- Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Bovolenta TM, Schumacher-Schuh AF, Santos-Lobato BLD, Godeiro Júnior CDO, Silva DJD, Nicaretta D, Barbosa ER, Cardoso FEC, Della Coletta MV, Braga Neto P, Cury RG, Tumas V, Felicio AC. Average annual cost of Parkinson's disease in a Brazilian multiethnic population. Parkinsonism Relat Disord 2023; 117:105897. [PMID: 37931350 DOI: 10.1016/j.parkreldis.2023.105897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION With the current demographic transition, it is estimated that by 2050 Brazil will have a population of 90 million people aged 60 years or more, and in parallel Parkinson's disease (PD) will bring a considerable economic burden to our society. Brazil is considered multiracial due to its colonization, generating important social and regional inequalities. Knowing the costs of the PD may aid to improve local public policies. However, in Brazil, no estimates of these values have been made so far. OBJECTIVES To evaluate direct, indirect, and out-of-pocket costs in Brazilian people with PD (PwP). METHODS Categorical and numerical data were collected through a customized and standardized cost-related-questionnaire from 1055 PwP nationwide, from 10 tertiary movement disorders centers across all Brazilian regions. RESULTS The estimated average annual cost of PwP was US$ 4020.48. Direct and indirect costs accounted for 63% and 36% of the total, respectively, and out-of-pocket costs were 49%. There were no evidence of differences in the total cost of PD across the regions of the country; however, differences were reported between the stages of the Hoehn and Yahr scale (H&Y). CONCLUSION This data suggests a considerable burden of PD for Brazilian society in general, not only for the public health system, but mainly for those with PD.
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Affiliation(s)
| | | | | | | | - Delson José da Silva
- Neuroscience Core, Hospital Clinics, Federal University of Goiás, Brazil Integrated Neurosciences Institute, Goiás, Brazil.
| | - Denise Nicaretta
- School of Medicine and Surgery - UNIRIO HUGG/EBSERH Rio de Janeiro, Brazil.
| | - Egberto R Barbosa
- Movement Disorders Clinic, Department of Neurology, School of Medicine of the University of São Paulo, São Paulo, SP, Brazil.
| | - Francisco E C Cardoso
- Movement Disorders Unit Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | | | - Pedro Braga Neto
- Department of Clinical Medicine, Neurology Section, Federal University of Ceará, Ceará, Brazil.
| | - Rubens G Cury
- Movement Disorders Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Vitor Tumas
- Department of Neuroscience and Sciences of Behavior, Division of Neurology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
| | - Andre C Felicio
- Department of Neurology and Brain Institute, Hospital Israelita Albert Einstein, São Paulo, Brazil.
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Gencer GYG, Erdem NŞ, Ipek L, Özkaynak SS, Uçar T. Caregiver Burden and Quality of Life of Caregivers for Patients with Parkinson's Disease Treated with Deep Brain Stimulation. Ann Indian Acad Neurol 2023; 26:530-536. [PMID: 37970306 PMCID: PMC10645263 DOI: 10.4103/aian.aian_210_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/18/2023] [Accepted: 06/17/2023] [Indexed: 11/17/2023] Open
Abstract
Objective This study aimed to identify caregiver burden (CB) and contributing factors to CB for Parkinson's disease (PD) patients under Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) treatment, and investigation the factors, affecting the caregivers' quality of life (QoL). Methods Twenty-four PD patients under STN-DBS treatment and their caregivers participated in this study. Unified Parkinson's Disease Rating Scale (UPDRS) was applied for the clinical assessment of the patients. Beck Depression Inventory-II (BDI), Hospital Anxiety and Depression Scale (HADS), and Minnesota Impulse Control Disorders Interview (MIDI) were used to screen for neuropsychiatric symptoms of the patients. CB was evaluated with the Caregivers Burden Inventory (CBI) and the Burden Scale for Family Caregivers (BSFC-s). The health-related QoL of caregivers was assessed with the Short Form Survey-36 (SF-36). Results Mean total CBI and BSFC-s scores of caregivers were 32.53 ± 19.71 and 11.66 ± 8.86, respectively. Nineteen caregivers defined moderate or severe caregiver burden according to BSFC-s. Both CBI and BSFC-s scores were significantly associated with UPDRS-part-1 scores, but not with the age and gender of both the patients and their caregivers, disease duration, PDQ39, BDI, HADS, LARS scores, and scores of patients for other UPDRS parts. The presence of impulse control behaviors (ICBs) significantly increased the total CBI score and total BSFC-s (P < 0.01). The caregivers' total and all domain scores of SF-36 were significantly affected by higher CBI and BSFC-s scores. Conclusions The CB of the patients under STN-DBS treatment was severe. Non-motor symptoms, particularly impulsivity, significantly increased CB and worsened the caregivers' mental and physical health.
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Affiliation(s)
| | - Nazan Şimşek Erdem
- Department of Neurology, Private Termessos Hospital, Konyaaltı/Antalya, Turkey
| | - Lutfiye Ipek
- Department of Gerontology Faculty of Health Sciences, Akdeniz University, Konyaaltı/Antalya, Turkey
| | | | - Tanju Uçar
- Department of Neurosurgery, Akdeniz University Hospital, Konyaaltı/Antalya, Turkey
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Fitzgeraldson E, Triandafilidis Z, Franklin Y, Palazzi K, Kay-Lambkin F, Fitzpatrick S. Feasibility and Acceptability of a Novel Online Program for Mental Health Carers. Int J Psychol Res (Medellin) 2023; 16:41-55. [PMID: 37547866 PMCID: PMC10402641 DOI: 10.21500/20112084.5733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 07/11/2022] [Accepted: 09/21/2022] [Indexed: 08/08/2023] Open
Abstract
Objective To evaluate the feasibility and acceptability of a new online program (Minds Together ) for carers of a person with depressive or anxiety symptoms. Methods Using a two-arm randomised controlled trial design, 108 carers of a person with depressive or anxiety symptomology aged 16 years or over (89% female; mean age 50 years) received immediate or delayed access to the Minds Together program. Feasibility was measured using program activation and survey completion rates. Acceptability was measured using a project-specific satisfaction scale, semi-structured interviews, and program completion metadata. The study used intention-to-treat (ITT) analysis for participant-reported outcomes (carer burden, coping self-efficacy) across groups. Results Feasibility and acceptability thresholds were consistent with similar studies: 59% activated their program account, 47% met the program completion threshold, and almost all reported satisfaction with the program. The ITT indicated trends in increased coping self-efficacy and reduced carer burden for the Intervention group, compared to the Waitlist control. Conclusions The Minds Together program is a feasible and acceptable program for carers supporting a person with depressive or anxiety symptomology. Results support exploration of the program's efficacy in a full-scale RCT.
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Affiliation(s)
- E Fitzgeraldson
- Everymind, Newcastle, Australia. University of Newcastle, Newcastle, Australia. University of NewcastleUniversity of NewcastleAustralia
| | - Z Triandafilidis
- School of Medicine and Public, University of Newcastle, Newcastle, Australia. University of NewcastleUniversity of NewcastleAustralia
| | - Y Franklin
- Everymind, Newcastle, Australia. Australia
| | - K Palazzi
- Everymind, Newcastle, Australia. Australia
| | - F Kay-Lambkin
- Hunter Medical Research Institute, New Lambton Heights, Australia. Hunter Medical Research InstituteAustralia
| | - S Fitzpatrick
- University of Newcastle, Newcastle, Australia. University of NewcastleUniversity of NewcastleAustralia
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Cha Y, Park TY, Leblanc P, Kim KS. Current Status and Future Perspectives on Stem Cell-Based Therapies for Parkinson's Disease. J Mov Disord 2023; 16:22-41. [PMID: 36628428 PMCID: PMC9978267 DOI: 10.14802/jmd.22141] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/15/2022] [Accepted: 10/29/2022] [Indexed: 01/12/2023] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease, affecting 1%-2% of the population over the age of 65. As the population ages, it is anticipated that the burden on society will significantly escalate. Although symptom reduction by currently available pharmacological and/or surgical treatments improves the quality of life of many PD patients, there are no treatments that can slow down, halt, or reverse disease progression. Because the loss of a specific cell type, midbrain dopamine neurons in the substantia nigra, is the main cause of motor dysfunction in PD, it is considered a promising target for cell replacement therapy. Indeed, numerous preclinical and clinical studies using fetal cell transplantation have provided proof of concept that cell replacement therapy may be a viable therapeutic approach for PD. However, the use of human fetal cells remains fraught with controversy due to fundamental ethical, practical, and clinical limitations. Groundbreaking work on human pluripotent stem cells (hPSCs), including human embryonic stem cells and human induced pluripotent stem cells, coupled with extensive basic research in the stem cell field offers promising potential for hPSC-based cell replacement to become a realistic treatment regimen for PD once several major issues can be successfully addressed. In this review, we will discuss the prospects and challenges of hPSC-based cell therapy for PD.
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Affiliation(s)
- Young Cha
- Department of Psychiatry and Molecular Neurobiology Laboratory, McLean Hospital and Program in Neuroscience, Harvard Medical School, Belmont, MA, USA
| | - Tae-Yoon Park
- Department of Psychiatry and Molecular Neurobiology Laboratory, McLean Hospital and Program in Neuroscience, Harvard Medical School, Belmont, MA, USA
| | - Pierre Leblanc
- Department of Psychiatry and Molecular Neurobiology Laboratory, McLean Hospital and Program in Neuroscience, Harvard Medical School, Belmont, MA, USA
| | - Kwang-Soo Kim
- Department of Psychiatry and Molecular Neurobiology Laboratory, McLean Hospital and Program in Neuroscience, Harvard Medical School, Belmont, MA, USA
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Marinho JDS, Batista IB, Nobre RADS, Guimarães MSA, dos Santos-Orlandi AA, Brito TRP, Pagotto V, Saidel MGB, Fusco SDFB, Maia FDOM, Corona LP, Nunes DP. Burden, satisfaction caregiving, and family relations in informal caregivers of older adults. Front Med (Lausanne) 2022; 9:1059467. [PMID: 36619643 PMCID: PMC9813492 DOI: 10.3389/fmed.2022.1059467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Family caregivers of older persons devote much of their time and energy to caring for another person. This exposure may burden caregivers and compromise their health and quality of life. Objective To investigate the relationship between burden, sociodemographic, caregiving, and health characteristics of informal caregivers of dependent older adults. Methods Cross-sectional and analytical study carried out in Palmas, Tocantins, Brazil, with 52 informal caregivers of older persons who need full-time help for basic living activities. Caregivers' burden was assessed by Zarit Burden Interview (ZBI). Data were analyzed using a T-test, Pearson's correlation, and Multiple Linear Regression. Results The ZBI mean score of caregivers was 26.3 points (SD = 14.6; min = 0; max = 68). Burden scores were higher among caregivers who did not receive help from other people in care (p = 0.016), reported family dysfunction (p = 0.001), and had depression symptoms (p = 0.007). A correlation was found between the scores of burdens and satisfaction with care (r = 0.76; p < 0.001) and perceived material support (r = -0.30; p = 0.40). Satisfaction with care (β: 0.61; p < 0.001) and family dysfunction (β: 8.07; p = 0.033) were significantly associated with the burden score. Conclusion Caregivers with dysfunctional families and satisfaction with the care presented the highest-burden scores. The findings reveal the need for strategies to facilitate mediation and reduce caregiver burden by strengthening the family network support or providing professional assistance.
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Affiliation(s)
- Jéssica da Silva Marinho
- Postgraduate Science and Health Teaching Program, Federal University of Tocantins, Palmas, Tocantins, Brazil
| | - Ilaise Brilhante Batista
- Postgraduate Science and Health Teaching Program, Federal University of Tocantins, Palmas, Tocantins, Brazil
| | | | | | | | | | - Valéria Pagotto
- School of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Maria Giovana Borges Saidel
- Graduate Program in Nursing, University of Campinas, São Paulo, Brazil
- School of Nursing, University of Campinas, São Paulo, Brazil
| | - Suzimar de Fátima Benato Fusco
- Graduate Program in Nursing, University of Campinas, São Paulo, Brazil
- School of Nursing, University of Campinas, São Paulo, Brazil
| | - Flavia de Oliveira Motta Maia
- Graduate Program in Nursing, University of Campinas, São Paulo, Brazil
- School of Nursing, University of Campinas, São Paulo, Brazil
| | | | - Daniella Pires Nunes
- Graduate Program in Nursing, University of Campinas, São Paulo, Brazil
- School of Nursing, University of Campinas, São Paulo, Brazil
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Knight E, Geetha T, Burnett D, Babu JR. The Role of Diet and Dietary Patterns in Parkinson's Disease. Nutrients 2022; 14:4472. [PMID: 36364733 PMCID: PMC9654624 DOI: 10.3390/nu14214472] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 07/30/2023] Open
Abstract
Parkinson's Disease (PD) is a neurodegenerative disorder associated with diminished nutrition status and decreased quality of life. While the prevalence of PD is expected to increase, no preventative or curative therapy for PD exists at this time. Although nutrition and diet represent modifiable risk factors for reducing chronic disease risk, research on the impact of single nutrients on PD has yielded mixed results. As a result, this single-nutrient approach may be the driving force behind the inconsistency, and a holistic dietary approach may overcome this inconsistency by accounting for the interactions between nutrients. The following review aims to examine the impact of a generally healthy dietary pattern, the protein-restricted diet (PRD), the ketogenic diet (KD), the Mediterranean diet (MD), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet on PD risk, progression, and severity. While most of the included studies support the role of diet and dietary patterns in reducing the risk of PD or alleviating PD severity, the inconsistent results and need for further evidence necessitate more research being conducted before making dietary recommendations. Research on the potential beneficial effects of dietary patterns on PD should also investigate potential risks.
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Affiliation(s)
- Emily Knight
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
| | - Thangiah Geetha
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
| | - Donna Burnett
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
| | - Jeganathan Ramesh Babu
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
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Hallé MC, Delorme C, Coulombe É, Rekik O, Verduyckt I. Participants' perspective on a COVID-19 online vocal group stimulation for people with Parkinson's disease. Front Rehabilit Sci 2022; 3:951426. [PMID: 36189073 PMCID: PMC9397883 DOI: 10.3389/fresc.2022.951426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/12/2022] [Indexed: 11/15/2022]
Abstract
The COVID-19 related confinement and social distancing had negative consequences on the health of individuals living with Parkinson's Disease (PD). In collaboration with a non-profit organization, we developed and implemented a daily online vocal stimulation group named “Musculation de la Voix” (MdlV) in April 2020. To better understand the potential of MdlV to diversify existing services available to people with PD experiencing vocal symptoms, this study aimed to explore participants' experience and perception of MdlV in terms of participation, motivations, feelings, perceived changes, and appreciation. The 45 individuals who registered to the Summer 2020 Semester of MdlV were invited to complete an online ten-question survey. Responses to the four close-ended questions were analyzed using descriptive statistics while statements provided in response to the six open-ended questions were subjected to an inductive qualitative content analysis. Thirty seven participants completed the survey. Results revealed that the sample of respondents was mostly constituted of individuals who were engaged in this activity since its very beginning (62,2%), participated daily (59,5%), intended to keep participating in the activity (97,3%), and had never received speech-language therapy (SLT) services before (72,97%). The qualitative analysis yielded one theme relating to prior services: “Previous SLT services are variable and perceived as beneficial but with limitations,” and three themes pertaining to MdlV: “Seeking improvement and support as initial motivations to engage in MdlV,” “Unanticipated benefits and desired gains catalyzing motivation to participate in MdlV,” and “Perceived limitations of MdlV and persisting needs.” Our study participants' engagement and motivation toward MdlV as well as the benefits they perceived in relation to this activity suggest that an online vocal stimulation group may be a promising complement to currently limited SLT services. As limitations and persisting needs were also identified, future studies are required to elucidate what aspect of MdlV works, for whom and how.
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Affiliation(s)
- Marie-Christine Hallé
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
| | - Charline Delorme
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
| | - Édith Coulombe
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
| | - Ouswa Rekik
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
| | - Ingrid Verduyckt
- Laboratoire IV, École d'orthophonie et d'audiologie, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation (CRIR) du Montréal Métropolitain, Montréal, QC, Canada
- *Correspondence: Ingrid Verduyckt
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Shin JY, Habermann B. Nursing research in caregivers of people with Parkinson's disease from 2011 to 2021: A scoping review. Appl Nurs Res 2022; 66:151590. [DOI: 10.1016/j.apnr.2022.151590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/09/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
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12
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Zhong QQ, Zhu F. Trends in Prevalence Cases and Disability-Adjusted Life-Years of Parkinson's disease: Findings from the Global Burden of Disease Study 2019. Neuroepidemiology 2022; 56:261-270. [PMID: 35320800 DOI: 10.1159/000524208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/16/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Parkinson's disease is a common, age-related progressive neurodegenerative disorder with considerable socioeconomic burdens, although the studies in incremental burdens to the disease' rapid growth are incomplete and lag behind. We aim to assess global burdens of Parkinson's disease based on a public database online. METHODS Based on the Global Burden of Disease, Injuries, and Risk Factors Study, we screened a range of indicators including prevalence cases, disability-adjusted life-years (DALY), age-standardized prevalence rates (ASPR) and age-standardized DALY (ASDR). The Join point regression was used to assess the indicators, wherein the ASPR and the ASDR were referred to temporal trends for burdens of Parkinson's disease. RESULTS Prevalence cases of global Parkinson's disease were on the rise for 30 years, with an increase of 155.51% during 1990-2019. Temporal trend of ASDRs was on the rise during 1990-2002 but in decline during 2002-2019. The ASPRs had a turning point in 2017 and a decline during 2017-2019 (APC (annual percentage changes) =-0.51%, P > 0.05). China, India, the United States, Japan and Germany shared the five highest prevalence cases and DALYs in 2019. Socio-demographic Index (SDI) was in relation to a significantly positive ASPR (R=0.61, P < 0.001) but not a significantly negative ASDR (R=-0.044, P=0.53), respectively. CONCLUSIONS In this study, a range of indicators for global burdens of Parkinson's disease were on the rise during 1990-2019. Tremendous efforts should be in place to prevent Parkinson's disease, especially among the populations of males, with advanced ages, in East Asia, and in regions with high SDI.
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Affiliation(s)
- Qiong-Qiong Zhong
- Central Laboratory, Guangzhou Twelfth People's Hospital, Guangzhou, China
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Feng Zhu
- Central Laboratory, Guangzhou Twelfth People's Hospital, Guangzhou, China
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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13
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Gülke E, Pötter-nerger M. Caregiver Burden in Partners of Parkinsonian Patients with Deep Brain Stimulation. Brain Sci 2022; 12:238. [PMID: 35204001 PMCID: PMC8870343 DOI: 10.3390/brainsci12020238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 01/12/2023] Open
Abstract
In Parkinson’s disease (PD) patients, the progressive nature of the disease and the variability of disabling motor and non-motor symptoms contribute to the growing caregiver burden of PD partners and conflicts in their relationships. Deep brain stimulation (DBS) improves PD symptoms and patients’ quality of life but necessitates an intensified therapy optimization after DBS surgery. This review illuminates caregiver burden in the context of DBS, framing both pre- and postoperative aspects. We aim to provide an overview of perioperative factors influencing caregiver burden and wish to stimulate further recognition of caregiver burden of PD patients with DBS.
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Rodrigo-Baños V, Moral-Pairada MD, González-de Paz L. A Comprehensive Assessment of Informal Caregivers of Patients in a Primary Healthcare Home-Care Program. Int J Environ Res Public Health 2021; 18:11588. [PMID: 34770102 DOI: 10.3390/ijerph182111588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 11/24/2022]
Abstract
Studies of the characteristics of informal caregivers and associated factors have focused on care-receiver disease or caregiver social and psychological traits; however, an integral description may provide better understanding of informal caregivers’ problems. A multicenter cross-sectional study in primary healthcare centers was performed in Barcelona (Spain). Participants were a random sample of informal caregivers of patients in a home-care program. Primary outcomes were health-related quality of life and caregiver burden, and related factors were sociodemographic data, clinical and risk factors, social support and social characteristics, use of healthcare services, and care receivers’ status. In total, 104 informal caregivers were included (mean age 68.25 years); 81.73% were female, 54.81% were retired, 58.65% had high comorbidity, and 48.08% of care receivers had severe dependence. Adjusted multivariate regression models showed health-related quality of life and the caregivers’ burden were affected by comorbidity, age, time of care, and dependency of care receiver, while social support and depression also showed relative importance. Aging, chronic diseases, and comorbidity should be included when explaining informal caregivers’ health status and wellbeing. The effectiveness of interventions to support informal caregivers should comprehensively evaluate caregivers when designing programs, centering interventions on informal caregivers and not care receivers’ conditions.
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15
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Abstract
BACKGROUND Parkinson's disease is a progressive neurodegenerative disorder that negatively impacts the lives of affected people. The therapeutic benefits of treatment only decrease going forward from the time of diagnosis. Motor and non-motor symptoms alike create a heavy burden for patients and those involved in their care. Palliative care is utilized for patients with serious illnesses and when integrated into patients with Parkinson's disease, improves quality of life by addressing symptoms of discomfort, which ultimately reduces symptom burden to patients and alleviates caregiver stress. OBJECTIVE This review aims to assess the efficacy of palliative care in the management of Parkinson's disease by exploring the benefits of palliative care integration throughout multiple relevant themes to demonstrate the optimal care delivery. METHODS Comprehensive searches on the role of palliative care in Parkinson's disease patients within MEDLINE, PUBMED, CINAHL, CENTRAL, PsycINFO, Embase, and BioMed Central, considering publications between March 2010 - February 2020 were performed. A grey literature search was also performed for additional information. RESULTS Analysis of various existing literature has demonstrated promise in timely palliative care integration for patients with Parkinson's disease, which has shown improvement in the quality of life of Parkinson's disease patients. It also strives to alleviate caregivers' stress and improve their quality of life, although insufficient research exists to support this. Palliative care in Parkinson's disease is a growing area of interest, evidently demonstrating the potential to expand among the current approaches. CONCLUSION Understanding the connections between the themes surrounding palliative care is crucial for successful integration in Parkinson's disease management. It is determined that integration of palliative care in patients with Parkinson's disease help to not only improve patients' experiences but also their caregiver's experiences throughout the disease trajectory. Further research should be conducted to address how palliative care will focus on alleviating caregiver burden and establish specific prognostication tools for Parkinson's disease patients.
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Affiliation(s)
- Helen Senderovich
- Department of Family and Community Medicine, Division of Palliative Care, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, Baycrest, Toronto, Canada
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16
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Heine J, von Eichel H, Staege S, Höglinger GU, Wegner F, Klietz M. Relationship Satisfaction in People with Parkinson's Disease and Their Caregivers: A Cross-Sectional Observational Study. Brain Sci 2021; 11:822. [PMID: 34205764 DOI: 10.3390/brainsci11060822] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/06/2021] [Accepted: 06/18/2021] [Indexed: 01/01/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder, which leads to reduced health-related quality of life (HR-QoL) and autonomy in advanced stages of the disease. Hence, people with PD (PwPD) are in need of help, which is often provided by informal caregivers, especially spouses. This might influence the relationship satisfaction in patients and their spousal caregivers. Additionally, previous studies have shown that a reduced relationship satisfaction may result in mental disorders and reduced physical health. The aim of this study is to identify factors influencing PwPD and their caregivers' relationship satisfaction in a cross-sectional observational study. Analyses revealed an overall satisfying relationship, measured by the Quality of Marriage Index, in PwPD (n = 84) and their caregivers (n = 79). Relationship satisfaction in PwPD mildly decreased with reduced HR-QoL and more severe depressive symptoms. Reduced relationship satisfaction in caregivers was significantly associated with decreased HR-QoL, higher caregiver burden, more severe depressive symptoms and increased neuropsychiatric symptoms in PwPD. Further studies are needed to investigate the influence of the identified factors over time and if relationship satisfaction has a reciprocal impact on caregiver burden, HR-QoL as well as mental and physical health.
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17
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Abstract
INTRODUCTION The longstanding dogma that the healthy lung is sterile has been refuted by recent advances in culture-independent analyses of airway samples. The respiratory microbiome comprises all airway and lung tissue-associated microbes. These micro-organisms occur throughout the upper and lower respiratory tracts, with different populations and distinct burdens at specific sites and can be classified as pathogenic or commensal. AREAS COVERED The majority of studies investigating the respiratory microbiome have focused on bacteria; however, emerging evidence has revealed the composition of the lung virome, the global viral communities present in the lung tissue. In this review, we searched PubMed and used keywords such as airway microbiome. We restricted outputs to English language and did not limit by any dates. We summarize the up-to-date knowledge on how the microbiome interacts with the host immune system and influences the pathogenesis of pulmonary viral infections. EXPERT OPINION The relationship between colonizing microbes and the host is complex and various factors need to be considered in order to appreciate its pathophysiological consequences. Understanding these intricate mechanisms of interaction among the respiratory microbiome, viruses and the immune response may lead to the development of better therapies to treat or prevent respiratory viral infections.
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Affiliation(s)
- Bárbara N Porto
- Program in Translational Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Theo J Moraes
- Program in Translational Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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18
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Klietz M, von Eichel H, Schnur T, Staege S, Höglinger GU, Wegner F, Stiel S. One Year Trajectory of Caregiver Burden in Parkinson's Disease and Analysis of Gender-Specific Aspects. Brain Sci 2021; 11:295. [PMID: 33652825 DOI: 10.3390/brainsci11030295] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) is a slowly progressive neurodegenerative movement disorder that leads to impairments in activities of daily living. In addition to reducing patients' quality of life, this disease also affects caregivers' well-being. Until recently, caregiver burden was mainly assessed by generic questionnaires, which do not take the characteristics of the chronic disease into consideration. In the case of PD, this issue has been addressed by the introduction of the "Parkinson's disease caregiver burden" questionnaire (PDCB). Data on longitudinal trajectories of caregiver burden are still missing in the literature. In this study, we assessed the one-year trajectory of caregiver burden by the PDCB as a disease-specific questionnaire. Further, gender-specific aspects of caregiver burden were analyzed by applying a caregiver task questionnaire. PDCB total score (n = 84 patients and caregivers) did not significantly change from baseline (30.4) to one year at follow-up (31.5). No significant difference was detected between female and male caregivers in global burden and-specific caregiver tasks. Our data showed only a mild increase of caregiver burden in the timeframe of one year. Gender-specific differences do not seem to impact-specific caregiver tasks in the presented study population.
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19
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Bivona U, Villalobos D, De Luca M, Zilli F, Ferri G, Lucatello S, Iannetti M, Cellupica L, Mungiello F, Lo Sterzo P, Marchegiani V, Puccitti A, Lombardi G, Moretti G, Donvito T, Penza F, Formisano R. Psychological status and role of caregivers in the neuro-rehabilitation of patients with severe Acquired Brain Injury (ABI). Brain Inj 2020; 34:1714-1722. [PMID: 33190555 DOI: 10.1080/02699052.2020.1812002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the relationships between (a) the psychological status of the caregiver, (b) the specific features of caregiving as perceived by the cognitive therapist in neuro-rehabilitation, (c) the caregivers' subjective approach to neuro-rehabilitation, and (d) the functional outcome of the patient. METHODS Twenty-four patients with severe acquired brain injury and their 24 caregivers participated in this observational study. Caregivers underwent a psychological assessment examining emotional distress, burden and family strain; their subjective approach to neuro-rehabilitation has been evaluated by two specific answers. The patients' cognitive therapists responded to an ad-hoc questionnaire, namely the "Caregiving Impact on Neuro-Rehabilitation Scale" (CINRS), evaluating the features (i.e., amount and quality) of caregiving. Finally, the functional outcome of the patient was assessed through standardized scales of disability and cognitive functioning. RESULTS The caregivers' psychological well-being was associated to the features of caregiving, to the subjective approach to neuro-rehabilitation, and to the functional recovery of their loved ones. A better caregivers' approach to neuro-rehabilitation was also associated to an overall positive impact of caregiving in neuro-rehabilitation and to a better functional outcome of the patients. CONCLUSIONS We posited a virtuous circle involving caregivers within the neuro-rehabilitation process, according to which the caregivers' psychological well-being could be strictly associated to a better level of caregiving and to a better functional outcome of the patients that, in turn, could positively influence the caregivers' psychological well-being. Although preliminary, these results suggest a specific psycho-educational intervention, aimed at improving the caregivers' psychological well-being and at facilitating their caring of the loved one.
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Affiliation(s)
- U Bivona
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - D Villalobos
- Laboratory of Cognitive and Computational Neuroscience. Center for Biomedical Technology (Technical University of Madrid and Complutense University of Madrid), Madrid, Spain
| | - M De Luca
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - F Zilli
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - G Ferri
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - S Lucatello
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - M Iannetti
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - L Cellupica
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - F Mungiello
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - P Lo Sterzo
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - V Marchegiani
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - A Puccitti
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - G Lombardi
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - G Moretti
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - T Donvito
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - F Penza
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - R Formisano
- Post-Coma Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
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20
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Nene D, Yadav R. Neuropsychiatric Symptoms and Caregiver Burden in Parkinson's Disease: Mitigating the Lack of Awareness! Ann Indian Acad Neurol 2020; 23:575-576. [PMID: 33223690 PMCID: PMC7657276 DOI: 10.4103/aian.aian_301_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/16/2020] [Accepted: 04/14/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Devavrat Nene
- Clinical Fellow in Movement Disorders, Pacific Parkinson's Research Center and Center for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
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21
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Abstract
OBJECTIVE Caregiver burden is used frequently within the nursing literature. It has not yet been clearly defined as there are different opinions regarding this concept. The purpose of this paper is to provide clarity surrounding the concept caregiver burden. METHODS An electronic search of MEDLINE, CINAHL, Health Source Nursing/Academic Edition and Academic Search Complete (ASC) of EBSCO, China National Knowledge Infrastructure (CNKI) and Google Scholar were searched with a limit of 10 years and published in the English or Chinese language. The paper adopted the framework by Walker and Avant. The attributes, antecedents, consequences and uses of the concept were identified. RESULTS At total of 33 articles were included. The three attributes of caregiver burden were identified as self-perception, multifaceted strain, and over time. The antecedents included insufficient financial resources, multiple responsibility conflict, lack of social activities. The consequences of caregiver burden resulted in negative change which included decreased care provision, decrease in quality of life, physical and psychological health deterioration. CONCLUSION A definition of caregiver burden was developed. Tools to measure caregiver burden were identified. The findings from this analysis can be used in nursing practice, nursing education, research and administration.
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Affiliation(s)
- Zhu Liu
- Department of Hepatobiliary Surgery, The People’s Hospital of Deyang City, Deyang, Sichuan, China
| | - Catrina Heffernan
- Department of Nursing and Healthcare Sciences, Institute of Technology Tralee, Co. Kerry, Ireland
| | - Jie Tan
- Department of Hepatobiliary Surgery, The People’s Hospital of Deyang City, Deyang, Sichuan, China
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22
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Li GH, Li P, Lu L, Li Z, Mo MS, Chen X, Peng GY, Guo WY, Lin YW, Qiu JW, Yang XL, Liu XT, Xu PY. The outcome and burden of Chinese patients with neurodegenerative diseases: A 10-year clinical feature study. Int J Clin Pract 2020; 74:e13534. [PMID: 32418282 DOI: 10.1111/ijcp.13534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/11/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND As the Chinese population continues to age, the incidence of neurodegenerative diseases (NDDs) has increased dramatically, which results in heavy medical and economic burden for families and society. OBJECTIVE The objective of this study was to evaluate NDDs in a southern Chinese hospital over a 10-year period and examine trends in demographics, outcome, length of stay (LOS) and cost. METHODS Retrospective medical records of patients from January 2010 to December 2019 were collected, including 7231 patients with NDDs (as case group) and 9663 patients without any NDDs (as control group). The information of social demographic data, admission source, reasons for admission, outcomes, LOS, and cost were extracted and analysed. RESULT The average hospitalisation age of the patients with NDDs is over 65 years (peak age 70-89 years). Compared with the control group, the case group had a longer LOS and a higher cost and the numbers of patients with NDDs increased yearly from 2010 to 2019. The LOS shortened while the cost increased. Clinical features affected LOS and cost. Patients suffering from infection, abnormal blood pressure and the imbalance of water-electrolyte homoeostasis as main reasons for admission were decreased; however, heart disease, cerebrovascular accident and mental diseases were significantly increased, the overall change trend of fracture/trauma remained stable. The rate of discharge to home care and mortality declined; discharge to other medical or community facilities increased over 10 years. CONCLUSION The majority of NDDs patients tended to be older. During the last 10 years from 2010 to 2019, the numbers of NDDs patients increased yearly, the trend of LOS became shortening and the cost gradually increasing. The main reasons of admission and outcomes of hospital showed different trends.
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Affiliation(s)
- Gui-Hua Li
- Department of Neurology, Guangdong Second People's hospital, Guangzhou, Guangdong, China
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Peng Li
- Department of Anesthesiology, The Chinese Medicine Hospital of Changji, Changji, Xinjiang, China
| | - Lin Lu
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhe Li
- Department of Encephalopathy, The Second Affiliated Hospital of Guangzhou Medical University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ming-Shu Mo
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiang Chen
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Guo-You Peng
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wen-Yuan Guo
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yu-Wan Lin
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jie-Wen Qiu
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xin-Ling Yang
- Department of Neurology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xin-Tong Liu
- Department of Neurology, Guangdong Second People's hospital, Guangzhou, Guangdong, China
| | - Ping-Yi Xu
- Department of Neurology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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23
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Abstract
Background: Caregiver strain is recognized globally with Parkinson's disease (PD). Comparatively little is understood about caregiver burden and strain in Asia. Objective: To investigate caregiver strain for families living with PD in Singapore, in light of international data. Methods: Ninety-four caregivers were recruited via people living with idiopathic PD in Singapore. Caregiver strain was assessed using the Zarit Burden Interview (ZBI); health status was assessing using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). PD disability measures were the Unified Parkinson's Disease Rating Scale (UPDRS) and modified Hoehn and Yahr (1967) Scale. Results: Primary caregivers of people living with PD in Singapore were mostly cohabiting spouses, partners or offspring. Around half employed foreign domestic helpers. Mean caregiving duration was 5.9 years with an average of eight hours per day spent in caregiving roles. Most care providers were comparatively healthy. Caregivers reported significant levels of strain which increased with greater level of disability (r = 0.36, n = 94, p < 0.001). Associations were significant between caregiver strain and scores on the UPDRS mentation, behavior, and mood subscales [r = 0.46, n = 94, p < 0.001, 95% CI (0.28, 0.60)]. High scores on the UPDRS activities of daily living subscale were associated with caregiver strain [r = 0.50, n = 94, p < 0.001, CI (0.33, 0.64)]. Conclusion: Most caregivers in this Singapore sample reported high levels of strain, despite comparatively good physical function. Caregiver strain in PD spans geopolitical and cultural boundaries and correlates with disease severity. These results support the need for better early recognition, education, and support for caregivers of people living with PD.
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Affiliation(s)
- Siok-Bee Tan
- Nursing Division, Singapore General Hospital, Singapore, Singapore
| | - Allison F Williams
- School Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.,School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute (Singapore General Hospital Campus), Singapore, Singapore
| | - Richard B Clark
- Victorian Rehabilitation Centre, Healthscope ARCH and La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Melbourne, VIC, Australia
| | - Meg E Morris
- Victorian Rehabilitation Centre, Healthscope ARCH and La Trobe Centre for Sport and Exercise Medicine Research, La Trobe University, Melbourne, VIC, Australia
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