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Krieger T, Jozwiak L, Ebersbach G, Suess T, Falkenburger B, Feige T, Eggers C, Warnecke T, Scholl W, Schmidt-Heisch C, Folkerts AK, Kalbe E, Seven ÜS. Exploring the lived experiences of individuals with Parkinson's disease and their relatives: insights into care provision experiences, disease management support, self-management strategies, and future needs in Germany (qualitative study). BMC Neurol 2024; 24:208. [PMID: 38890614 PMCID: PMC11184701 DOI: 10.1186/s12883-024-03696-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) significantly impacts the health-related quality of life of affected individuals and their relatives. In order to support the affected individuals and their families in coping with PD, it is essential to offer comprehensive information about their experiences. A comprehensive understanding of their lived experiences with the disease, the healthcare system, applied self-management strategies and their needs is considered crucial for developing a PD support program. Therefore, we aimed to explore the lived experiences and support needs of individuals with PD and their relatives in Germany. METHODS This non-interventional, qualitative study conducted an explorative status quo and needs assessment. It generated knowledge through semi-structured focus groups and interviews with individuals with PD at various disease stages and their relatives. The interviews were digitally recorded, transcribed verbatim, and analysed using content analysis. RESULTS Fifty-two individuals with PD and 29 relatives participated in eight focus groups and 13 paired and 13 individual interviews. Four themes with corresponding subthemes emerged: (1) experiences, revealing individuals' experiences around their diagnosis and with disease-specific care provision; (2) management support offers, clarifying who provides support and the type of support offered; (3) self-management, including comprehensibility, meaningfulness and manageability; and (4) future needs, differentiating between deficits and needs. Most participants expressed a sense of abandonment when obtaining self-management strategies and mastering their lives with PD, often referred to as 'life 2.0'. They identified the lack of structured and adequate provision of information, system orientation and social awareness. CONCLUSIONS In Germany, there is an urgent need for a comprehensive PD care program that addresses the needs of individuals with PD and their relatives from the start of their care trajectory. It could assist individuals in gaining a comprehensive understanding of the disease, obtaining self-management strategies, building a support network, and becoming experts in self-managing their disease. Moreover, it may positively influence their care trajectory and reduce burdens, such as overburdening, fear of progression, and health anxiety. TRIAL REGISTRATION German Clinical Studies Register ( https://www.drks.de/DRKS00030090 , No. DRKS00030090, Date of registration: 15.12.2022).
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Affiliation(s)
- Theresia Krieger
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Leonie Jozwiak
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Georg Ebersbach
- Movement Disorder Clinic, Kliniken Beelitz, Beelitz-Heilstätten, Germany
| | - Thorsten Suess
- Movement Disorder Clinic, Kliniken Beelitz, Beelitz-Heilstätten, Germany
| | - Björn Falkenburger
- Department of Neurology, University of Technology Dresden, Dresden, Germany
| | - Tim Feige
- Department of Neurology, University of Technology Dresden, Dresden, Germany
| | - Carsten Eggers
- Knappschaftskrankenhaus Bottrop, Department of Neurology, Bottrop, Germany
| | - Tobias Warnecke
- Department of Neurology, University Hospital Munster, Munster, Germany
| | | | | | - Ann-Kristin Folkerts
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ümran Sema Seven
- Medical Psychology | Neuropsychology and Gender Studies, Centre for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
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Lou Y, Li Y, Chen Y. The palliative care needs and experiences of patients with advanced Parkinson's disease: a qualitative scoping review. Front Med (Lausanne) 2024; 11:1362828. [PMID: 38660425 PMCID: PMC11039912 DOI: 10.3389/fmed.2024.1362828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
Aim To determine the experiences and needs of palliative care in patients with advanced Parkinson's disease (PD). Methods A scoping literature review methodology, as described by the Joanna Briggs Institute, was employed to search for relevant literature. An electronic search of studies published in English was conducted across five databases from inception to 10 September 2023. Results The search yielded a total of 1,205 articles, with 20 meeting the inclusion criteria. The findings were organized into four themes: (1) unmet emotional and informational needs; (2) needs for effective coordination of care; (3) planning for the future; and (4) symptom management. This scoping review highlights the intricate nature of palliative care for patients with PD and sheds light on issues within current palliative care healthcare systems. The findings emphasize the necessity for individualized interventions and services to address the diverse unmet palliative care needs of people with PD. Conclusion The study reveals the complex landscape of palliative care for individuals with advanced PD, emphasizing the inadequacies within existing healthcare systems. The identified themes underscore the importance of tailored interventions to address the varied unmet palliative care needs of this population.
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Affiliation(s)
- Yan Lou
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
- Zhejiang Haining Health School, Haining City, Zhejiang, China
| | - Yiting Li
- School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yiping Chen
- School of Nursing, Shanxi Medical University, Taiyuan, Shanxi, China
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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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Wang Y, Song Z, Wei L, Liu Y, Bian J, Wang C, Wang S. The mediating role of psychological capital between post-traumatic growth and uncertainty in illness among patients with Parkinson's disease. Geriatr Nurs 2023; 50:194-202. [PMID: 36791544 DOI: 10.1016/j.gerinurse.2023.01.014] [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: 11/18/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 02/15/2023]
Abstract
With the application of positive psychology in health management, many studies have confirmed the close relationship between post-traumatic growth, psychological capital and uncertainty in illness. However, there is still a lack of attention to the positive psychology of patients with Parkinson's disease, and previous studies have not clarify the specific relationship. Therefore, the present study sought to explore the multiple mediating roles of psychological capital between post-traumatic growth and uncertainty in illness among patients with Parkinson's disease. We conducted a cross-sectional survey, a total of 268 patients with Parkinson's disease were investigated by the Post-Traumatic Growth Inventory, the Positive Psychological Capital Questionnaire and the Mishel Uncertainty in Illness Scale - Adults from November 2021 to June 2022 in the Parkinson's specialist outpatient department of three 3a-grade hospitals in Tianjin, China. The results showed that the score of post-traumatic growth was (51.78±17.872), the score of uncertainty in illness was (68.08±17.555), and the score of self-efficacy, resilience, hope, and optimism dimensions of psychological capital were (28.93±10.511), (28.79±11.553), (27.57±8.558) and (25.35±9.768). Post-traumatic growth was negatively correlated with uncertainty in illness and positively correlated with all four dimensions of psychological capital (p < 0.01), and uncertainty in illness was negatively correlated with all four dimensions of psychological capital (p < 0.01). Bootstrap test showed that the direct effect of post-traumatic growth on uncertainty in illness of patients with Parkinson's disease was not significant; the total indirect effect of psychological capital between post-traumatic growth and uncertainty in illness was significant. The mediating effects of resilience and hope were significant, accounting for 53.07% and 19.41% of the total indirect effects, respectively. Based on the research results, psychological capital played a completely mediating role between post-traumatic growth and uncertainty in illness of patients with Parkinson's disease. Post-traumatic growth affected uncertainty in illness through two dimensions: resilience and hope. Healthcare professionals should pay attention to the level of psychological capital of patients with Parkinson's disease and implement targeted positive psychological interventions focusing on the two dimensions of resilience and hope, to enhance post-traumatic growth and reduce the level of uncertainty in illness.
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Affiliation(s)
- Ya'nan Wang
- BSN, The First Central Clinical School, Tianjin Medical University, Tianjin, China
| | - Zhengyang Song
- BSN, The First Central Clinical School, Tianjin Medical University, Tianjin, China
| | - Lirong Wei
- BSN, Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yun Liu
- BSN, Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jiping Bian
- BSN, Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Cong Wang
- BSN, The First Central Clinical School, Tianjin Medical University, Tianjin, China
| | - Shen Wang
- MD, Preventive Health Service, Tianjin First Central Hospital, 24 Fukang Road, Nankai District, Tianjin, China.
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Höllerhage M, Klietz M, Höglinger GU. Disease modification in Parkinsonism: obstacles and ways forward. J Neural Transm (Vienna) 2022; 129:1133-1153. [PMID: 35695938 PMCID: PMC9463344 DOI: 10.1007/s00702-022-02520-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/21/2022] [Indexed: 12/19/2022]
Abstract
To date, the diagnoses of Parkinson syndromes are based on clinical examination. Therefore, these specific diagnoses are made, when the neuropathological process is already advanced. However, disease modification or neuroprotection, is considered to be most effective before marked neurodegeneration has occurred. In recent years, early clinical or prodromal stages of Parkinson syndromes came into focus. Moreover, subtypes of distinct diseases will allow predictions of the individual course of the diseases more precisely. Thereby, patients will be enrolled into clinical trials with more specific disease entities and endpoints. Furthermore, novel fluid and imaging biomarkers that allow biochemical diagnoses are under development. These will lead to earlier diagnoses and earlier therapy in the future as consequence. Furthermore, therapeutic approaches will take the underlying neuropathological process of neurodegenerative Parkinson syndromes more specific into account. Specifically, future therapies will target the aggregation of aggregation-prone proteins such as alpha-synuclein and tau, the degradation of pathological aggregates, and the spreading of pathological protein aggregates throughout the brain. Many of these approaches are already in (pre)clinical development. In addition, anti-inflammatory approaches are in development. Furthermore, drug-repurposing is a feasible approach to shorten the developmental process of new drugs.
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Affiliation(s)
- M Höllerhage
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - M Klietz
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - G U Höglinger
- Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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