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McDaniels B, Pontone GM, Mathur S, Subramanian I. Staying hidden: The burden of stigma in PD. Parkinsonism Relat Disord 2023; 116:105838. [PMID: 37689498 DOI: 10.1016/j.parkreldis.2023.105838] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Despite the myriad motor and non-motor challenges associated with Parkinson's disease (PD) diagnosis, the hidden issue of stigma may be among the most influential factors negatively affecting quality of life. A number of qualitative studies have been published assessing various aspects of stigma in PD, and quantitative studies assert that most people with PD experience stigma during the course of their disease. Stigma is associated with poorer mental and physical health, poorer quality of life, decreased levels of hope, self-esteem and self-efficacy. The resulting stigma can lead to social anxiety and isolation, reluctance to seek medical care, loneliness, depression and anxiety. Therefore, understanding what stigma is, where it comes from, and how it affects people living with PD may offer clinicians and care partners tools to help mitigate the negative effects. FOCUS Over the past few decades, we have seen a move away from simply focusing on the effects of a disease (medical model) toward a holistic biopsychosocial approach that considers the role of environmental factors (stigma) when assessing overall well-being. We review some proactive practical suggestions to help people living with PD effectively combat the negative effects of stigma. CONCLUSION The additional hidden burden of stigma from PD affects quality of life. Having a better understanding of the role of stigma and its impact may allow clinicians to provide proactive care and greater empathy for those living with the challenges of this disease.
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Affiliation(s)
- Bradley McDaniels
- Department of Rehabilitation and Health Services, University of North Texas, Denton, TX, USA.
| | - Gregory M Pontone
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Indu Subramanian
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA; Parkinson's Disease Research, Education and Clinical Center (PADRECC), Veterans Administration Greater Los Angeles Health Care System, Los Angeles, CA, USA
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Qasim MMM, Daghriri AA, Alanazi OA, AlOmari LI, Alzibali KF, Alrezqi WA, Albalawi RF, AlHadi KM, Alhazmi YA, Refai HM. Evaluation of Knowledge and Attitudes of the Population of Tabuk City Regarding Parkinson's Disease: A Cross-Sectional Study. Cureus 2023; 15:e46442. [PMID: 37927685 PMCID: PMC10622602 DOI: 10.7759/cureus.46442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND The lack of awareness and information about PD may be a barrier to early diagnosis and the delivery of the best care to patients with the condition, given its rising prevalence. In order to determine the variables that are connected to these parameters, this study sought to ascertain the general public's knowledge and awareness of PD in Tabuk City. METHODS In Tabuk City, a cross-sectional demographic survey was carried out. A validated structured questionnaire was used to interview adult respondents by random sampling regarding specific knowledge, attitudes, and awareness related to Parkinson's disease. According to the density of the city, a total of 426 members of the general population were chosen at random and interviewed by skilled interviewers. RESULTS Age and educational attainment were independently linked to PD awareness. Bachelor's degree subjects and those between the ages of 18 and 45 displayed a greater awareness of PD. Those above 60 and those between the ages of 46 and 60 lacked sufficient knowledge. The majority of participants demonstrated adequate understanding and awareness of PD in their respective occupations. CONCLUSIONS Age, gender, occupation, and level of education were all adequately covered by knowledge and understanding of PD. To increase public knowledge, attitudes, and awareness of PD, however, suitable educational tactics and approaches targeting particular subgroups are required.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Hayat M Refai
- Medicine, King Salman Armed Forces Hospital, Tabuk, SAU
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Crooks S, Carter G, Wilson CB, Wynne L, Stark P, Doumas M, Rodger M, O’Shea E, Mitchell G. Exploring public perceptions and awareness of Parkinson's disease: A scoping review. PLoS One 2023; 18:e0291357. [PMID: 37713383 PMCID: PMC10503766 DOI: 10.1371/journal.pone.0291357] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a common neurological disease affecting around 1% of people above sixty years old. It is characterised by both motor and non-motor symptoms including tremor, slow movement, unsteady gait, constipation and urinary incontinence. As the disease progresses, individuals living with the disease are likely to lose their independence and autonomy, subsequently affecting their quality of life. People with PD should be supported to live well within their communities but there has been limited research regarding what the public know about PD. This review aims to develop an understanding of how the public view people living with PD, which has the potential to aid the development of an educational resource for the future to improve public awareness and understanding of PD. The purpose of this scoping review is to review and synthesise the literature on the public perception and attitudes towards people living with PD and identify and describe key findings. AIM This scoping review aims to explore public perceptions and awareness of Parkinson's Disease among diverse populations, encompassing beliefs, knowledge, attitudes, and the broader societal context influencing these perceptions. METHODS A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for ScR (PRISMA-ScR). Four electronic databases were searched systematically (CINAHL Plus, Medline, PsycINFO and International Bibliography of the Social Sciences). The Joanna Briggs Institute Critical Appraisal Tools (JBI) were used to assess the quality of primary studies, however, all relevant studies were considered regardless of their methodological quality. The 'Population-Concept-Context' framework was used in the screening process to identify eligible papers. RESULTS A total of 23 studies were included in the review representing global research in quantitative (n = 12) and mixed methods approaches (n = 11). All 23 studies adopted some aspect of cross-sectional design. Three themes emerged from the studies, the first being public knowledge of symptoms, causes and treatment of PD and this highlighted a lack of understanding about the disease. Secondly, the review identified public attitudes towards PD, highlighting the social consequences of the disease, including the association between PD and depression, isolation and loss of independence. Finally, the third theme highlighted that there was a paucity of educational resources available to help increase public understanding of PD. CONCLUSION Findings from this scoping review have indicated that public awareness of PD is a growing area of interest. To our knowledge, this is the first scoping review on this topic and review findings have indicated that public knowledge and attitudes towards PD vary internationally. The implications of this are that people with PD are more likely to be a marginalised group within their communities. Future research should focus on understanding the perception of the public from the perspective of people with PD, the development of interventions and awareness campaigns to promote public knowledge and attitude and further high-quality research to gauge public perceptions of PD.
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Affiliation(s)
- Sophie Crooks
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Gillian Carter
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Christine Brown Wilson
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Lisa Wynne
- Parkinson’s Association of Ireland, Dublin, Ireland
| | - Patrick Stark
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Michail Doumas
- School of Psychology, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Matthew Rodger
- School of Psychology, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
| | - Emma O’Shea
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland
| | - Gary Mitchell
- School of Nursing & Midwifery, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom
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Moving the Dial Toward Equity in Parkinson's Disease Clinical Research: a Review of Current Literature and Future Directions in Diversifying PD Clinical Trial Participation. Curr Neurol Neurosci Rep 2022; 22:475-483. [PMID: 35713775 DOI: 10.1007/s11910-022-01212-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Parkinson's disease (PD), the second most common neurodegenerative disease, has a worldwide prevalence projected at 12 million by 2040. While PD has been extensively researched, our understanding of the disease is based on research studies that include mostly participants of European descent. The lack of diversity in clinical trial enrollment has limited the generalizability of scientific discoveries in the field. Here, we discuss contributors to racial and ethnic disparities in PD clinical research enrollment, summarize recently proposed and tested interventions, and propose next steps to increase equity and representation in PD research. RECENT FINDINGS Enrollment in PD clinical research is vulnerable to upstream disparities and inequities from PD awareness to access to specialized PD centers. While additional research is still needed, recent studies have identified some potential strategies for increasing underrepresented minority (URM) recruitment including increasing the availability of linguistically and culturally diverse research materials and team members, partnering with community organizations, and forming relationships with URM-serving community physicians. To move the dial toward equity in PD research, it will be necessary to implement known successful strategies and further investigate additional contributors to the underrepresentation of URMs in PD clinical research while developing and testing interventions to address these factors.
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Rosa TDL, Scorza FA. Stigma in Parkinson's disease: Placing it outside the body. Clinics (Sao Paulo) 2022; 77:100008. [PMID: 35172270 PMCID: PMC8903808 DOI: 10.1016/j.clinsp.2022.100008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/08/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Tomás de la Rosa
- Neurology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Fúlvio Alexandre Scorza
- Neurology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Exploring the perceptions and stigmatizing experiences of Israeli family caregivers of people with Parkinson's disease. J Aging Stud 2021; 56:100910. [PMID: 33712095 DOI: 10.1016/j.jaging.2020.100910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 12/19/2022]
Abstract
Providing care to people with Parkinson's disease (PD) poses challenges for family carers, including experiencing stigmatic beliefs -i.e., family stigma. However, to the best of our knowledge, there is no empirical study examining the stigmatic experiences of family members of people with PD. This was the aim of the present study. Three focus groups with 22 Israeli spouses of people with PD were conducted. Data were analyzed using theory-led thematic analysis. Overall, the spouses in our study shared mainly experiences of the stigma attached to the illness and/or to their loved ones, and not to themselves as carers. Three major themes emerged: the stereotypes that typify PD, stigmatizing behaviors towards the person with the disease, and structural stigma. Our findings highlight the profound stigma confronting carers of persons with PD, particularly when it comes to structural stigma.
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Hou M, Mao X, Hou X, Li K. Stigma and Associated Correlates of Elderly Patients With Parkinson's Disease. Front Psychiatry 2021; 12:708960. [PMID: 34335340 PMCID: PMC8319540 DOI: 10.3389/fpsyt.2021.708960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/15/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Stigmatizing experiences is common in Parkinson's disease (PD) and appears to provide a negative contribution to the quality of life. Our aim of this study was to investigate the extent of stigma and its predictive factors in patients with PD from our hospital in Shanghai, China. Methods: In 276 individuals with PD (135 women and 141 men), stigma was measured by the 24-item Stigma Scale for Chronic Illness (SSCI). Multivariate linear regression model was used to assess predictors of stigma including demographics (age and gender), disease duration, stage (Hoehn and Yahr Scale), motor function (Unified Parkinson's Disease Rating Scale Part 3, UPDRS-III), non-motor symptoms (Non-Motor Symptoms Scale, NMSS), cognitive level (Mini-Mental State Examination, MMSE), as well as anxiety (Hamilton Anxiety Rating Scale, HAM-A) and depressive disorders (Hamilton Depression Rating Scale, HAM-D-24). Results: The total score of SSCI was 49.9 ± 14.3, and 48.5% of the patients checked "rarely" to "sometimes." For the total sample, the full model accounted for 47.8% of the variance in stigma (P < 0.05). Higher UPDRS-III scores, longer course of disease, younger age, tremor-dominant subtype, and higher depression scores were significantly associated with stigma among individuals with PD. Conclusion: Our finding suggested a mild-to-moderate level of stigma in patients with PD. Tremor-dominant subtype, longer course of disease, younger age, severe motor symptoms, and depression are the predictors of stigma in PD.
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Affiliation(s)
- Miaomiao Hou
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xiaowei Mao
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xiaojun Hou
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Kunpeng Li
- Department of Neurorehabilitation, The Second Rehabilitation Hospital of Shanghai, Shanghai, China.,School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Pan S, Stutzbach J, Reichwein S, Lee BK, Dahodwala N. Knowledge and attitudes about Parkinson's disease among a diverse group of older adults. J Cross Cult Gerontol 2015; 29:339-52. [PMID: 24752756 DOI: 10.1007/s10823-014-9233-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Underserved minorities are vulnerable to diagnostic delays and under-treatment of Parkinson's disease (PD). The purpose of this mixed-methods study was to understand knowledge and attitudes about PD among a racially/ethnically diverse group of community members. In the qualitative arm, ten homogeneous focus groups of 6 to 8 White, African-American and Chinese American older adults at senior centers in Philadelphia were conducted. Next, for the quantitative arm, a questionnaire of knowledge and attitudes about PD was administered among a larger group of senior center members. Themes were identified from the focus group discussions. ANOVA and chi-square tests were used to assess differences in PD knowledge and attitudes among the different racial/ethnic groups. Logistic regression analyzed for independent factors associated with barriers to treatment. Seventy-five adults participated in the focus groups (23 Whites, 36 African-Americans and 16 Chinese-Americans) and 154 completed the questionnaire (62 Whites, 47 African-Americans and 45 Chinese-Americans). One common theme about developing PD was fear of losing independence. Racial/ethnic groups identified unique barriers to care: mistrust in the healthcare system by African-Americans and language difficulties by Chinese-Americans. Eighty percent of all participants had no to some knowledge of PD. African-Americans and Chinese-Americans were more likely to perceive PD as a part of normal aging than whites. Chinese-Americans were more likely to perceive barriers to treatment than whites. A diverse sample of older adults demonstrated low levels of PD knowledge through both qualitative and quantitative methods. Many barriers to PD care were identified. Targeted community outreach and education efforts should incorporate information about PD and how to receive care.
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Affiliation(s)
- Sarah Pan
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA
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Gender differences in lay persons’ beliefs and knowledge about Alzheimer's disease (AD): A national representative study of Israeli adults. Arch Gerontol Geriatr 2013; 56:400-4. [DOI: 10.1016/j.archger.2012.11.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 10/30/2012] [Accepted: 11/02/2012] [Indexed: 11/21/2022]
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