The "Sense of Coherence" and the coping capacity of patients with Parkinson disease

Concept Mapping to Define Components for an Occupation-Based Intervention for Parkinson's Disease and Anxiety

BACKGROUND

Anxiety, a common symptom of Parkinson's disease (PD), results in reduced life quality, reduced participation in meaningful roles and daily activities, and increased health burden. There are no evidence-based interventions to reduce the impact of anxiety in PD on participation.

OBJECTIVE

This study aimed to identify the key components required for the co-production of an occupation- and community-based intervention for people with PD-related anxiety.

METHODS

A participatory mixed-methods research study was conducted using online Group Concept Mapping methodology that included five stages: brainstorming, idea synthesis, sorting activity, rating activity, and analysis. A cluster map, pattern match, and 'go-zone' charts were created through multivariate statistical analysis based on participants' responses. The stages were guided by questions generated by the research team working with stakeholders.

RESULTS

Eighty-three people participated, with 64 taking part in more than one activity. Participants included people with PD (n = 72), care partners (n = 6), and occupational therapists (n = 5). The final map contained 119 statements with eight clusters (stress value 0.252): exercise, lifestyle changes, self-help, coping, access to information, professional help, peers and groups, support from others. Significant agreement existed between the importance and feasibility rating activities (r = -0.07). 'Go-zone' charts highlighted the priority statements for intervention development.

CONCLUSIONS

This novel participatory study highlighted priority components that provide starting points for future development of an occupation- and community-based intervention for people with PD-related anxiety.

Frequency of Impulsive-Compulsive Behavior and Associated Psychological Factors in Parkinson's Disease: Lack of Control or Too Much of It?

Background and Objectives: Impulse Control Disorders (ICDs) including pathological gambling, hypersexuality, compulsive eating, compulsive buying, and other related behaviors are well-known distinct non-motor symptoms in Parkinson's Disease (PD). Some large-scale studies present a prevalence of at least 10%, however, there are other reports providing much higher rates. The majority of the conducted studies investigating ICDs focus mainly on pharmacological factors, however, from a psychological perspective, there is yet enough room for investigation. In order to address the above issues, we designed a two-part study. Materials and Methods: First, we aimed to identify the incidence of ICD and related behaviors in a cohort of 892 Greek PD patients. Second, we administered a comprehensive battery of psychometric tools to assess psychological factors such as personality dimensions, quality of life, defenses, coherence, and resilience as well as to screen general cognitive capacity in PD patients with ICD manifestations. Results: With regard to the first part, we identified ICD manifestations in 12.4% of the patients. Preliminary findings from the second part indicate elevated activity, rather than impulsivity, as well as interrelations between several variables, including measures of activity, coping mechanisms, and quality of life. Conclusions: We present a working hypothesis for the contribution of high activity channeled to specific behavioral patterns through specific coping mechanisms, concerning the emergence of ICDs and related behaviors in PD, and further stress the importance of compulsivity rather than impulsivity in this process.

Exploring factors that influence HRQoL for people living with Parkinson's in one region of Ireland: A cross-sectional study

BACKGROUND

The diversity of symptoms associated with Parkinson's and their impact on functioning have led to an increased interest in exploring factors that impact Health-Related Quality of Life (HRQoL). Although the experience of Parkinson's is unique, some symptoms have a greater impact than others, e.g. depression. Moreover, as the risk of Parkinson's increases with age, the financial and public health impact of this condition is likely to increase, particularly within the context of a globally ageing population. In Ireland, research is ongoing in the pursuit of causes and effective treatments for Parkinson's; however, its impact on everyday living, functioning, and HRQoL is largely under-examined. This study aims to describe factors that influence HRQoL for people with Parkinson's (PwP) in one region of Ireland.

METHODS

A cross-sectional postal survey was conducted among people living with Parkinson's (n = 208) in one area of Ireland. This survey included socio-demographic questions, Nonmotor Symptoms Questionnaire for Parkinson's disease (NMSQuest), the Geriatric Depression Scale (GDS-15), and the Parkinson's disease Questionnaire (PDQ-39). Statistical analysis was conducted using SPSS, IBM version 25 (SPSS Inc., Chicago, II, USA).

RESULTS

Participants reflected a predominantly older population who were married, and lived in their own homes (91%). Participants diagnosed the longest reported poorer HRQoL regarding mobility, activities of daily living, emotional well-being, social support, cognition, communication domains and overall HRQoL. Lower HRQoL correlated with higher depression scores p < 0.001 and participants in the lower HRQoL cohort experienced 2.25 times more non-motor symptoms (NMSs) than participants with higher HRQoL. Hierarchical multiple linear regression analysis predicted Geriatric Depression Scale (GDS15) score, NMS burden, and years since diagnosis to negatively impact HRQoL. Principal component analysis (PCA) also indicated that for the population in this study, components measuring 1) independence/dependence 2) stigma 3) emotional well-being, and 4) pain were central to explaining core aspects of participants' HRQoL.

CONCLUSIONS

Findings highlighted the negative impact of longer disease duration, NMS burden, depression, mobility impairments, and perceived dependence on HRQoL for PwP. The positive influence of perceived independence, social engagement along with close supportive relationships were also identified as key components determining HRQoL. Findings emphasised the importance of long-term healthcare commitment to sustaining social and community supports and therapeutic, rehabilitative initiatives to augment HRQoL for PwP.

Coping Styles in Patients with Parkinson’s Disease: Consideration in the Co-Designing of Integrated Care Concepts

Integrated care models may help in designing care for Parkinson’s disease (PD) that is more efficient and patient-centered. However, in order to implement such models successfully, it is important to design these models around patients’ needs and preferences. Personality traits and coping styles play a well-studied important role in patients’ disease perception and their utilization of medical and social services to cope with their disease. There is evidence that coping styles remain largely unchanged over the course of PD; coping styles are defined in the early stages of life and extend over the entire lifespan of the patient. Therefore, it seems necessary to consider aspects of the personality traits and coping styles of PD patients in the development and implementation of care models. We postulate that by taking patients’ personality traits and coping styles into account, care models for PD can be designed in a more individualized and, thus, more effective way. This paper, structured in three main sections, attempts to structure the uptake of patients’ coping styles in the co-design of integrated care models. However, further studies are needed to better develop tailored care concepts to the needs of people living with PD and their individual coping styles.

The association between sense of coherence and quality of life: a cross-sectional study in a sample of patients on hemodialysis

Background

Patients on hemodialysis universally experience detriments in their general quality of life (QOL). Sense of coherence (SOC) is a long-standing factor that affects QOL. Nevertheless, the association between SOC and QOL in patients on hemodialysis was seldom investigated. Our research aims to study this association in a sample of Lebanese adult patients on hemodialysis.

Methods

In this cross-sectional study, SOC was measured using the short version of the “Orientation of Life" scale (SOC-13). QOL was assessed using the Kidney Disease Quality of Life- Short Form (KDQOL-SF). The association between SOC and QOL and its submodalities was first explored using Pearson Correlation and multivariate linear regression analyses, controlling for sociodemographic variables and medical variables.

Results

157 patients on hemodialysis (mean(SD) age: 62.1(13.81) years; 58.6% males) were included. Mean QOL score was 51.65 and that of SOC was 48.06. SOC was strongly corrected with the total QOL (r = 0.832; p value < 0.001), as well as its physical functioning (r = 0.767; p value < 0.001), emotional functioning (r = 0.757; p value < 0.001), cognitive functioning (r = 0.740; p value < 0.001), and social functioning (r = 0.773; p value < 0.001) submodailties. SOC was moderately correlated with professional functioning submodality of QOL (r = 0.618; p value < 0.001), but not correlated with the satisfaction with the quality of care (r = 0.052; p = 0.520). Within the regression models accounting for sociodemographic and medical variables, SOC was significantly associated with the total QOL (unstandardized B = 0.803; 95% CI 0.714, 0.893), physical functioning (unstandardized B = 0.761; standardized B = 0.763; 95% CI 0.661, 0.861), emotional functioning (unstandardized B = 1.205; standardized B = 0.757; 95% CI 1.037, 1.372), professional functioning (unstandardized B = 1.142; standardized B = 0.498; 95% CI 0.843, 1.442), cognitive functioning (unstandardized B = 1.239; standardized B = 0.739; 95% CI 1.058, 1.420), and social functioning (unstandardized B = 0.912; standardized B = 0.768; 95% CI 0.790, 1.034).

Conclusions

In a sample of adult patients on hemodialysis, SOC was positively significantly associated with QOL and its submodalities, expect the satisfaction with the quality of care. The confirmation of the general hypothesis that relates the SOC with the QOL encourages more salutogenic research among this patient population.

Sense of Coherence and Health-Related Quality of Life in Patients with Multiple Sclerosis: The Role of Physical and Neurological Disability

Multiple sclerosis is a progressive demyelinating disease of the central nervous system that can lead to permanent disability and significantly impact the quality of life. The present study explores the relationship between neurological disability and disease symptoms, quality of life, and the level of sense of coherence, which is an important resource for coping with the disease. EDSS, GNDS, SOC-29, and MSIS-29 were used in the presented study. The study group consisted of 137 people diagnosed with multiple sclerosis. The study showed the correlation between most of the analyzed variables. Mood disability and fatigue were significant predictors of the sense of coherence and explained 34% of its variance. Physical disability and fatigue served as significant predictors of the physical aspect of quality of life, explaining 49% of its variance. Fatigue and sense of coherence were significant predictors of the psychological aspect of quality of life, explaining 47% of the variance. In studies on a group of people with multiple sclerosis, it is worth considering, in addition to the level of disability, also invisible symptoms, such as fatigue or mood disability, which are important for the quality of life and the level of resources. As this study suggests, a sense of coherence is a resource essential for the quality of life of people with disabilities.

Sense of coherence and coping behaviours in persons with late effects of polio

BACKGROUND

Sense of coherence (SOC), comprising "comprehensibility", "manageability" and "meaningfulness", is important for successful adaptation in persons with late effects of polio (LEoP) and can be used as an estimate of the ability to cope with stressors. Coping behaviours are the actions a person performs to reduce stress and can be divided into problem-focused coping, emotion-focused coping and less useful coping. Our knowledge is very limited of what coping behaviours persons with LEoP use to manage their life situation as well as the association between SOC and coping behaviours.

OBJECTIVE

The aims of this cross-sectional study were to assess coping behaviours and to explore the association between SOC and coping behaviours in persons with LEoP.

METHODS

In total, 93 ambulant persons (52% women, mean [SD] age 74 [8] years) with clinically and electromyographically verified LEoP responded to a postal survey with the Sense of Coherence Scale 13 items (SOC-13) and the Brief Cope Scale. Three linear regression analyses were used to explore the association between SOC and problem-focused coping, emotion-focused coping and less useful coping, controlling for age and sex.

RESULTS

The most-used coping behaviours belonged to the categories problem-focused and emotion-focused coping. We found a significant negative association between SOC and less useful coping; less useful coping explained 34% of the variance of SOC (adj R2 = 0.34, p < 0.001), whereas age and sex were not significant in the analyses.

CONCLUSIONS

Persons with LEoP primarily use problem-focused and emotion-focused coping behaviours, which suggests that generally they have adapted well to their disability. Regardless of age and sex, persons with lower SOC scores use less useful coping behaviours, which suggests that they are not as well adapted. These results can facilitate the development of rehabilitation interventions that help persons with LEoP adapt to their situation with a life-long disability.

'Striving for normality' when coping with Parkinson's disease in everyday life: A metasynthesis

BACKGROUND

Parkinson's disease is a chronic, progressive neurodegenerative disease which affects more than ten million people worldwide. Living with Parkinson's disease has a high impact on everyday life, and may affect quality of life negatively. Individualized coping strategies are needed to deal with the disease on a daily basis and still enjoy a social life.

OBJECTIVE

The aim of this study was to identify and describe strategies for coping adopted by individuals living with Parkinson's disease in their daily lives.

DESIGN

The study is designed as a meta-ethnographic metasynthesis and follows Sandelowski and Barroso's guidelines for synthesizing qualitative research.

DATASOURCES

Based on an exhaustive literature search in the following databases: CINAHL, MEDLINE, PsychINFO, Scopus and Swemed, as well as Mednar, parkinson.org, Google Scholar and OpenGrey, with no limit on the search date, 14 articles were included.

REVIEW METHODS

The data were analyzed through a taxonomic and inductive analysis focusing on coping with Parkinson's disease in daily life.

RESULTS

The findings revealed that the overarching motivation for patients to cope with Parkinson's disease was maintaining normality and preserving the self. The coping strategies used were: Staying independent, Focusing on the present and Avoiding challenging situations.

CONCLUSIONS

Coping with Parkinson's disease is an ongoing and complex process of balancing the strategies used, while holding on to the 'self' that pre-dated Parkinson's disease, and at the same time adjusting one's identity to embrace living with a chronic condition. In this process, optimism and positive thinking would seem to be very fruitful. Further, the synthesis revealed that relatives often act as informal caregivers and hence as an important support in daily life. Healthcare professionals must know about coping strategies in order better to support the patients.

Coping Styles among People with Parkinson's Disease: A Three-Year Follow-Up Study

People with Parkinson’s disease (PD) experience a gradual loss of functional abilities that affects all facets of their daily life. There is a lack of longitudinal studies on coping styles in relation to the disease progression among people with PD. The aim of this study was to explore how coping styles in PD evolve over a 3-year period. Data from the longitudinal project “Home and Health in People Ageing with PD” was utilized (N = 158), including baseline and 3-year follow-up assessments. Coping was captured by ratings of 13 different coping styles. A factor analysis was conducted to analyse patterns of coping styles. Stability and change were analysed for each of the 13 styles with respect to the course of the disease. The factor analysis revealed four coping patterns: pessimistic, optimistic, persistent and support-seeking. The stability of each coping style over time ranged from 75.3% to 90.5%. Those who experienced a worsening of the disease were most inclined to change their coping style (p = 0.006). The results suggest that even when facing severe challenges due to PD in daily life, coping styles remain relatively stable over time. However, a worsening in PD severity appeared to trigger a certain re-evaluation of coping styles.

Association between different coping styles and health-related quality of life in people with Parkinson's disease: a cross-sectional study

OBJECTIVE

To describe overlapping coping strategies in people with Parkinson's disease.

DESIGN

Cross-sectional, cohort study.

SETTING

Monocentric, inpatient and outpatient, university hospital.

PARTICIPANTS

Two-hundred participants enrolled, 162 patients with Parkinson's disease (without dementia) analysed.

PRIMARY AND SECONDARY OUTCOME MEASURES

Prevalence of different coping styles according to the German Essen Coping Questionnaire. Association between coping, sociodemographic and clinical parameters (Movement Disorder Society (MDS)-sponsored revision of the Unified Parkinson's Disease Rating Scale (UPDRS), non-motor symptoms questionnaire (NMS-Quest), Montreal cognitive assessment (MoCA), Beck depression inventory (BDI) and health-related quality of life (Short Form Health Survey 36 (SF-36))).

RESULTS

In comparison with patients who employed a passive coping style, patients using an active form of coping were characterised by a shorter disease duration (p=0.017), fewer motor impairments (MDS-UPDRS II p=0.040, MDS-UPDRS III p=0.003), a lower non-motor burden (NMS-Quest p=0.048), better cognitive function (MoCA p=0.036) and fewer depressive symptoms (BDI p<0.001). From the 162 participants, 24% showed an overlap of active and passive coping strategies. The most common combination was acting/problem-oriented coping and distance and self-promotion. In comparison with patients who employed passive coping, the group with an overlapping coping style was characterised by a shorter disease duration (p=0.023) and lower depressive burden (p=0.001). In comparison with patients who employed active coping, the overlap group was characterised by poorer cognitive function (p=0.045). The SF-36 values of the overlap group were between those of the active and passive coping groups.

CONCLUSION

Knowledge about overlapping coping strategies is relevant to the implementation of strategies to promote active and healthy coping.

Sense of Coherence and the Association with Sociodemographics and Disability Related Factors in Persons with Late Effects of Polio

BACKGROUND

Sense of Coherence (SOC) is important for successful adaptation in persons with life-long disabilities. A previous study has shown that persons with Late Effects of Polio (LEoP) have a level of SOC indicating that they generally have the ability to understand, handle, and have the motivation to deal with stressful events and problems arising in their lives. However, no study has explored the associations between SOC, sociodemographics, and disability-related factors in persons with LEoP.

OBJECTIVE

To explore the associations between SOC, sociodemographics, and disability-related factors in persons with LEoP.

DESIGN

A cross-sectional design.

SETTING

University hospital outpatient clinic.

STUDY PARTICIPANTS

Ninety-three persons (mean age 74 years, 52% women) with LEoP.

MAIN OUTCOME MEASUREMENTS

Swedish versions of the Sense of Coherence scale (SOC-13), Self-reported Impairments in Persons with Late Effects of Polio (SIPP) scale, Reintegration to Normal Living Index (RNL-I) (subscales "Daily Functioning" and "Perceptions of Self"), and Satisfaction With Life Scale (SWLS).

METHODS

The participants responded to a postal survey with background information and the four rating scales. To determine factors associated with SOC, a hierarchical regression analysis was performed with SOC as the dependent variable.

RESULTS

Higher age, less bothered by symptoms of LEoP, better perceptions of self, and higher life satisfaction were significantly associated with a greater SOC score. The final model explained 60% of the variance in the SOC (R² Adj = 0.60, P < .001).

CONCLUSIONS

The strong association between SOC, higher age, and disability-related factors is important to consider in the rehabilitation of persons with LEoP. This knowledge can assist rehabilitation professionals to plan interventions that enable people with LEoP to develop strategies to better manage their daily life.

LEVEL OF EVIDENCE

III.

Well-being and distress of patients with Parkinson's disease: a comparative investigation

ABSTRACTBackground:Psychological resources, such as psychological well-being (PWB) and life satisfaction (LS) can aid individuals suffering from chronic illnesses to cope with their illness. The aim of this study was to investigate PWB, LS, quality of life (QoL), and distress in patients with Parkinson's disease (PD) and to compare them with healthy controls.

METHODS

One hundred and thirteen individuals were recruited. Fifty of the participants suffered from PD, while 53 individuals reported other non-neurological diseases. PD patients were assessed through medical routine examinations. All participants had to be devoid of severe cognitive impairment. They were administered self-report questionnaires to measure PWB, LS, QoL, and distress. A cross-sectional comparative design was applied.

RESULTS

PD patients reported higher general PWB than controls with the exception of the autonomy subscale where the PD patients scored lower. However, they also reported higher distress (anxiety, depression, somatic symptoms, and hostility-irritability), lower LS, and poorer QoL compared to controls. In regressive models, general PWB and LS were significantly correlated to the presence of PD, to its functional impairments, and not to other socio-demographic variables.

CONCLUSIONS

Findings confirmed previous literature on other neurological conditions, showing that PD may be associated with greater psychological distress, lower levels of LS and QoL. At the same time, PD patients may preserve their PWB, which is a protective factor for mental and physical health. The presence of these psychological resources is inversely related to functional impairments. Future studies should better investigate the pattern of PWB in PD.

Comparison of three scales to evaluate personality traits in Parkinson's disease: which one to use?

BACKGROUND

Personality traits have gained interest in the field of disability and stress, because they may either prompt or deny compliance. They can also foster motivation and influence outcome. Parkinson disease (PD) is a disabling and stressful condition that requires coping strategies and rehabilitation plans. Three constructs and their relative scales have been a matter of investigation, namely dispositional optimism (DO), locus-of-control (LOC), and sense-of-coherence (SOC).

AIM

The present study compared the psychometric properties of three constructs in Parkinson's disease (PD). The health-related variables were: emotional distress (ED), quality of life (HR-QoL) and activities of daily living (ADL). The final objective was to provide guidance on scale selection to be implemented in clinical protocols.

DESIGN

A cross sectional study.

SETTING

Community-based general physicians.

POPULATION

Participants with PD (N.=84) from community-based general physicians.

METHODS

PD patients completed 3 self-report scales, namely Life Orientation Test-Revised (LOT-R, measuring Dispositional Optimism), Internal and External Locus Of Control (LOC-int. LOC-ext) and Sense of Coherence (SOC). All participants had magnetic resonance imaging. The MDS-UPDRS and the Barthel Scale were compiled by the investigator with the assistance of a caregiver.

RESULTS

LOC-ext was the only scale to be associated with PD severity and disability (P<0.05). A higher level of LOC-ext was also associated with a higher level of ED (P<0.005). LOT-R was inversely associated with ED. Subjects in the highest tertile had a 41% lower ED (P<0.001). SOC was also inversely associated with degree of ED. Subjects in the highest tertile have a 44% lower ED (P<0.01). Moreover, HR-QoL is associated with several parameters, but LOT-R is the one with the strongest association (P<0.001).

CONCLUSIONS

DO and SOC are predictive of important end-points, namely HR-QoL and ED. DO is even better under this respect. Conversely, those clinicians who are more interested in motor problems may find LOC more suitable. DO may be the most efficient construct to use in PD because of its favorable psychometric properties.

CLINICAL REHABILITATION IMPACT

DO, LOC and SOC are constructs to be implemented in both research and clinical PD protocols. It is recommended to implement these, because they have predictive value especially when HR-QoL and ED are studied.

Subjective and psychological well-being in Parkinson's Disease: A systematic review

OBJECTIVES

The aim of this review is to summarize studies investigating subjective and psychological well-being in patients with Parkinson's disease (PD).

MATERIALS AND METHODS

A systematic and integrative review according to PRISMA criteria was performed with a literature search from inception up to September 2017 in multidisciplinary databases (PubMED, Scopus, Web of Knowledge) by combining together key words related to PD and well-being. Studies were included if: their full-text was available; they involved PD patients; focused on the selected positive dimensions; written in English. Case studies, conference proceedings, abstract, dissertations, book chapters, validation studies and reviews were excluded. Data extracted from the studies included sample characteristics, the positive dimension investigated, type of measure, study aims, design and results. One reviewer extracted details and commented results with other reviewers. The studies' quality was assessed following Kmet, Lee, and Cook.

RESULTS

Out of 1425 studies extracted, 12 studies (9 quantitative, 2 qualitative, 1 mixed methods) involving 2204 patients with PD were included. Most of the studies had a cross-sectional design and/or evaluated the effect of physical rehabilitation on well-being. Articles documented that the illness could impair well-being for its progressive impact on patients' motor autonomy. Preserving motor and musculoskeletal functioning facilitate patients' experience of well-being, social contribution and the maintenance of their job.

CONCLUSIONS

Research on positive resources in PD is still scarce compared to other chronic illnesses. The few available investigations suggest the need of preserving motor abilities by proper rehabilitation programs for maintaining and/or promoting patients' well-being and life engagement.

Coping mediates the relationship between sense of coherence and mental quality of life in patients with chronic illness: a cross-sectional study

PURPOSE

The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus' and Folkman's stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status.

METHODS

The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS.

RESULTS

The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL.

CONCLUSIONS

Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus' and Folkman's stress and coping theory.

A High Sense of Coherence as Protection Against Adverse Health Outcomes in Patients Aged 80 Years and Older

PURPOSE

We set out to assess whether a high sense of coherence (SOC) protects from adverse health outcomes in patients aged 80 years and older who have multiple chronic diseases.

METHODS

A population-based prospective cohort study in 29 primary care practices throughout Belgium included 567 individuals aged 80 years and older. We plotted the highest tertile of SOC scores in Kaplan-Meier curves representing 3-year mortality and time to first hospitalization. Using Cox proportional hazard regression analyses and multiple logistic regression analyses adjusted for sociodemographic characteristics, depression, cognition, disability, and multimorbidity we examined the relationship between SOC and mortality, hospitalization, and decline in performance of activities of daily living (ADL).

RESULTS

Subjects with high SOC scores showed a higher cumulative survival than others (Log rank = 0.004) independent of other prognostic characteristics (adjusted hazard ratio 0.62 (95% CI, 0.38-1.00), P = .049). For ADL decline, a high SOC was shown to be protective, and this effect tended to be independent from the covariates under study (adjusted odds ratio 0.56 (95% CI, 0.31-1.0), P = .05).

CONCLUSION

Even very elderly persons with high SOC scores were shown to have lower mortality rates and less functional decline. These effects were independent of multimorbidity, depression, cognition, disability, and sociodemographic characteristics.

Psychological Predictors of Anxiety and Depression in Parkinson's Disease: A Systematic Review

OBJECTIVES

Parkinson's disease (PD) is a neurodegenerative disorder, affecting the motor system with psychological difficulties also frequently reported. While explanations for psychological difficulties are historically situated within a biomedical framework, more recently the relevance of psychological determinants has become a research focus. This review therefore examines this relationship with the two most commonly reported psychological difficulties (anxiety and depression) in people with PD.

METHOD

Databases were systematically searched up to December 17, 2013, identifying 24 studies meeting inclusion criteria.

RESULTS

Significant predictors of heightened anxiety and depression included increased emotion-focused coping; less problem-focused coping; lower perceived control; more dominant beliefs about PD as part of a person's identity and influence on life; less social support and more avoidant personality types.

CONCLUSIONS

Relationships between some specific psychological predictors and depression and anxiety seem well supported. The complexity of relationships between these psychological determinants should be taken into consideration when delivering psychological interventions.

‘Locus of control’, health-related quality of life, emotional distress and disability in Parkinson’s disease

This cross-sectional study evaluated locus of control and its subscales in Parkinson’s disease. A total of 50 consecutive Parkinson’s disease participants and 50 healthy volunteers (control group) were enrolled. External locus of control was significantly higher in Parkinson’s disease participants, whereas internal locus of control had no significant differences. External locus of control and internal locus of control were correlated in control group, but not in Parkinson’s disease. In Parkinson’s disease participants, external locus of control was negatively associated with health-related quality of life as well as positively associated with emotional distress and disease severity (but not with disability). After adjusting to confound variables, the associations remained. On the other hand, internal locus of control was negatively associated with depression.

The sense-of-coherence predicts health-related quality of life and emotional distress but not disability in Parkinson's disease

Background

Personality traits are deemed important in many fields of Medicine. The present study aimed at evaluating i) the presence of Sense-of-Coherence (SOC) in patients suffering from Parkinson’s Disease (PD) in comparison with an age-matched general control population, ii) the influence of SOC on health-related variables, such as depression and anxiety, quality of life (Qol), and activities of daily living (ADL).

Methods

SOC was measured in 50 PD patients and in 50 matched controls enrolled in cross-sectional study. The other clinical measures included: Mini Mental State Examination (MMSE), Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Well-being Index (WHO-5), Hospital Anxiety and Depression Scale (HADS) and the Barthel Index of ADL (BI). Data were analysed with univariate statistics and loglinear adjusted regression models.

Results

No difference emerged between PD and controls on socio-demographic and SOC. A statistically significant positive correlation was found between SOC and Qol (0.40, p < 0.004) and a negative significant correlation between SOC and emotional distress (−0.37, p < 0.008). The multivariate regression analysis confirmed the negative effect of SOC on total emotional distress (−3%, p = 0.01) and positive effect on Qol (2%, p = 0.01). SOC and BI were uncorrelated.

Conclusions

SOC is predictive of QoL and emotional distress in PD, whereas no evidence of a predictive effect for disability could be found. These results support only partially, the Salutogenic Theory in PD, i.e. a strong SOC positively influences psychosocial health, but does not influence physical health.

Psychological well-being revisited: advances in the science and practice of eudaimonia

This article reviews research and interventions that have grown up around a model of psychological well-being generated more than two decades ago to address neglected aspects of positive functioning such as purposeful engagement in life, realization of personal talents and capacities, and enlightened self-knowledge. The conceptual origins of this formulation are revisited and scientific products emerging from 6 thematic areas are examined: (1) how well-being changes across adult development and later life; (2) what are the personality correlates of well-being; (3) how well-being is linked with experiences in family life; (4) how well-being relates to work and other community activities; (5) what are the connections between well-being and health, including biological risk factors, and (6) via clinical and intervention studies, how psychological well-being can be promoted for ever-greater segments of society. Together, these topics illustrate flourishing interest across diverse scientific disciplines in understanding adults as striving, meaning-making, proactive organisms who are actively negotiating the challenges of life. A take-home message is that increasing evidence supports the health protective features of psychological well-being in reducing risk for disease and promoting length of life. A recurrent and increasingly important theme is resilience - the capacity to maintain or regain well-being in the face of adversity. Implications for future research and practice are considered.