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Yu P, Zhang W, Li S, Luo X, Chen H, Mi J. Psychological resilience in the relationship between family function and illness uncertainty among family members of trauma patients in the intensive care unit. BMC Psychiatry 2024; 24:486. [PMID: 38961366 PMCID: PMC11223282 DOI: 10.1186/s12888-024-05883-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 06/03/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Severe trauma accounts for a main factor inducing mortality for individuals aged < 45 years in China, which requires admission to intensive care unit (ICU) to receive comprehensive treatment. Family members of patients with unanticipated and life-threatening trauma during their ICU stays often experience psychosocial distress due to illness uncertainty. Previous research has shown that family function and psychological resilience are associated with illness uncertainty, respectively. However, little is known about the current situation and interacting mechanism between family function, psychological resilience, and illness uncertainty of family members for ICU trauma patients. Therefore, this study focused on exploring the current situation and relationships between these three factors in family members for ICU trauma patients. METHODS The convenience sampling approach was adopted in the present cross-sectional survey, which involved 230 family members for ICU trauma patients from 34 hospitals in Chongqing, China. Related data were extracted with self-reporting questionnaires, which included sociodemographic characteristic questionnaire, the Family Adaptability, Partnership, Growth, Affection and Resolve Scale (APGAR), the 10-item Connor-Davidson Resilience Scale (10-CD-RISC) and the Mishel's Illness Uncertainty Scale for Family Members (MUIS-FM). Pearson correlation analysis was conducted to examine the correlations between various variables. Additionally, a structural equation model was adopted to assess the mediating effect of psychological resilience on family function and illness uncertainty. RESULTS According to our results, family members for ICU trauma patients experienced high illness uncertainty with moderate family dysfunction and low psychological resilience. Family function directly affected illness uncertainty and indirectly affected illness uncertainty through psychological resilience in family members of ICU trauma patients. CONCLUSIONS Family function and psychological resilience are the protective factors for reducing illness uncertainty. Healthcare providers should take effective measures, including family-functioning improvement and resilience-focused interventions, for alleviating illness uncertainty in family members of ICU trauma patients.
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Affiliation(s)
- Peilin Yu
- The School of Nursing, Chongqing Medical University, Chongqing, China
| | - Wanzhu Zhang
- The School of Nursing, Chongqing Medical University, Chongqing, China
| | - Shijie Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuan Luo
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Mi
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- The School of Nursing, Chongqing Medical University, Chongqing, China.
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2
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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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3
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Aamodt WW, Kluger BM, Mirham M, Job A, Lettenberger SE, Mosley PE, Seshadri S. Caregiver Burden in Parkinson Disease: A Scoping Review of the Literature from 2017-2022. J Geriatr Psychiatry Neurol 2024; 37:96-113. [PMID: 37551798 PMCID: PMC10802092 DOI: 10.1177/08919887231195219] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Caregiver burden is a term that refers to the adverse effect of caregiving on the physical, emotional, social, spiritual, and financial well-being of the caregiver. Caregiver burden is associated with providing care to an individual with a chronic illness or disability, and the unique symptoms of Parkinson disease (PD) can amplify a patient's needs and reliance on others, leading to adverse outcomes for patients and their caregivers. In this scoping review of the literature from January 2017 through April 2022 that included 114 studies, we provide an updated, evidence-based summary of patient and caregiver-related factors that contribute to caregiver burden in PD. We also describe the impact of caregiver stress and burden on caregivers based on qualitative research studies and review recent interventions to mitigate burden. By providing clinical updates for practitioners, this review is designed to improve recognition of caregiver burden in the post-pandemic era and foster the development of targeted interventions to reduce caregiver burden in PD.
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Affiliation(s)
- Whitley W. Aamodt
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
- Translational Center of Excellence for Neuroepidemiology and Neurology Outcomes Research, University of Pennsylvania, Philadelphia, PA, USA
| | - Benzi M. Kluger
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Miray Mirham
- School of Medicine, University of Rochester, Rochester, NY, USA
| | - Anna Job
- University of Rochester, Rochester, NY, USA
| | | | - Philip E. Mosley
- School of Medicine, University of Queensland, Herston, QLD, Australia
| | - Sandhya Seshadri
- Department of Neurology, University of Rochester, Rochester, NY, USA
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García PS, Souto Serrano M, Alcedo Rodríguez MÁ, Peña Suárez E, Pedrosa I, Diaz ALA. Ageing with Parkinson's: Identification of Personal Needs in the Northern Spanish Context. Healthcare (Basel) 2024; 12:498. [PMID: 38391873 PMCID: PMC10888230 DOI: 10.3390/healthcare12040498] [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: 12/13/2023] [Revised: 02/02/2024] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
As individuals diagnosed with Parkinson's disease enter older age, the myriad challenges and complications associated with this condition tend to escalate. Hence, there is a critical necessity to comprehensively discern the perceived needs of these individuals, along with their proposed remedies and essential support requisites. Additionally, understanding the perspectives of their families becomes imperative to formulate tailored interventions aimed at enhancing their overall development, progression, and quality of life. The study's main objective is to assess the perceived needs of individuals with PD and their family members, propose necessary solutions, and suggest future perspectives. The study encompassed a cohort of 268 participants, comprising 179 individuals diagnosed with Parkinson's disease and 89 of their relatives. A meticulously designed structured interview instrument consisting of 93 items was employed to assess various domains encompassing perceived needs, institutional support mechanisms, essential solutions, and future anticipations. Results: Statistically significant differences were found in health resources, social services resources, obstacles, solutions, and future outlook, with higher mean values from the relatives. Conclusions: The results highlight the most concerning needs in this context. Specifically, those needs related to health resources, social services resources, and future outlook present the greatest differences between the two subsamples, with the family members perceiving more needs. This alignment extended to both the categorization of unmet needs and the requisite solutions envisioned to address them. Suggested improvements include a sociosanitary strategy, stakeholder involvement, and prioritizing flexible home assistance to support older individuals with PD and their families.
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Affiliation(s)
| | | | | | - Elsa Peña Suárez
- Department of Education of the Government of the Principality of Asturias, 33007 Oviedo, Spain
| | - Ignacio Pedrosa
- Information and Communication Technology Center, 33203 Gijón, Spain
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5
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Ferraris G, Zarzycki M, Gérain P, Elayan S, Morrison V, Sanderman R, Hagedoorn M. Does willingness to care fluctuate over time? A weekly diary study among informal caregivers. Psychol Health 2023:1-19. [PMID: 37608731 DOI: 10.1080/08870446.2023.2249538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 07/21/2023] [Accepted: 08/12/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE Informal caregivers are expected to be willing to care for relatives with care needs. Little is known about whether and how willingness to care changes over time. Using a weekly diary study, we examined changes in the willingness of 955 caregivers from nine countries. Caregivers provided information on their caregiving context, relationship type, and relationship satisfaction with the care recipient. METHODS AND MEASURES For 24 consecutive weeks, caregivers evaluated willingness to care as it was 'right now'. RESULTS Willingness differs from one caregiver to another (68% between-level variability) but also fluctuates in the same caregiver from week to week (32% within-level variability), with a decrease over 6 months (intercept = 8.55; slope = -0.93; p < .001). Regardless of individual differences in average willingness to care based on caregiving context and relationship satisfaction, caregivers reported decreases in willingness. Caregivers who presented one or more health conditions themselves reported higher weekly fluctuations in willingness than caregivers with no health conditions. CONCLUSION Willingness is not a stable attitude because it decreases and caregivers experience fluctuations from week to week. A clearer understanding of weekly processes is optimal for monitoring the caregivers' well-being and tailoring interventions in line with weekly individual variations.
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Affiliation(s)
- Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Mikołaj Zarzycki
- Department of Psychology, Liverpool Hope University, Liverpool, UK
| | - Pierre Gérain
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Saif Elayan
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Val Morrison
- School of Human and Behavioural Science, Bangor University, Bangor, UK
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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6
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Chen Y, Zhang R, Lou Y, Li W, Yang H. Facilitators and barriers to the delivery of palliative care to patients with Parkinson's disease: a qualitative study of the perceptions and experiences of stakeholders using the socio-ecological model. BMC Health Serv Res 2023; 23:215. [PMID: 36879235 PMCID: PMC9990289 DOI: 10.1186/s12913-023-09203-2] [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: 10/12/2022] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVE Palliative care (PC) can improve the quality of life of Parkinson's disease (PD) patients and their carers. However, the impact of PC services on patients with PD remains unclear. This research was conducted to identify the barriers and facilitators influencing PC services for patients with PD based on the Social Ecological Model (SEM) framework. METHODS This research was conducted through semi-structured interviews, employing SEM to organize themes and identify potential solutions across multiple levels. RESULTS A total of 29 interviewees (5 PD clinicians, 7 PD registered nurses, 8 patients, 5 caregivers, and 4 policy makers) completed the interviews. Facilitators and barriers were identified according to the levels of the SEM. Several facilitators were identified, i.e., (1) individual level: the critical needs among PD patients and their relatives and the desire for PC knowledge among health professionals; (2) interpersonal level: social support; (3) organizational level: the investments towards systematization of PC; and nurses are the bridge between patients and doctors; (4) community level: the convenience of community services; and hospital-community-family-based services; (5) culture and policy level: existing policy. CONCLUSION The social-ecological model proposed in this study helps illuminate the complex and multilevel factors that may influence PC delivery to PD patients.
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Affiliation(s)
- Yiping Chen
- School of nursing, Shanxi Medical University, Taiyuan City, Shanxi Province, China
| | - Ru Zhang
- School of nursing, Shanxi Medical University, Taiyuan City, Shanxi Province, China
| | - Yan Lou
- Hangzhou Normal Unviersity, Hangzhou, Zhejiang Province, China
| | - Wei Li
- International Medical Department, Peking Union Medical College Hospital, Beijing, China
| | - Hui Yang
- Department of Neurology, First Hospital of Shanxi Medical University, No.56, Xinjian South Road, Yingze District, Taiyuan City, Shanxi Province, China.
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7
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Chen Y, Zhou W, Hou L, Zhang X, Wang Q, Gu J, Zhang R, Yang H. The subjective experience of family caregivers of people living with Parkinson's disease: a meta-ethnography of qualitative literature. Aging Clin Exp Res 2022; 34:959-970. [PMID: 34648175 DOI: 10.1007/s40520-021-01995-9] [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: 09/09/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Parkinson's disease patients (PwPD) rely heavily on their family caregivers. However, there remains uncertainty regarding the subjective experience of the family caregivers of PwPD. This study aims to provide an in-depth summary of the current knowledge about the subjective experiences of family caregivers caring for PwPD, to understand the factors that influence this experience and to provide the evidence for healthcare services. METHODS We conducted a systematic review and meta-ethnography using Noblit and Hare's approach. The search strategy used MeSH terms in combination with free-text searching of 10 databases (from their inception until July 2021). Titles and abstracts were reviewed by two reviewers and, for the studies that met the eligibility criteria, full-text articles were obtained. The Critical Appraisal Skills Program (CASP) checklist was employed to assess the quality of studies. RESULTS A total of 3318 studies were screened and 29 qualitative studies were included in this review. These studies recorded the experience of 399 participants across 12 countries, most were females. Five themes emerged: (a) feelings related to PD; (b) challenges to family life; (c) external challenges; (d) adjustment and adaptation; (e) external support. We propose a new conceptual model that highlights that the experiences of caregivers for PwPD are dynamic and influenced by a variety of internal and external factors. CONCLUSION Our findings illustrate the complex and dynamic experiences of family caregivers for PwPD. It is necessary to explore how the influencing factors can be modified to improve the lived experience of family caregivers.
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8
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Bhasin SK, Bharadwaj IU. Perceptions and meanings of living with Parkinson's disease: an account of caregivers lived experiences. Int J Qual Stud Health Well-being 2021; 16:1967263. [PMID: 34414851 PMCID: PMC8381973 DOI: 10.1080/17482631.2021.1967263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: Current study looked into caregiving process of those dealing with family members suffering from Parkinson’s disease, within the changing social milieu in India. It aimed to understand the experiential and existential impact on the lifeworld of caregivers. Method: Narrative interviews of 10 female caregivers referred by neurologists were gathered. Employing Existential Phenomenological Analysis, the caregiver experiences were understood phenomenologically within an existential framework, six themes were generated. Results: Themes were – Becoming a caregiver: Undertaking immeasurable and unrelenting responsibilities; Rising patient-hood of one’s family member: pain of losing the person in the patient; Experience of altered temporality: living in pain with the uncertainty and duration of the disease; Encountering meaninglessness: dwindling faith in principles of life; Existing as a “Being For” and not “Being With”: a caregiver’s self-estrangement and blurring of Identity and lastly Self-Preservation through brief moments of respite: coping with caregiving. Conclusion: The study illuminated how caregiving is experienced by an individual at a process and psychic level by shedding light on the conflicts, concerns and exhaustions endured by them. Adopting an existential approach in healthcare setups can aid in moving closer to felt experiences of these caregivers and in developing integrative and meaningful interventions for enhancing their well-being.
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9
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Tan QY, Cox NJ, Lim SER, Coutts L, Fraser SDS, Roberts HC, Ibrahim K. The Experiences of Treatment Burden in People with Parkinson's Disease and Their Caregivers: A Systematic Review of Qualitative Studies. JOURNAL OF PARKINSONS DISEASE 2021; 11:1597-1617. [PMID: 34334419 DOI: 10.3233/jpd-212612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BackgroundHigh treatment burden is associated with poor adherence, wasted resources, poor quality of life and poor health outcomes. Identifying factors that impact treatment burden in Parkinson's disease can offer insights into strategies to mitigate them.ObjectiveTo explore the experiences of treatment burden among people with Parkinson's disease (PwP) and their caregivers.MethodsA systematic review of studies published from year 2006 was conducted. Qualitative and mixed-method studies with a qualitative component that relate to usual care in Parkinson's disease were included. Quantitative studies and grey literature were excluded. Data synthesis was conducted using framework synthesis.Results1757 articles were screened, and 39 articles included. Understanding treatment burden in PwP and caregivers was not the primary aim in any of the included studies. The main issues of treatment burden in Parkinson's disease are: 1) work and challenges of taking medication; 2) healthcare provider obstacles including lack of patient-centered care, poor patient-provider relationships, lack of care coordination, inflexible organizational structures, lack of access to services and issues in care home or hospital settings; and 3) learning about health and challenges with information provision. The treatment burden led to physical and mental exhaustion of self-care and limitations on the role and social activities of PwP and caregivers.Conclusion:There are potential strategies to improve the treatment burden in Parkinson's disease at an individual level such as patient-centered approach to care, and at system level by improving access and care coordination between services. Future research is needed to determine the modifiable factors of treatment burden in Parkinson's disease.
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Affiliation(s)
- Qian Yue Tan
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Natalie J Cox
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton, UK
| | - Stephen E R Lim
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
| | - Laura Coutts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Simon D S Fraser
- National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK.,School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Trust, Southampton, UK
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK.,National Institute for Health Research Applied Research Collaboration Wessex, University of Southampton, Southampton, UK
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10
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Scharfenort M, Timpka J, Sahlström T, Henriksen T, Nyholm D, Odin P. Close relationships in Parkinson´s disease patients with device-aided therapy. Brain Behav 2021; 11:e02102. [PMID: 33949144 PMCID: PMC8213651 DOI: 10.1002/brb3.2102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 01/31/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Deep brain stimulation, continuous subcutaneous apomorphine infusion, and levodopa-carbidopa intestinal gel infusion, together called device-aided therapies (DAT), are introduced when oral and transdermal pharmacotherapy are not enough for a satisfactory control of Parkinson's disease (PD) symptoms. Solid relationships are central to an individual's well-being, but the impact of close relationships in advanced PD remains underexplored. The aim of this study was to investigate the development of close relationships between PD patients and their partners following the initiation of DAT and to examine the relationship structures in these relationships. MATERIALS AND METHODS This was a retrospective quantitative multicenter pilot study wherein 41 couples, patients with advanced PD and their partners, retrospectively rated their relationship satisfaction before the start of DAT, after one year of DAT and at the time of the interview. The couples also answered the Experiences in Close Relationships-Questionnaire of Relational Structures (ECR-RS). RESULTS Partners more often report changes in relationship satisfaction than patients between baseline and both 1 year after start of DAT (p = .049) and last evaluation (p = .041). The ECR-RS data reported significantly higher avoidance score for partners (p = .005) and significantly higher anxiety score for patients (p = .024). CONCLUSIONS The close relationship wherein one part has PD and receives DAT has a high risk of being unequal. Prospective studies are needed for further clarification of the interplay between advanced PD, DAT, and close relationships, this in order to improve pre- and postinterventional support for PD patients receiving DAT, as well as their partners.
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Affiliation(s)
- Monica Scharfenort
- Division of Neurology, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Jonathan Timpka
- Division of Neurology, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | | | - Tove Henriksen
- Department of Neurology, University Hospital of Bispebjerg, Copenhagen, Denmark
| | - Dag Nyholm
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Per Odin
- Division of Neurology, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
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11
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Xue M, Zhai X, Liu S, Xu N, Han J, Zhou M. The experience of family caregivers of patients receiving home nasogastric tube feeding in China: A descriptive qualitative study. J Hum Nutr Diet 2021; 35:14-22. [PMID: 33908101 PMCID: PMC9291130 DOI: 10.1111/jhn.12908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/18/2021] [Accepted: 04/20/2021] [Indexed: 11/30/2022]
Abstract
Background The value of caregivers with respect to ensuring safety during home nasogastric tube (NGT) feeding is increasingly acknowledged. However, little attention has been given to the experience of caregivers. Methods A qualitative descriptive design using semi‐structured interviews via purposive sampling at a comprehensive hospital in China was employed. Family caregivers of patients with home NGT feeding were recruited. Interviews were recorded, transcribed verbatim and analysed qualitatively using inductive content analysis. Results Thirteen family caregivers of patients with home NGT feeding were interviewed. Four main themes were generated: negative experience (uncertainty and ambivalence, transition gaps between hospitals and home care services), new role: adapting to the lifestyle (participating in decision‐making, being responsible for everything, adjusting own life to NGT feeding), perceived benefit of caregiving (personal growth, development of positive attitudes and achievements) and expectations (expectations from continuity health system services, expectations from social support). Conclusions The present study highlights the vulnerability and perceived benefits embedded in the role of a family caregiver. Improving communication and standardising practices between home and hospitals should be considered.
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Affiliation(s)
- Min Xue
- Qilu Hospital, Shandong University, Jinan, China.,Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | | | - Sihan Liu
- Qilu Hospital, Shandong University, Jinan, China
| | - Nana Xu
- Qilu Hospital, Shandong University, Jinan, China
| | - Jing Han
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Min Zhou
- Qilu Hospital, Shandong University, Jinan, China
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12
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Counterpunching to improve the health of people with Parkinson's disease. J Am Assoc Nurse Pract 2021; 33:1230-1239. [PMID: 33859075 DOI: 10.1097/jxx.0000000000000598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Boxing programs designed specifically for people with Parkinson's disease (PD) can be beneficial in improving the physical, mental, and functional health of persons with PD. PURPOSE This study examined the effect of a boxing program, Rock Steady Boxing (RSB), on the health of people with PD from both the boxers' and their caregivers' perspectives as well as evaluated balance, quality of life (QoL), and depressive symptoms after 12 weeks of RSB. METHODS A mixed methods, one-group experimental design with focus groups were embedded within an intervention study. Six boxers completed baseline and 12-week postassessments. RESULTS The majority of boxers maintained or improved scores for balance, QoL, and reduced depressive symptoms. Findings indicate physical and mental benefits of RSB among persons with PD and this was further validated by qualitative data from boxers and caregivers, along with quantitative data of boxers. Caregivers and boxers reported that boxers' ability to perform activities of daily living (ADLs) improved and is supported by quantitative improvements in the Parkinson's disease Questionnaire-39 ADL subscale. All boxers reported reduced stigma, and caregivers and boxers valued the opportunity to work out in an environment free of stigma, a finding not previously reported. CONCLUSIONS It is important for nurse practitioners to recognize exercise benefits for people with PD and recommend the program to patients and include caregivers in their overall assessment of health and wellness. IMPLICATIONS FOR PRACTICE Nurse practitioners and other health practitioners may consider recommending a boxing program, such as RSB, for their PD patients as a sole or supplemental exercise program.
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13
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Pearce C, Newman S, Mulligan K. Illness Uncertainty in Parents of Children with Juvenile Idiopathic Arthritis. ACR Open Rheumatol 2021; 3:250-259. [PMID: 33710801 PMCID: PMC8063149 DOI: 10.1002/acr2.11238] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 01/22/2021] [Indexed: 01/21/2023] Open
Abstract
Objective To gain a better understanding of uncertainty regarding the illness experienced by parents of children with juvenile idiopathic arthritis (JIA). Methods Parents/guardians of a child or young person (aged less than 18 years) diagnosed JIA were recruited in the United Kingdom via the National Rheumatoid Arthritis Society JIA group. Semistructured telephone interviews were conducted with the parents. Results Twenty parents took part, including 19 mothers and one father. Their children with JIA were mostly female (n = 15; 75%) with polyarticular arthritis (n = 12; 60%), averaged 8 years of age, and had been diagnosed for a mean of 3.7 (SD 2.3) years. Parents expressed uncertainty in the following five key domains: diagnosis, cause, symptoms, and prognosis; medical management; impact; parenting uncertainty; and awareness of JIA. All participants expressed uncertainty in at least four of the five domains. Although parents’ uncertainty in the early stages of the disease related to lack of information and understanding of JIA, much uncertainty could not be resolved by receipt of information. These included concerns about their child’s future and a lack of support with managing the emotional aspects of living with JIA. Conclusion We found that parents’ experiences of uncertainty went beyond dealing with the purely medical aspects of JIA. Provision of information about JIA, although essential, is not sufficient to help parents manage the considerable uncertainty they experience about many aspects of their child’s JIA. Identifying ways to incorporate support for coping with uncertainty into routine care will be an important way of supporting parents to care for their child with JIA.
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Affiliation(s)
- Caroline Pearce
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom
| | - Stanton Newman
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom
| | - Kathleen Mulligan
- School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom.,East London NHS Foundation Trust, 9 Alie St, London, E1 8DE, United Kingdom
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14
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Navarta-Sánchez MV, Ambrosio L, Portillo MC, Ursúa ME, Senosiain JM, Riverol M. Evaluation of a psychoeducational intervention compared with education in people with Parkinson's disease and their informal caregivers: a quasi-experimental study. J Adv Nurs 2020; 76:2719-2732. [PMID: 32798329 DOI: 10.1111/jan.14476] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/22/2020] [Accepted: 06/15/2020] [Indexed: 12/21/2022]
Abstract
AIM To evaluate the effects of a psychoeducational intervention compared with an education programme to strengthen quality of life, psychosocial adjustment, and coping in people with Parkinson's disease and their informal caregivers. DESIGN A quasi-experimental study was performed with repeated measures at baseline, after the intervention and 6 months post-intervention. METHODS The study was carried out at seven primary care centres from 2015-2017. A total of 140 people with Parkinson's and 127 informal caregivers were allocated to the experimental and the control groups. The experimental group received a 9-week psychoeducational intervention, whereas the control group received a 5-week education programme. Repeated measures ANOVA were used to test differences in quality of life, psychosocial adjustment, and coping between the experimental and control groups and over time. RESULTS Patients and informal caregivers in both the experimental and control groups showed significantly better psychosocial adjustment at the post-intervention measurement compared with baseline data. We also found significantly greater quality of life in patients and coping skills in caregivers after the end of the interventions in the experimental and control groups. Nevertheless, no significant differences were identified on the outcomes at the 6-month post-intervention measurement. CONCLUSION The effect of the psychoeducational intervention was not different from the effect of the education programme. The strategies applied in both interventions followed a group approach led by a multidisciplinary team covering information about PD, healthy lifestyles, and social resources. They might be easily sustained in Primary Care to improve care for people with Parkinson's and informal caregivers.
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Affiliation(s)
| | - Leire Ambrosio
- Faculty of Nursing, University of Navarre, Pamplona, Navarre, Spain
| | - Mari Carmen Portillo
- Faculty of Health Sciences, University of Southampton, Southampton, Hampshire, UK
| | - Maria Eugenia Ursúa
- Primary Health Care Center of San Juan, Navarre Health Service, Pamplona, Navarre, Spain
| | | | - Mario Riverol
- Department of Neurology, University of Navarra Clinic, Pamplona, Navarre, Spain
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15
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Rowsell A, Ashburn A, Fitton C, Goodwin VA, Hulbert S, Lamb SE, McIntosh E, Nieuwboer A, Pickering R, Rochester L, Chivers-Seymour K, Ballinger C. Participant expectations and experiences of a tailored physiotherapy intervention for people with Parkinson's and a history of falls. Disabil Rehabil 2020; 44:727-735. [PMID: 32573284 DOI: 10.1080/09638288.2020.1779824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: People with Parkinson's are twice as likely to fall as older people within the general population. This longitudinal qualitative study was part of a larger programme of research including a randomised controlled trial to test the effectiveness of a tailored physiotherapy intervention. Specific qualitative aims focused on a subsample of trial participants in the intervention arm of the trial, and comprised the following:To explore the expectations of participants about the intervention.To investigate participants' experiences of the intervention, and its perceived impacts.To understand the facilitators and barriers to engagement.Methods: Two semi-structured interviews were completed with a theoretical sample of people with Parkinson's from the intervention arm, initially after randomisation but before the intervention commenced, and then again six months later.Results: Forty-two participants out of a large clinical trial were interviewed initially, with 37 agreeing to a second interview at six months. Prior experience of rehabilitation plus information accessed through the trial consent procedure informed participants' realistic expectations. Most found the level of the intervention acceptable, and perceived a range of benefits. However, views about equipment provided were more equivocal. The biggest barriers to participation were time and motivation, whilst social support facilitated engagement with the intervention.Conclusions: This study is the first to capture expectations about participation in a programme of exercises and strategies. It highlights that previous challenges to engagement in physical exercises and activities are not a barrier to future participation and provides new insights into the role of equipment and technology in programmes of physical activity for people with Parkinson's. The challenge of ensuring that programmes of exercise and strategies become an embedded feature of everyday life is highlighted, particularly alongside busy social engagements and leisure pursuits.Implications for rehabilitationFor people with Parkinsons, a programme of exercises and strategies has the potential to reduce the risk of falls amongst those with a history of falling.Adherence to such programmes can prove challenging for a variety of reasons, even when participants have realistic expectations about the commitment and effort needed.Clear explanations about the role of equipment and technology within such programmes could enhance adherence.In order to further individualise programmes of exercise for people with Parkinsons, choice regarding social support, reminders and integration into everyday activities should be explored.
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Affiliation(s)
- Alison Rowsell
- Health Sciences, University of Southampton, Southampton, UK
| | - Ann Ashburn
- Health Sciences, University of Southampton, Southampton, UK
| | - Carolyn Fitton
- Health Sciences, University of Southampton, Southampton, UK
| | | | | | - Sarah E Lamb
- Institute for Health Research, University of Exeter, Exeter, UK
| | - Emma McIntosh
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Alice Nieuwboer
- Rehabilitation Sciences, University of Leuven, Leuven, Belgium
| | - Ruth Pickering
- Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Lynn Rochester
- Translational and Clinical Research Institute, University of Newcastle, Newcastle, UK
| | | | - Claire Ballinger
- Biomedical Research Centre, University of Southampton, Southampton, UK
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16
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Timotijevic L, Hodgkins CE, Banks A, Rusconi P, Egan B, Peacock M, Seiss E, Touray MML, Gage H, Pellicano C, Spalletta G, Assogna F, Giglio M, Marcante A, Gentile G, Cikajlo I, Gatsios D, Konitsiotis S, Fotiadis D. Designing a mHealth clinical decision support system for Parkinson's disease: a theoretically grounded user needs approach. BMC Med Inform Decis Mak 2020; 20:34. [PMID: 32075633 PMCID: PMC7031960 DOI: 10.1186/s12911-020-1027-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 01/20/2020] [Indexed: 11/13/2022] Open
Abstract
Background Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a mHealth CDSS for Parkinson’s disease (PD), which is theoretically grounded in the psychological literature about expert decision making and judgement under uncertainty. Methods A suite of user needs studies was conducted in 4 European countries (Greece, Italy, Slovenia, the UK) prior to the development of PD_Manager, a mHealth-based CDSS designed for Parkinson’s disease, using wireless technology. Study 1 undertook Hierarchical Task Analysis (HTA) including elicitation of user needs, cognitive demands and perceived risks/benefits (ethical considerations) associated with the proposed CDSS, through structured interviews of prescribing clinicians (N = 47). Study 2 carried out computational modelling of prescribing clinicians’ (N = 12) decision strategies based on social judgment theory. Study 3 was a vignette study of prescribing clinicians’ (N = 18) willingness to change treatment based on either self-reported symptoms data, devices-generated symptoms data or combinations of both. Results Study 1 indicated that system development should move away from the traditional silos of ‘motor’ and ‘non-motor’ symptom evaluations and suggest that presenting data on symptoms according to goal-based domains would be the most beneficial approach, the most important being patients’ overall Quality of Life (QoL). The computational modelling in Study 2 extrapolated different factor combinations when making judgements about different questions. Study 3 indicated that the clinicians were equally likely to change the care plan based on information about the change in the patient’s condition from the patient’s self-report and the wearable devices. Conclusions Based on our approach, we could formulate the following principles of mHealth design: 1) enabling shared decision making between the clinician, patient and the carer; 2) flexibility that accounts for diagnostic and treatment variation among clinicians; 3) monitoring of information integration from multiple sources. Our approach highlighted the central importance of the patient-clinician relationship in clinical decision making and the relevance of theoretical as opposed to algorithm (technology)-based modelling of human judgment.
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Affiliation(s)
- L Timotijevic
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
| | - C E Hodgkins
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - A Banks
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - P Rusconi
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - B Egan
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - M Peacock
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - E Seiss
- Department of Psychology, University of Bournemouth, Bournemouth, UK
| | - M M L Touray
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - H Gage
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - C Pellicano
- Department of Neurorehabilitation, Fondanzione Santa Lucia, Rome, Italy
| | - G Spalletta
- Department of Neurorehabilitation, Fondanzione Santa Lucia, Rome, Italy
| | - F Assogna
- Department of Neurorehabilitation, Fondanzione Santa Lucia, Rome, Italy
| | - M Giglio
- Fondanzione Ospedale San Camillo (I.R.C.C.S.), Parkinson's Department Institute of Neurology, Venice, Italy
| | - A Marcante
- Fondanzione Ospedale San Camillo (I.R.C.C.S.), Parkinson's Department Institute of Neurology, Venice, Italy
| | - G Gentile
- Fondanzione Ospedale San Camillo (I.R.C.C.S.), Parkinson's Department Institute of Neurology, Venice, Italy
| | - I Cikajlo
- University Rehabilitation Institute, Republic of Slovenia, Soča, Ljubljana, Slovenia
| | - D Gatsios
- Department of Material Sciences and Engineering, University of Ioannina, Ioannina, Greece
| | - S Konitsiotis
- Nurology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - D Fotiadis
- Department of Material Sciences and Engineering, University of Ioannina, Ioannina, Greece
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17
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Quiñoa-Salanova C, Porta-Sales J, Monforte-Royo C, Edo-Gual M. The experiences and needs of primary family caregivers of patients with multiple myeloma: A qualitative analysis. Palliat Med 2019; 33:500-509. [PMID: 30761947 DOI: 10.1177/0269216319830017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Family caregivers play a key role in the lives of patients with multiple myeloma. However, very little is known about the impact that the disease (its diagnosis, course and prognosis) has on the main family caregiver. AIM To achieve a deeper understanding of the lived experience of individuals who are the primary caregiver of a relative with multiple myeloma and to shed light on their needs. DESIGN Interpretative phenomenological study. SETTING AND PARTICIPANTS A total of 12 individuals who were the main family caregivers of a relative with multiple myeloma who was under outpatient follow-up at a cancer unit in Barcelona were recruited via purposive sampling until data saturation was reached. In semi-structured in-depth interviews, participants described their experiences of caring for their relative with multiple myeloma. Interviews were recorded, transcribed and analysed using ATLAS.ti v7.2. The seven steps proposed by Colaizzi were used for data analysis, and the relationships among emerging themes were examined. FINDINGS Four main themes emerged: (a) a new life, adapting to the disease, (b) commitment to the patient, (c) the emotional sphere and (d) experiences in relation to the care and support received. The analysis also revealed a core overarching theme: uncertainty. CONCLUSION Primary family caregivers experienced intense uncertainty, and they described a strong need to air their feelings. Specific practical initiatives, targeting both health-related and logistical aspects of care, need to be developed in order to support family caregivers of myeloma patients.
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Affiliation(s)
- Carmen Quiñoa-Salanova
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.,2 Consorci Corporació Sanitària Parc Taulí, Sabadell, Spain
| | - Josep Porta-Sales
- 3 Palliative Care Service, Institut Català d'Oncologia (ICO), Barcelona, Spain.,4 Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,5 Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cristina Monforte-Royo
- 1 Department of Nursing, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Montserrat Edo-Gual
- 6 Department of Nursing, Escola Universitària d'Infermeria Gimbernat, Barcelona, Spain
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18
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Choi M, Lee J, Oh EG, Chu SH, Sohn YH, Park CG. Factors Associated With Uncertainty in Illness Among People With Parkinson's Disease. Clin Nurs Res 2018; 29:469-478. [PMID: 30019611 DOI: 10.1177/1054773818788492] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
People with Parkinson's disease (PD) reported to experience uncertainty because of gradually progressive disease characteristics with no cure, and variably manifesting and unpredictable symptoms. This study was designed to identify illness-related variables influencing uncertainty in PD patients and to analyze direct and indirect paths between these variables. Data were collected from 206 participants using a structured questionnaire. Path analysis revealed the direct and/or indirect effects of economic status, disease severity, social support, and resilience on uncertainty in people with PD. Disease severity, social support, and resilience were shown to have significant direct effects on uncertainty. Economic status and disease severity had indirect effects on uncertainty, which were mediated by social support. Disease severity and social support also had indirect effects on uncertainty, which were mediated by resilience. Therefore, the efforts of health care professionals should be directed not only toward managing PD symptoms, but also toward facilitating social support and resilience.
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Affiliation(s)
- MoonKi Choi
- Department of Nursing, Bucheon University, South Korea
| | - JuHee Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Eui Geum Oh
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Sang Hui Chu
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Young H Sohn
- College of Medicine, Yonsei University, Seoul, South Korea
| | - Chang Gi Park
- College of Nursing, The University of Illinois at Chicago, USA
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