1
|
Furrer RA, Merner AR, Stevens I, Zuk P, Williamson T, Shen FX, Lázaro-Muñoz G. Public Perceptions of Neurotechnologies Used to Target Mood, Memory, and Motor Symptoms. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.09.24308176. [PMID: 38946963 PMCID: PMC11213062 DOI: 10.1101/2024.06.09.24308176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Background Advances in the development of neurotechnologies have the potential to revolutionize treatment of brain-based conditions. However, a critical concern revolves around the willingness of the public to embrace these technologies, especially considering the tumultuous histories of certain neurosurgical interventions. Therefore, examining public attitudes is paramount to uncovering potential barriers to adoption ensuring ethically sound innovation. Methods In the present study, we investigate public attitudes towards the use of four neurotechnologies (within-subjects conditions): deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), pills, and MRI-guided focused ultrasound (MRgFUS) as potential treatments to a person experiencing either mood, memory, or motor symptoms (between-subjects conditions). US-based participants (N=1052; stratified to be nationally representative based on sex, race, age) were asked about their perceptions of risk, benefit, invasiveness, acceptability, perceived change to the person, and personal interest in using these neurotechnologies for symptom alleviation. Results Descriptive results indicate variability between technologies that the U.S. public is willing to consider if experiencing severe mood, memory, or motor symptoms. The main effect of neurotechnology revealed DBS was viewed as the most invasive and risky treatment and was perceived to lead to the greatest change to who someone is as a person. DBS was also viewed as least likely to be personally used and least acceptable for use by others. When examining the main effects of symptomatology, we found that all forms of neuromodulation were perceived as significantly more beneficial, acceptable, and likely to be used by participants for motor symptoms, followed by memory symptoms, and lastly mood symptoms. Neuromodulation (averaging across neurotechnologies) was perceived as significantly riskier, more invasive, and leading to a greater change to person for mood versus motor symptoms; however, memory and motor symptoms were perceived similarly with respect to risk, invasiveness, and change to person. Conclusion These results suggest that the public views neuromodulatory approaches that require surgery (i.e., DBS and MRgFUS) as riskier, more invasive, and less acceptable than those that do not. Further, findings suggest individuals may be more reluctant to alter or treat psychological symptoms with neuromodulation compared to physical symptoms.
Collapse
|
2
|
Hjelle EG, Rønn-Smidt H, Haahr A, Haavaag SB, Sørensen D, Navarta-Sánchez MV, Portillo MC, Bragstad LK. Filling the gap in service provision. Partners as family carers to people with Parkinson's disease: A Scandinavian perspective. Chronic Illn 2024; 20:258-270. [PMID: 37161264 DOI: 10.1177/17423953231174470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVES The purpose of this study was to explore the expectations of and experiences with the public healthcare system of domestic partners of people with Parkinson`s disease (PD) in Denmark and Norway. METHODS A qualitative exploratory design was applied. The sample consisted of 14 people from Denmark (n = 9) and Norway (n = 5) living with a partner with PD. Semi-structured individual interviews were conducted between June and September 2020, digitally recorded, transcribed verbatim and analysed using a reflexive thematic analysis approach combining inductive and deductive approaches. RESULTS The main themes were 'negotiating systems of support' and 'balancing being both a partner and a family carer'. Partners take responsibility for the people with whom they live and attempt to fill gaps in the public healthcare system. The most frequently described needs were more information, service coordination as the illness progressed and acknowledgement of the complex role. DISCUSSION A recommendation for practice is recognition of the complex roles of partners to people with PD and reaching out to both regularly to determine needs. This may enhance the collaboration between partner carers, people with PD and healthcare providers, ensure sustainability of the system and optimise living with PD in the family.
Collapse
Affiliation(s)
- Ellen Gabrielsen Hjelle
- Department of Public Health Science and CHARM - Research Centre for Habilitation and Rehabilitation Services and Models, University of Oslo, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Helle Rønn-Smidt
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus, Denmark
| | - Anita Haahr
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Dorthe Sørensen
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Mari Carmen Portillo
- NIHR Applied Research Collaboration Wessex. School of Health Sciences, University of Southampton, Southampton, UK
| | - Line Kildal Bragstad
- Department of Public Health Science and CHARM - Research Centre for Habilitation and Rehabilitation Services and Models, University of Oslo, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
3
|
Cavallieri F, Ghirotto L, Sireci F, Parmeggiani M, Pedroni C, Mardones FA, Bassi MC, Fioravanti V, Fraix V, Moro E, Valzania F. Caregivers' burden and deep brain stimulation for Parkinson disease: A systematic review of qualitative studies. Eur J Neurol 2024; 31:e16149. [PMID: 37975788 PMCID: PMC11235895 DOI: 10.1111/ene.16149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND AND PURPOSE The impact of subthalamic nucleus deep brain stimulation (STN-DBS) on caregivers' burden is understudied. We perform a systematic review and meta-synthesis aggregating qualitative studies involving partners of people with Parkinson disease (PwP) to explore their experiences and unmet needs. METHODS A systematic review for retrieving qualitative studies included six databases: MEDLINE, Embase, CINAHL, Cochrane, PsycInfo, and Scopus. Inclusion criteria were as follows: (i) studies on the experience of caregivers of PwP in the context of STN-DBS, (ii) English peer-reviewed articles, and (iii) qualitative or mixed methods studies reporting caregivers' quotations. After the appraisal of included studies, we performed meta-synthesis of qualitative findings. Descriptive themes and conceptual elements related to PwP partners' experiences and unmet needs were generated. RESULTS A total of 1108 articles were screened, and nine articles were included. Three categories were identified: (i) dealing with Parkinson disease (PD) every day (the starting situation characterized by the impact of PD on ordinary life; the limitations to partners' socialization; partners' efforts in stepping aside for love and care activities), (ii) facing life changes with STN-DBS (the feeling of being unprepared for changes; the fear and concern due to loved ones' behavioral changes; struggling to find an explanation for those changes), and (iii) rebuilding the role of caregiver and partner after STN-DBS. CONCLUSIONS This meta-synthesis elucidates concerns, challenges, and unmet needs of partners of PwP who underwent STN-DBS. It is important to provide them with information, education, and adequate support to face these challenges. Professionals need to involve partners in the care and decision process, because STN-DBS-related outcomes do not depend solely on the well-being of PwP but also on the well-being of individuals surrounding them.
Collapse
Affiliation(s)
- Francesco Cavallieri
- Neurology Unit, Neuromotor and Rehabilitation DepartmentAzienda USL–IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Luca Ghirotto
- Qualitative Research UnitAzienda USL–IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Francesca Sireci
- Neurology Unit, Neuromotor and Rehabilitation DepartmentAzienda USL–IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Margherita Parmeggiani
- Neurology Unit, Neuromotor and Rehabilitation DepartmentAzienda USL–IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Cristina Pedroni
- Direzione delle Professioni Sanitarie Azienda USL–IRCCS di Reggio EmiliaReggio EmiliaItaly
| | | | | | - Valentina Fioravanti
- Neurology Unit, Neuromotor and Rehabilitation DepartmentAzienda USL–IRCCS di Reggio EmiliaReggio EmiliaItaly
| | - Valérie Fraix
- Division of Neurology, Centre Hospitalier Universitaire de Grenoble, Grenoble Institute of NeuroscienceGrenoble Alpes UniversityGrenobleFrance
| | - Elena Moro
- Division of Neurology, Centre Hospitalier Universitaire de Grenoble, Grenoble Institute of NeuroscienceGrenoble Alpes UniversityGrenobleFrance
| | - Franco Valzania
- Neurology Unit, Neuromotor and Rehabilitation DepartmentAzienda USL–IRCCS di Reggio EmiliaReggio EmiliaItaly
| |
Collapse
|
4
|
Glover L, Dixon C, Kobylecki C, Eccles FJR. Parkinson's and the couple relationship: a qualitative meta-synthesis. Aging Ment Health 2023; 27:2420-2429. [PMID: 37354064 DOI: 10.1080/13607863.2023.2227119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/08/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE The aim was to synthesise the current qualitative literature on the impact of Parkinson's on the couple relationship, including individual and dyad studies. METHODS Noblit and Hare's meta-ethnography approach was applied; 19 studies were included in the review following a systematic search of four electronic databases. The studies included experiences of 137 People with Parkinson's and 191 partners. FINDINGS Analysis produced three themes: (1) Disruption of roles and responsibilities; (2) Challenges to communication and closeness; and (3) Grief, burden, and isolation. The themes are discussed with supporting extracts from the 19 included studies. CONCLUSION The findings highlight the challenges that couples experience and the individual and relational resources that support coping. Support should be individually tailored to each couple as the impact on the couple may change in response to individual and contextual factors. This review adds further evidence to the case for relationally focused multidisciplinary team input at all stages of Parkinson's disease.
Collapse
Affiliation(s)
- Louise Glover
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK
| | - Clare Dixon
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK
| | - Christopher Kobylecki
- Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford, UK
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Fiona J R Eccles
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK
| |
Collapse
|
5
|
Shahmoon S, Limousin P, Jahanshahi M. Exploring the Caregiver Role after Deep Brain Stimulation Surgery for Parkinson’s Disease: A Qualitative Analysis. PARKINSON'S DISEASE 2023; 2023:5932865. [PMID: 37065969 PMCID: PMC10098415 DOI: 10.1155/2023/5932865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 12/22/2022] [Accepted: 03/18/2023] [Indexed: 04/07/2023]
Abstract
This pilot study aimed to explore how caregiver spouses make sense of themselves one and five years after their partner’s deep brain stimulation (DBS) surgery for Parkinson’s disease. 16 spouse (8 husbands and 8 wives) caregivers were recruited for the interview. Eight struggled to reflect on their own lived experience and primarily focused on the impact of PD on their partners, such that their transcripts were no longer viable for interpretative phenomenological analysis (IPA). A content analysis showed (1) how these 8 caregivers shared less than half as many self-reflections than the other caregivers, (2) that there was a bias to reflect on their partner’s experience answering the opening question, (3) the bias continued when answering subsequent questions, and (4) there was a lack of awareness of this bias. No other patterns of behaviour or themes were able to be extracted. The remaining 8 interviews were transcribed and analysed using IPA. This analysis discovered 3 inter-related themes: (1) DBS allows carers to question and shift the caregiver role, (2) Parkinson’s unites and DBS divides, and (3) seeing myself and my needs, DBS enhances visibility. How these caregivers interacted with these themes depended on when their partners were operated. The results suggested that spouses maintained the role of caregiver one year post DBS because they struggle to identify themselves in any other way but were more comfortable reassociating into the role of spouse 5 years post surgery. Further inquiry into caregiver and patient identity roles post DBS is recommended as a means of supporting their psychosocial adjustment after surgery.
Collapse
Affiliation(s)
- Suzette Shahmoon
- Unit of Functional Neurosurgery, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK
| | - Patricia Limousin
- Unit of Functional Neurosurgery, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK
| | - Marjan Jahanshahi
- Unit of Functional Neurosurgery, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK
| |
Collapse
|
6
|
Van Hienen MM, Kuiper R, Middelkoop HA, Van Hilten JJ, Contarino MF, Geraedts VJ. Patient-Related Factors Influencing Caregiver Burden in Parkinson’s Disease Patients: Comparison of Effects Before and After Deep Brain Stimulation. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1285-1293. [PMID: 35275557 PMCID: PMC9484085 DOI: 10.3233/jpd-213093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: Caregivers of Parkinson’s disease (PD) patients provide important support during the pre- and postoperative phase of deep brain stimulation (DBS). High levels of caregiver burden have been reported after DBS. However, a comparison between preoperative and postoperative burden and associated factors has been insufficiently studied. Objective: To investigate the influence of DBS on caregiver burden, and to identify the differential impact of patient-related factors on caregiver burden before and after DBS. Methods: Consecutive patients referred for DBS eligibility screening or during one-year follow-up assessments were included. Caregiver burden was measured with the short Zarit Burden Interview (ZBI-12). Inverse Probability Weighting (IPW) was used to compare caregiver burden between preoperative and postoperative assessments. Results: We included 47 patients (24 screening, 23 follow-up) (median age 65 years, 29.4% female sex). DBS did not impact caregiver burden (screening: median ZBI-12 9.5 (IQR 3.25, 16.75); follow-up median ZBI-12 6 (IQR 4, 14); IPW-coefficient 0.57 (95% CI –2.75, 3.89)). Worse caregiver burden during DBS screening was associated with worse patient-related scores on depressive symptoms, anxiety, QoL, and impulsiveness. Worse scores on depressive symptoms, anxiety, apathy, postural-instability-gait-disorder, and QoL were associated with worse caregiver burden at one-year follow-up. Conclusion: DBS appears not associated with changes in caregiver burden. Various symptoms are valued differently between screening and follow-up assessments in terms of caregiver burden. Early recognition of caregivers “at risk” may improve guidance of patient-caregiver dyads throughout the DBS process.
Collapse
Affiliation(s)
| | - Roy Kuiper
- Department of Neurology, LUMC, Leiden, the Netherlands
| | - Huub A.M. Middelkoop
- Department of Neurology, LUMC, Leiden, the Netherlands
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
| | | | - Maria Fiorella Contarino
- Department of Neurology, LUMC, Leiden, the Netherlands
- Department of Neurology, Haga Teaching Hospital, Den Haag, the Netherlands
| | - Victor J. Geraedts
- Department of Neurology, LUMC, Leiden, the Netherlands
- Department of Clinical Epidemiology, LUMC, Leiden, the Netherlands
| |
Collapse
|
7
|
Chacón Gámez YM, Brugger F, Biller-Andorno N. Parkinson's Disease and Deep Brain Stimulation Have an Impact on My Life: A Multimodal Study on the Experiences of Patients and Family Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189516. [PMID: 34574440 PMCID: PMC8467519 DOI: 10.3390/ijerph18189516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/09/2021] [Accepted: 07/21/2021] [Indexed: 12/21/2022]
Abstract
Parkinson’s disease (PD) has a large impact on patients’ physical and mental health, which also greatly affects their family caregivers. Deep brain stimulation (DBS) has emerged as an effective treatment for PD, but different authors have expressed their concerns about the potential impact of DBS on personality and identity. Our study aims at better understanding how patients and family caregivers experience life with PD and DBS, the impact of both on their personal and social lives, and their perception of the changes that have occurred as a result of the disease and the treatment. Our study applies a multimodal approach by means of narrative semi-structured interviews and drawings. Seven principal themes have been identified: “everyone’s Parkinson’s is different”, “changing as a person during the disease”, “going through Parkinson’s together”, “DBS improved my life”, “I am treated with DBS but I have Parkinson’s still”, “DBS is not perfect”, and “being different after DBS”. PD is perceived as an unpredictable and heterogeneous disease that changes from person to person, as does the effect of DBS. While DBS side-effects may have an impact on patients’ personality, behavior, and self-perception, PD symptoms and drug side-effects also have a great impact on these aspects.
Collapse
Affiliation(s)
- Yolanda María Chacón Gámez
- Institute of Medical Bioethics and History of Medicine, University of Zurich, Wintherthurerstrasse 30, 8006 Zurich, Switzerland;
- Correspondence:
| | - Florian Brugger
- Kantonsspital St. Gallen, Klinik für Neurologie, Haus 04 Rorsacher Strasse 95, 9007 St. Gallen, Switzerland;
| | - Nikola Biller-Andorno
- Institute of Medical Bioethics and History of Medicine, University of Zurich, Wintherthurerstrasse 30, 8006 Zurich, Switzerland;
| |
Collapse
|
8
|
Moos TAO, Rydahl-Hansen S. 'Everything is as before, but nothing is as it was'-A phenomenological-hermeneutic study of meaningfulness in adult patients with refractory epilepsy after interdisciplinary epilepsy rehabilitation. Epilepsy Behav 2021; 122:108168. [PMID: 34271324 DOI: 10.1016/j.yebeh.2021.108168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Interdisciplinary Rehabilitation aimed at adults with refractory epilepsy (RE) establishes scientific evidence of higher health-related QoL, including improved self-worth and increased self-awareness as outcomes. Yet, there is very little research-based knowledge of how life transforms itself after the rehabilitation program from patients' perspectives. AIM The aim of this study was to identify and describe how - from the patient perspectives - life transforms itself after rehabilitation among adults with RE, focusing on the meaningfulness of interdisciplinary rehabilitation. METHOD Nine patients, who all completed an Interdisciplinary Rehabilitation Program in an Adult Epilepsy Clinic, were interviewed between six months and two years after rehabilitation. Nine interviews were recorded, transcribed verbatim, and analyzed as described by the phenomenological method 'Reflective Lifeworld Research' (RLR). FINDINGS The essence of the phenomenon was revealed as life as a struggle for a dignified existence with RE as a navigating life companion. Through the clusters of meaning, four constituents emerged from the phenomenon: 1) to accept the limitations of body and mind; 2) to be on a journey toward your inner self; 3) to be quietly understood; 4) to fight for renewed hope and recognition during transition. CONCLUSION The patients consider it significant to know their own bodies with the constraints that this involves. This knowledge helps them make decisions that not only have a positive effect on their epilepsy, but also raise their self-esteem and give them renewed hope and courage to face life. However, the struggle for a dignified life is continuously hard, and it comes to a head in patients' transition from 'patient to citizen', where asymmetries arise. These asymmetries leave considerable marks on the patients' worlds and challenge their renewed hope for a dignified existence.
Collapse
Affiliation(s)
- Trine Arnam Olsen Moos
- Department of Adult Epileptology and PNES, The Danish National Epilepsy Center, Filadelfia, Kolonivej 2 A, 1. Sal, 4293 Dianalund, Denmark.
| | - Susan Rydahl-Hansen
- Research Unit of Nursing and Healthcare, Institute of Public Health Health, Aarhus University, Department of Public Health - Department of Science in Nursing, Campus Emdrup, Tuborgvej 164, bygning B8, 1. sal, 2400 Copenhagen NV, Denmark.
| |
Collapse
|
9
|
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.
Collapse
|
10
|
Spouse Caregivers' Experiences of Suffering in Relation to Care for a Partner With Brain Tumor: A Qualitative Study. Cancer Nurs 2021; 45:E320-E328. [PMID: 33654012 DOI: 10.1097/ncc.0000000000000935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Spouses often undertake the main caring role for a partner with primary malignant brain tumor (PMBT). Yet, demanding and challenging caring responsibilities especially because of the partner's cognitive declines can affect the spouse caregiver's well-being. OBJECTIVE The aim of this study was to investigate spouses' experiences of suffering in their role as main caregiver of a partner with PMBT. METHODS A hermeneutical qualitative design was used to collect and analyze data. Ten spouses (aged 36-76 years) were interviewed in depth twice 1 year apart, using semistructured interview guides. RESULTS The spouse caregivers' experiences of suffering in their role as their partner's main caregiver were interpreted according to 3 central themes: "Enduring everyday life," "Being overlooked and hurt," and "Being acknowledged and feeling good." CONCLUSION Spouse caregivers of a partner with PMBT are suffering from exhaustion and suppression of their own emotions to endure the caring responsibilities. They need support to manage their everyday hardship; however, their experiences seem to be easily overlooked. This causes disappointment and hurts their dignity. Acknowledgment through simple acts of practical help or time to talk are consoling and alleviate their experiences of suffering. IMPLICATIONS FOR PRACTICE An intervention that supports healthcare professionals to facilitate the spouse caregivers' suffering is welcoming. The focus of the intervention may involve a sensitive awareness toward the spouse caregiver's individual resources and limitations and the relational and communicative competences of the healthcare professionals in their encounters with spouse caregivers that avoid hurting the spouse caregiver's dignity.
Collapse
|
11
|
van Hienen MM, Contarino MF, Middelkoop HAM, van Hilten JJ, Geraedts VJ. Effect of deep brain stimulation on caregivers of patients with Parkinson's disease: A systematic review. Parkinsonism Relat Disord 2020; 81:20-27. [PMID: 33038702 DOI: 10.1016/j.parkreldis.2020.09.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Caregivers of patients with Parkinson's Disease (PD) often provide important support in the pre- and postoperative phase of Deep Brain Stimulation (DBS). DBS-associated changes of patient-functioning may affect caregiver wellbeing and impact the support system. Factors influencing caregiver-wellbeing under these circumstances are incompletely known. OBJECTIVE to systematically review studies of sufficient methodological quality on the impact of DBS on caregivers of PD patients. METHODS using PRISMA guidelines, major databases were searched up to May 2020. Five subcategories were identified: Caregiver burden, Caregiver cognitive and psychiatric functioning, Caregiver Quality of Life (QoL), Marital Satisfaction/Conflicts, and Caregiver Satisfaction. Quality was assessed using an in-house checklist. RESULTS 293 studies were identified; 12 were ultimately included. Caregiver burden, psychiatric and cognitive functioning and QoL remained relatively unchanged. Results on marital satisfaction/conflicts were contrasting: an increase in marital conflicts despite improved relationship quality scores DBS. Caregiver satisfaction with surgery was low with 50-58% of caregivers being disappointed with DBS outcomes. Concerning caregiver related factors: a higher preoperative caregiver QoL, younger age, lower scores on psychiatric rating scales, and more favourable preoperative relationship quality scores, were associated with better caregiver wellbeing. A favourable patient-profile includes younger age and age-at-onset, shorter disease duration, lower medication requirements, and lower scores on psychiatric rating scales. CONCLUSION Although most patient- and caregiver-related subdomains remained unchanged after DBS, dissatisfaction among caregivers and marital problems may constitute a large risk for a well-functioning patient-caregiver dyad. Early recognition of potential problem situations may improve post-DBS care for both patients and caregivers.
Collapse
Affiliation(s)
- Marle M van Hienen
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Maria Fiorella Contarino
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Department of Neurology, Haga Teaching Hospital, the Hague, the Netherlands
| | - Huub A M Middelkoop
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands
| | - Jacobus J van Hilten
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Victor J Geraedts
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
| |
Collapse
|
12
|
Prasad S, Bhattacharya A, Sahoo LK, Batra D, Kamble N, Yadav R, Srinivas D, Pal PK. Knowledge, Attitude, and Perceptions about Deep Brain Stimulation for Parkinson's Disease: Observations from a Single Indian Center. J Mov Disord 2020; 14:60-64. [PMID: 32942838 PMCID: PMC7840234 DOI: 10.14802/jmd.20066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/21/2020] [Indexed: 12/05/2022] Open
Abstract
Objective Willingness to undergo deep brain stimulation (DBS) among patients with Parkinson’s disease (PD) and their overall satisfaction with the procedure is highly dependent upon expectations, which are based on the core concepts of knowledge, attitude and perceptions. The present study aims to evaluate these factors in patients and caregivers with PD from a single tertiary care hospital in India. Methods A structured questionnaire designed to assess the knowledge, attitude and perceptions about DBS in PD was administered to 400 patients with PD and their caregivers. Results A very small proportion of patients and caregivers were aware of DBS. Even those who claimed to be aware of DBS were inadequately informed and had incorrect knowledge, which led to wrong attitudes and perceptions. Conclusion There are very significant knowledge gaps and misconceptions regarding DBS among patients with PD and caregivers. Adequate and appropriate education is necessary to clarify these misconceptions to avoid the development of unrealistic expectations and poor satisfaction.
Collapse
Affiliation(s)
- Shweta Prasad
- Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Karnataka, India.,Department of Neurology, National Institute of Mental Health & Neurosciences, Karnataka, India
| | - Amitabh Bhattacharya
- Department of Neurology, National Institute of Mental Health & Neurosciences, Karnataka, India
| | - Lulup Kumar Sahoo
- Department of Neurology, National Institute of Mental Health & Neurosciences, Karnataka, India
| | - Dhruv Batra
- Department of Neurology, National Institute of Mental Health & Neurosciences, Karnataka, India
| | - Nitish Kamble
- Department of Neurology, National Institute of Mental Health & Neurosciences, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health & Neurosciences, Karnataka, India
| | - Dwarakanath Srinivas
- Department of Neurosurgery, National Institute of Mental Health & Neurosciences, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Karnataka, India
| |
Collapse
|
13
|
Karlstedt M, Fereshtehnejad SM, Aarsland D, Lökk J. Mediating effect of mutuality on caregiver burden in Parkinson's disease partners. Aging Ment Health 2020; 24:1421-1428. [PMID: 31140294 DOI: 10.1080/13607863.2019.1619165] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objectives: Parkinson's disease (PD) is a complex neurodegenerative disorder with a broad list of motor and non-motor symptoms (NMS) that has been shown to affect the relationship quality (mutuality) and caregiver burden. However, little is known if the effect of motor and NMS on caregiver burden is mediated by mutuality. Therefore, the aim of this study was to explore if perceived mutuality by patients and partners mediates the effect of motor and NMS on caregiver burden.Methods: Data were collected from 51 dyads with one PD patient, including measures of motor signs, NMS, impaired cognition, patients' and partners' perceived mutuality, caregiver burden and dependency in activities in daily life (ADL). Structural equation model with manifest variables were applied to explore if patients' and partners' mutuality score mediated the effect of motor signs, NMS, ADL or impaired cognition on caregiver burden.Result: Our results suggest that having a partner with PD who is dependent in ADL or has impaired cognition decreases partners' mutuality which leads to elevated burden. Motor symptoms or other NMS were not associated with partners' mutuality or caregiver burden. Instead, increasing severity of motor symptoms decrease patients' mutuality in turn leading to lower level of partners' mutuality.Conclusion: Our findings enhance the understanding of the complexity of living with PD for the partner and suggest that clinical assessment should include evaluation of how PD symptoms influence the quality of the relationship between partners and patients.
Collapse
Affiliation(s)
- Michaela Karlstedt
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Dag Aarsland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Johan Lökk
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Baumann-Vogel H, Bodenmann G, Schmid J, Waldvogel D, Ineichen C, Baumann CR. Partners' view after subthalamic deep brain stimulation: Better relationships despite patients being less active. Clin Park Relat Disord 2020; 3:100052. [PMID: 34316635 PMCID: PMC8298790 DOI: 10.1016/j.prdoa.2020.100052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/11/2020] [Accepted: 03/30/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction After deep brain stimulation (DBS) of the subthalamic nucleus (STN), Parkinson patients report difficulties in the relationship with their partners. The partners' experience after DBS appears to be variable and complex. Purpose of this pilot study was to investigate the partners' perspective on the relationship following STN-DBS. Subjects and methods We conducted a postoperative questionnaire assessment in 56 partners of Parkinson patients with STN-DBS, using questionnaires addressing partnership satisfaction, dyadic coping, and role allocation in duties and activities of daily living. Results Regarding overall relationship satisfaction after surgery, 40% of partners were happier with their relationship than before DBS, and 14% were less satisfied. Partners reported that patients involved themselves distinctly less in duties and activities of daily living, leaving partners to take over. A need for more professional support for the relationship following surgery was noted by 27% of the partners. Conclusion Although quality of relationship and dyadic coping improved or remained unchanged according to the majority of partners, patients became less prone to take over common duties and activities despite being in a better and more stable motor state. Potential conflicts and problems in role allocation in relationships following DBS need to be addressed in patients care.
Collapse
Affiliation(s)
- Heide Baumann-Vogel
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland.,University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Guy Bodenmann
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Jonas Schmid
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Daniel Waldvogel
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Christian Ineichen
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Christian R Baumann
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland.,Clinical Research Priority Program "Sleep and Health", University of Zurich, Zurich, Switzerland
| |
Collapse
|
16
|
Haahr A, Norlyk A, Hall EOC, Hansen KE, Østergaard K, Kirkevold M. Sharing our story individualized and triadic nurse meetings support couples adjustment to living with deep brain stimulation for Parkinson's disease. Int J Qual Stud Health Well-being 2020; 15:1748361. [PMID: 32268846 PMCID: PMC7178889 DOI: 10.1080/17482631.2020.1748361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Treatment with deep brain stimulation for Parkinson’s disease, leads to a rapid improvement in mobility, which may challenge patients and spouses when adjusting to everyday life. An intervention, developed to support the adjustment to everyday life with DBS, demonstrated that individualized meetings with a specialized nurse was experienced as important and fruitful by both patient and spouses. Purpose: The aim was to gain a deeper understanding of how the meetings contributed to the adjustment process. Method: 38 audio-recorded meetings and six written summaries from eight couples participating in the intervention, were analyzed in a hermeneutic process. Results: The analysis revealed four themes: A relational triad of co-creating personal knowing. Sharing and listening in an atmosphere of trust and openness. Unveiling the couple’s everyday life, coping strategies and expectations. Supporting adjustment through knowing their personal story. Conclusion: The triadic dynamics in the meetings were quite particular. The main focus was the patients’ and spouses’ stories, individually and as a couple. The DBS nurse pursues solutions based on professional and specialized knowledge of Parkinson’s disease and the couple’s everyday life. Thus, the intervention meetings offered tailored, individualized and specialized care in supporting adjustment to DBS for PD both individually and as couples.
Collapse
Affiliation(s)
- Anita Haahr
- Research Centre for Health and Welfare Technology, Programme for Rehabilitation, VIA University College, Aarhus, Denmark
| | | | - Elisabeth O C Hall
- Public Health, Nursing, Aarhus University, Aarhus, Denmark.,Faculty of Health Sciences and Nursing, University of the Faroe Islands, Tórshavn, Faroe Islands
| | | | - Karen Østergaard
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Marit Kirkevold
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway.,Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
17
|
Gilbert F, Brown, Dasgupta, Martens, Klein, Goering. An Instrument to Capture the Phenomenology of Implantable Brain Device Use. NEUROETHICS-NETH 2019. [DOI: 10.1007/s12152-019-09422-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
18
|
Mosley PE, Robinson K, Coyne T, Silburn P, Breakspear M, Carter A. ‘Woe Betides Anybody Who Tries to Turn me Down.’ A Qualitative Analysis of Neuropsychiatric Symptoms Following Subthalamic Deep Brain Stimulation for Parkinson’s Disease. NEUROETHICS-NETH 2019. [DOI: 10.1007/s12152-019-09410-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|
19
|
Mapping the experiences and needs of deep brain stimulation for people with Parkinson’s disease and their family members. BRAIN IMPAIR 2019. [DOI: 10.1017/brimp.2019.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackgroundDeep brain stimulation (DBS) is an effective treatment for the motor symptoms of Parkinson’s disease (PD). The lived experience of people with PD suggests a process of adjustment follows. This study aimed to explore the adjustment and associated education and support needs of people with PD undergoing DBS and their family members across the continuum of the DBS experience.MethodA structured qualitative description study including semi-structured interviews with people with PD (n = 14), family members (n = 10) and clinicians (n = 11) was conducted to explore lived experiences, needs, perspectives and clinical considerations. Inductive analysis indicated common temporal stages related to undergoing DBS, and the related experiences and needs were mapped.FindingsFour stages, each with unique needs, emerged: Considering DBS involved needs for peer-based education and realistic, meaningful goal setting; Surgery and Support shifted to clinical support related to the surgery and support for the person and their family around immediate changes experienced; Seeking Stability focused on timely clinical and practical support for the person and family around new changes and challenges to symptoms, behaviours and roles; and Next Steps involved direction and support for reengagement in the self-management of the condition, and current and future changes related to PD.All participants with PD and their family members in this study indicated that overall their experiences with DBS had led to positive changes in their symptoms and lives. Consideration of different needs at different times in the process may be applied within clinical practice to support adjustment.
Collapse
|
20
|
Baertschi M, Favez N, Flores Alves Dos Santos J, Radomska M, Herrmann F, Burkhard P, Canuto A, Weber K. The Impact of Deep Brain Stimulation for Parkinson's Disease on Couple Satisfaction: An 18-Month Longitudinal Study. J Clin Psychol Med Settings 2019; 26:461-469. [PMID: 30706305 DOI: 10.1007/s10880-019-09601-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Patients with Parkinson's disease (PD) may benefit from deep brain stimulation (DBS) to improve motor and medication-induced symptoms. Yet mixed evidence regarding the outcome of successful DBS on couple satisfaction has been highlighted in the literature. Thirty patients diagnosed with PD were included in a study investigating couple satisfaction (MSS-14), depression (HAD-D) and anxiety (HAD-A) at four measurement times: before DBS and 6, 12, and 18 months post-surgically. Sixteen spouses/partners were included as well. Couple satisfaction from the patient perspective was never associated with depression or anxiety. However, poor marital adjustment (i.e., difference and absolute difference between patients and spouses/partners MSS-14 scores) predicted patients' pre-operative depressive mood. Longitudinal analyses showed that couple satisfaction (n = 9) worsened at 12 months and 18 months compared to pre-DBS scores, F(2.047, 16.378) = 8.723, p = .003, and despite concomitant motor improvement. Growth curve analyses showed that couple satisfaction worsening occurred between 6 and 12 months post-operatively (b = 2.938, p < .001). Thus, couple satisfaction did not increase along with motor improvement and deteriorated after the adjustment period following DBS.
Collapse
Affiliation(s)
- Marc Baertschi
- Faculty of Psychology, University of Geneva, Boulevard du Pont-d'Arve 40, 1205, Geneva, Switzerland. .,Service of General Psychiatry and Psychotherapy, Nant Foundation, Avenue des Alpes 66, 1820, Montreux, Switzerland.
| | - Nicolas Favez
- Faculty of Psychology, University of Geneva, Boulevard du Pont-d'Arve 40, 1205, Geneva, Switzerland
| | - João Flores Alves Dos Santos
- Service of Liaison Psychiatry and Crisis Intervention, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.,Liaison Psychiatry and Emergency Psychiatric Center, Neuchatel Psychiatric Center, Maladière 45, 2000, Neuchâtel, Switzerland
| | - Michalina Radomska
- Faculty of Psychology, University of Geneva, Boulevard du Pont-d'Arve 40, 1205, Geneva, Switzerland
| | - François Herrmann
- Division of Geriatrics, Geneva University Hospitals, Chemin du Pont-Bochet 3, 1226, Thônex, Switzerland
| | - Pierre Burkhard
- Service of Neurology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Alessandra Canuto
- Executive and General Management Service, Hôpital de Nant, Nant Foundation, 1804, Corsier-sur-Vevey, Switzerland
| | - Kerstin Weber
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Les Voirons - Chemin du Petit-Bel-Air 2, 1225, Chêne-Bourg, Switzerland
| |
Collapse
|
21
|
"It Is Hard Work, But It Is Worth It": Patients and Spouses' Experiences of a Nursing Intervention to Promote Adjustment to Deep Brain Stimulation for Parkinson's Disease-A Feasibility Study. ANS Adv Nurs Sci 2018; 41:174-187. [PMID: 29727341 DOI: 10.1097/ans.0000000000000208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article evaluates the feasibility of a nursing intervention when adjusting to deep brain stimulation for Parkinson disease. Eight couples were included in the study. Main activities of the intervention were a diary and individualized meetings between nurses, patients, and spouses with a focus on everyday life and expectations to deep brain stimulation. All meetings were audio recorded and analyzed together with the content of the diary. The intervention was evaluated as feasible and experienced as meaningful. It supports the need for individualized care involving both patients and spouses and contributes to the development of an evidence-based nursing practice.
Collapse
|
22
|
Shin JY, Pohlig RT, Habermann B. Feasibility of Using PROMIS
®
in Individuals With Advanced Parkinson's Disease and Their Caregivers. Res Gerontol Nurs 2018; 11:129-136. [DOI: 10.3928/19404921-20180329-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 02/12/2018] [Indexed: 11/20/2022]
|
23
|
Navarta-Sánchez MV, Ursua ME, Riverol Fernández M, Ambrosio L, Medina M, Díaz de Cerio S, Álvarez MJ, Senosiain JM, Gorraiz A, Caparrós N, Anaut S, Martín-Lanas R, Recio M, Portillo MC. Implementation of a multidisciplinary psychoeducational intervention for Parkinson's disease patients and carers in the community: study protocol. BMC FAMILY PRACTICE 2018; 19:45. [PMID: 29621985 PMCID: PMC5887225 DOI: 10.1186/s12875-018-0730-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 03/19/2018] [Indexed: 11/21/2022]
Abstract
Background Parkinson’s disease progressively limits patients at different levels and as a result family members play a key role in their care. However, studies show lack of an integrative approach in Primary Care to respond to the difficulties and psychosocial changes experienced by them. The aim of this study is to evaluate the effects of a multidisciplinary psychoeducational intervention focusing on improving coping skills, the psychosocial adjustment to Parkinson’s disease and the quality of life in patients and family carers in a Primary Care setting. Methods This quasi-experimental study with control group and mixed methods was designed to evaluate a multidisciplinary psychoeducational intervention. Based on the study power calculations, 100 people with Parkinson’s disease and 100 family carers will be recruited and assigned to two groups. The intervention group will receive the ReNACE psychoeducational intervention. The control group will be given a general educational programme. The study will be carried out in six community-based health centres. The results obtained from the two groups will be collected for evaluation at three time points: at baseline, immediately after the intervention and at 6 months post-intervention. The results will be measured with these instruments: the Quality of Life Scale PDQ-39 for patients and the Scale of Quality of Life of Care-givers SQLC for family carers, and for all participants the Psychosocial Adjustment to Illness scale and the Brief COPE Inventory. Focus groups will be organised with some patients and family carers who will have received the ReNACE psychoeducational intervention and also with the healthcare professionals involved in its development. Discussion An important gap exists in the knowledge and application of interventions with a psychosocial approach for people with PD and family carers as a whole. This study will promote this comprehensive approach in Primary Care, which will clearly contribute in the existing knowledge and could reduce the burden of PD for patients and family carers, and also in other long-term conditions. Trial registration NCT03129425 (ClinicalTrials.gov). Retrospectively registered on April 26, 2017.
Collapse
Affiliation(s)
- M V Navarta-Sánchez
- Faculty of Nursing, University of Navarre, C/ Irunlarrea, s/n, Edif. De los Castaños, 31008, Pamplona, Navarre, Spain
| | - M E Ursua
- Primary Health Care Center of San Juan, Navarre Service of Health-Osasunbidea, Plaza Obispo Irurita s/n Planta Baja, 31011, Pamplona, Navarre, Spain
| | - M Riverol Fernández
- Department of Neurology, Clínica Universidad de Navarra, Avenida Pio XII, 36, 31008, Pamplona, Navarre, Spain
| | - L Ambrosio
- Faculty of Nursing, University of Navarre, C/ Irunlarrea, s/n, Edif. De los Castaños, 31008, Pamplona, Navarre, Spain
| | - M Medina
- Primary Health Care Center of San Juan, Navarre Service of Health-Osasunbidea, Plaza Obispo Irurita s/n Planta Baja, 31011, Pamplona, Navarre, Spain
| | - S Díaz de Cerio
- Navarre Association of Parkinson's patients, C/ Aralar 17, 31004, Pamplona, Navarre, Spain
| | - M J Álvarez
- Public University of Navarre, Campus de Arrosadia, s/n, 31006, Pamplona, Navarre, Spain
| | - J M Senosiain
- Faculty of Nursing, University of Navarre, C/ Irunlarrea, s/n, Edif. De los Castaños, 31008, Pamplona, Navarre, Spain
| | - A Gorraiz
- Navarre Association of Parkinson's patients, C/ Aralar 17, 31004, Pamplona, Navarre, Spain
| | - N Caparrós
- Faculty of Law and Social Sciences, University of La Rioja, C/ Cigüeña 60, 26004, Logroño, La Rioja, Spain
| | - S Anaut
- Department of Social Work, Public University of Navarre, Campus de Arrosadia, s/n, 31006, Pamplona, Navarre, Spain
| | - R Martín-Lanas
- Department of Psychiatry and Medical Psychology, Clínica Universidad de Navarra, Avenida Pio XII, 36, 31008, Pamplona, Navarre, Spain
| | - M Recio
- Department of Neurology, Clínica Universidad de Navarra, Avenida Pio XII, 36, 31008, Pamplona, Navarre, Spain
| | - M C Portillo
- NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton Highfield Campus, University Road, Southampton, SO17 1BJ, UK.
| |
Collapse
|
24
|
Viaña JNM, Gilbert F. Deep brain stimulation for people with Alzheimer's disease: Anticipating potential effects on the tripartite self. DEMENTIA 2018. [PMID: 29528701 DOI: 10.1177/1471301218761147] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Memory dysfunction and cognitive impairments due to Alzheimer’s disease can affect the selfhood and identity of afflicted individuals, causing distress to both people with Alzheimer’s disease and their caregivers. Recently, a number of case studies and clinical trials have been conducted to determine the potential of deep brain stimulation as a therapeutic modality for people with Alzheimer’s disease. Some of these studies have shown that deep brain stimulation could induce flashbacks and stabilize or even improve memory. However, deep brain stimulation itself has also been attributed as a potential threat to identity and selfhood, especially when procedure-related adverse events arise. We anticipate potential effects of deep brain stimulation for people with Alzheimer’s disease on selfhood, reconciling information from medical reports, psychological, and sociological investigations on the impacts of deep brain stimulation or Alzheimer’s disease on selfhood. A tripartite model of the self that extends the scope of Rom Harré’s and Steve Sabat’s social constructionist framework was used. In this model, potential effects of deep brain stimulation for Alzheimer’s disease on Self 1 or singularity through use of first-person indexicals, and gestures of self-reference, attribution, and recognition; Self 2 or past and present attributes, knowledge of these characteristics, and continuity of narrative identity; and Self 3 or the relational and social self are explored. The ethical implications of potential effects of deep brain stimulation for Alzheimer’s disease on the tripartite self are then highlighted, focusing on adapting informed consent procedures and care provided throughout the trial to account for both positive and negative plausible effects on Self 1, Self 2, and Self 3.
Collapse
Affiliation(s)
- John Noel M Viaña
- Wicking Dementia Research and Education Centre, College of Health and Medicine; Ethics, Policy and Public Engagement Program, Australian Research Council Centre of Excellence for Electromaterials Science; Philosophy and Gender Studies Program, School of Humanities, College of Arts, Law, and Education, University of Tasmania, Hobart, Australia
| | - Frederic Gilbert
- Center for Sensorimotor Neural Engineering and Department of Philosophy, University of Washington, Seattle, WA, USA; Ethics, Policy and Public Engagement Program, Australian Research Council Centre of Excellence for Electromaterials Science, University of Tasmania, Hobart, Australia
| |
Collapse
|
25
|
Liddle J, Phillips J, Gustafsson L, Silburn P. Understanding the lived experiences of Parkinson's disease and deep brain stimulation (DBS) through occupational changes. Aust Occup Ther J 2017; 65:45-53. [PMID: 29165825 DOI: 10.1111/1440-1630.12437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS), a surgically based treatment for people living with Parkinson's disease (PD), can result in a significant improvement of motor symptoms. However, the broader impact of DBS and the changes it creates are not well understood. Greater understanding of the experiences and needs related to DBS would enable development of relevant outcome measures and supports. OBJECTIVES To explore the lived experiences of people undergoing DBS for Parkinson's disease. METHODS A descriptive phenomenological study was undertaken exploring experiences, perspectives and outcomes with key stakeholders. Semi-structured, audiotaped interviews were undertaken with people with PD who have had DBS, their family members and health professionals across four states and territories in Australia. RESULTS Perspectives and experiences of 14 people with PD undergoing DBS, 10 family members and 11 health professionals were analysed. Occupations emerged as a key aspect throughout the DBS experience. Two major themes captured the role of occupation in relation to DBS: Occupations as a barometer, where occupational experiences and performances shaped people's understanding of their condition, the impact of treatments and their overall adjustment; and Shifting occupational identity where the life transition of DBS altered the occupational experiences of relationships, volition, roles and responsibilities of people with PD and their family members. CONCLUSION Occupational experiences and changes served as an important way for people with PD and their families to understand and communicate their experiences of PD and related treatments. There is an identified need for outcome measures and clinical education and interventions to reflect this.
Collapse
Affiliation(s)
- Jacki Liddle
- Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland
| | - Jessie Phillips
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Louise Gustafsson
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter Silburn
- Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland
| |
Collapse
|
26
|
Navarta-Sánchez MV, Caparrós N, Riverol Fernández M, Díaz De Cerio Ayesa S, Ursúa Sesma ME, Portillo MC. Core elements to understand and improve coping with Parkinson's disease in patients and family carers: A focus group study. J Adv Nurs 2017; 73:2609-2621. [PMID: 28494098 DOI: 10.1111/jan.13335] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study were: (1) To explore the meaning that coping with Parkinson's disease has for patients and family carers; (2) To suggest the components of an intervention focused on enhancing their coping with the disease. BACKGROUND Adapting to Parkinson's disease involves going through many difficult changes; however, it may improve quality of life in patients and family carers. One of the key aspects for facilitating the psychosocial adjustment to Parkinson's disease is the strengthening of coping skills. DESIGN A sequential explanatory mixed methods study was carried out. Findings from the qualitative phase are presented. METHODS Data were collected in May 2014 through three focus groups: one of people with Parkinson's disease (n = 9), one of family carers (n = 7) and one of healthcare professionals (n = 5). All focus groups were digitally recorded and transcribed verbatim and content analysis was independently carried out by two researchers. FINDINGS The participants coincided in highlighting that coping with Parkinson's disease helped the patient and the family carer in their search for balance; and it implied a transformation in their lives. To aid the process of coping with Parkinson's disease, a multifaceted intervention is proposed. CONCLUSION Coping with Parkinson's disease is a complex process for both patients and family carers and it should therefore be considered a standard service in healthcare policies aimed at this group. The proposed intervention constitutes a nursing tool which has great potential to improve the quality of life in Parkinson's disease and in other long-term conditions.
Collapse
Affiliation(s)
| | - Neus Caparrós
- Faculty of Law and Social Sciences, University of La Rioja, Logroño, La Rioja, Spain
| | | | | | - M Eugenia Ursúa Sesma
- San Juan Primary Health Centre, Navarre Service of Health-Osasunbidea, Pamplona, Navarre, Spain
| | - Mari Carmen Portillo
- NIHR CLAHRC WESSEX, Faculty of Health Sciences, University of Southampton, Southampton, Hampshire, UK
| |
Collapse
|
27
|
Tackling psychosocial maladjustment in Parkinson's disease patients following subthalamic deep-brain stimulation: A randomised clinical trial. PLoS One 2017; 12:e0174512. [PMID: 28399152 PMCID: PMC5388322 DOI: 10.1371/journal.pone.0174512] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 03/08/2017] [Indexed: 01/10/2023] Open
Abstract
Background Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for the motor and non-motor signs of Parkinson’s disease (PD), however, psychological disorders and social maladjustment have been reported in about one third of patients after STN-DBS. We propose here a perioperative psychoeducation programme to limit such social and familial disruption. Methods Nineteen PD patients and carers were included in a randomised single blind study. Social adjustment scale (SAS) scores from patients and carers that received the psychoeducation programme (n = 9) were compared, both 1 and 2 years after surgery, with patients and carers with usual care (n = 10). Depression, anxiety, cognitive status, apathy, coping, parkinsonian disability, quality-of-life, carers’ anxiety and burden were also analysed. Results Seventeen patients completed the study, 2 were excluded from the final analysis because of adverse events. At 1 year, 2/7 patients with psychoeducation and 8/10 with usual care had an aggravation in at least one domain of the SAS (p = .058). At 2 years, only 1 patient with psychoeducation suffered persistent aggravated social adjustment as compared to 8 patients with usual care (p = .015). At 1 year, anxiety, depression and instrumental coping ratings improved more in the psychoeducation than in the usual care group (p = .038, p = .050 and p = .050, respectively). No significant differences were found between groups for quality of life, cognitive status, apathy or motor disability. Conclusions Our results suggest that a perioperative psychoeducation programme prevents social maladjustment in PD patients following STN-DBS and improves anxiety and depression compared to usual care. These preliminary data need to be confirmed in larger studies.
Collapse
|
28
|
[Psychosocial strategies to strengthen the coping with Parkinson's disease: Perspectives from patients, family carers and healthcare professionals]. Aten Primaria 2016; 49:214-223. [PMID: 27566906 PMCID: PMC6876005 DOI: 10.1016/j.aprim.2016.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 11/20/2022] Open
Abstract
Objetivo Explorar los principales aspectos psicosociales que influyen en el afrontamiento de la enfermedad de los pacientes con enfermedad de Parkinson (EP) y sus familiares cuidadores. Diseño Estudio cualitativo exploratorio que constituye la segunda fase de un proyecto de metodología combinada. Emplazamiento Estudio multicéntrico realizado en la Comunidad Autónoma de Navarra en 2014 con la colaboración de Atención Primaria del Servicio Navarro de Salud-Osasunbidea, la Clínica Universidad de Navarra y la Asociación Navarra de Parkinson. Participantes Un total de 21 participantes: 9 personas con EP, 7 familiares cuidadores y 5 profesionales sociosanitarios. Método Los participantes fueron seleccionados mediante muestreo opinático. Se realizaron grupos focales hasta que se consideró adecuada la saturación de los datos. Las transcripciones fueron analizadas por 2 investigadores a través de un análisis de contenido. Resultados Se identificaron 3 aspectos que influían en cómo pacientes y familiares afrontaban la EP: funcionalidad de la atención sanitaria; entorno familiar, y aceptación de la enfermedad. Considerando estos resultados, se proponen estrategias que podrían promover estos aspectos desde atención primaria, para así mejorar la adaptación a esta enfermedad en pacientes y en sus familiares cuidadores. Conclusiones La atención sociosanitaria de las personas con EP debería adoptar un enfoque integral que aborde el control de los síntomas del paciente y que responda también a los aspectos psicosociales que influyen en el afrontamiento de la enfermedad, tanto en los pacientes como en sus familiares cuidadores.
Collapse
|
29
|
Abendroth M. Psychometric Testing and Modification of the Parkinson's Disease Caregiver Strain Risk Screen. J Nurs Meas 2016; 24:281-95. [PMID: 27535315 DOI: 10.1891/1061-3749.24.2.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The Caregiver Strain Risk Screen-10 (CSRS-10) was psychometrically tested as a modification of the 28-item Caregiver Strain Risk Screen (CSRS) to measure risk for strain in caregivers of persons with Parkinson's disease. Risk for strain in this population is high because of the unpredictability of disease progression. METHODS Caregivers (N = 223) provided data for confirmatory factor analysis (CFA) to assess the factor structure of the items. RESULTS CFA and subsequent modification indices supported a 10-item, single-factor model and was determined to be a valid, reliable measure of risk for strain in this population. CONCLUSIONS The CSRS-10 is an efficient, theory-based instrument to assess caregiver strain risk throughout the care recipient's illness progression. It is ideal for researchers and nurses seeking a succinct strain risk measure for this population.
Collapse
|
30
|
Abstract
Most people with Parkinson’s disease (PD) reside in their homes with their family members. Nurses are in a good position to partner with people with PD and their family members for better self-management of the disease and improved quality of life. The purpose of this systematic review was to assess the state of the science of nursing research related to PD during the 10-year period, 2006 to 2015. A total of 27 studies were included in this review. Family caregiving was the most studied topic, followed by symptom management/medication adherence, quality of life, end-of-life/palliative care, and functional status/improving function. Recommendations for future studies in PD include (a) developing and testing interventions based on theoretical models in the areas of self-management, symptom management, and function improvement in people with PD and for caregivers caring for people with advanced stage PD, and (b) building programs of research with interprofessional teams.
Collapse
|
31
|
Mathers J, Rick C, Jenkinson C, Garside R, Pall H, Mitchell R, Bayliss S, Jones LL. Patients' experiences of deep brain stimulation for Parkinson's disease: a qualitative systematic review and synthesis. BMJ Open 2016; 6:e011525. [PMID: 27338883 PMCID: PMC4932278 DOI: 10.1136/bmjopen-2016-011525] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To review and synthesise qualitative research studies that have explored patients' experience of deep brain stimulation (DBS) in advanced Parkinson's disease (PD). DESIGN Systematic review and meta-synthesis of 7 original papers, using metaethnography. SETTING Studies conducted in Denmark, France and Sweden. PARTICIPANTS 116 patients who had undergone DBS and 9 spouses of patients. RESULTS Prior to surgery, the experience of advancing PD is one of considerable loss and a feeling of loss of control. There are significant hopes for what DBS can bring. Following surgery, a sense of euphoria is described by many, although this does not persist and there is a need for significant transitions following this. We suggest that normality as a concept is core to the experience of DBS and that a sense of control may be a key condition for normality. Experience of DBS for patients and spouses, and of the transitions that they must undertake, is influenced by their hopes of what surgery will enable them to achieve, or regain (ie, a new normality). CONCLUSIONS There is a need for further qualitative research to understand the nature of these transitions to inform how best patients and their spouses can be supported by healthcare professionals before, during and after DBS. In assessing the outcomes of DBS and other treatments in advanced PD, we should consider how to capture holistic concepts such as normality and control. Studies that examine the outcomes of DBS require longer term follow-up.
Collapse
Affiliation(s)
- J Mathers
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - C Rick
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - C Jenkinson
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - R Garside
- European Centre for Environment and Human Health, University of Exeter, Exeter, UK
| | - H Pall
- Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - R Mitchell
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - S Bayliss
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - L L Jones
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| |
Collapse
|
32
|
Martin SC. Relational Issues Within Couples Coping With Parkinson's Disease: Implications and Ideas for Family-Focused Care. JOURNAL OF FAMILY NURSING 2016; 22:224-251. [PMID: 27044337 DOI: 10.1177/1074840716640605] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The ways in which Parkinson's disease (PD) impacts, and is experienced by, the couple (i.e., the individual with PD and his or her spouse or other romantic partner) have not been fully elucidated. Such research is strongly warranted because when one member of a couple is chronically ill, it can cause major distress for not only the patient but also for his or her partner and their relationship. Therefore, the goal of this study was to examine how PD affects a couple's relationship. Data from 44 individual, in-depth interviews (with 21 persons with PD and 23 partners) revealed several challenges that PD commonly invokes in the patient-partner relationship, though most participants reported that PD had not decreased their overall relational closeness. The findings have significant practical implications for family-focused care.
Collapse
|
33
|
Navarta-Sánchez MV, Senosiain García JM, Riverol M, Ursúa Sesma ME, Díaz de Cerio Ayesa S, Anaut Bravo S, Caparrós Civera N, Portillo MC. Factors influencing psychosocial adjustment and quality of life in Parkinson patients and informal caregivers. Qual Life Res 2016; 25:1959-68. [PMID: 26742928 PMCID: PMC4945683 DOI: 10.1007/s11136-015-1220-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 12/20/2022]
Abstract
Objective The influence that social conditions and personal attitudes may have on the quality of life (QoL) of Parkinson’s disease (PD) patients and informal caregivers does not receive enough attention in health care, as a result of it not being clearly identified, especially in informal caregivers. The aim of this study was to provide a comprehensive analysis of psychosocial adjustment and QoL determinants in PD patients and informal caregivers. Methods Ninety-one PD patients and 83 caregivers participated in the study. Multiple regression analyses were performed including benefit finding, coping, disease severity and socio-demographic factors, in order to determine how these aspects influence the psychosocial adjustment and QoL in PD patients and caregivers. Results Regression models showed that severity of PD was the main predictor of psychosocial adjustment and QoL in patients. Nevertheless, multiple regression analyses also revealed that coping was a significant predictor of psychosocial adjustment in patients and caregivers. Furthermore, psychosocial adjustment was significantly related to QoL in patients and caregivers. Also, coping and benefit finding were predictors of QoL in caregivers but not in patients. Conclusions Multidisciplinary interventions aimed at improving PD patients’ QoL may have more effective outcomes if education about coping skills, and how these can help towards a positive psychosocial adjustment to illness, were included, and targeted not only at patients, but also at informal caregivers.
Collapse
Affiliation(s)
| | | | - Mario Riverol
- Department of Neurology, Clínica Universidad de Navarra, Navarre, Spain
| | | | | | | | | | - Mari Carmen Portillo
- Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO171BJ, UK.
| |
Collapse
|
34
|
Norlyk A, Haahr A, Hall E. Interviewing with or without the partner present? - an underexposed dilemma between ethics and methodology in nursing research. J Adv Nurs 2015; 72:936-45. [DOI: 10.1111/jan.12871] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Annelise Norlyk
- Section for Nursing; Department of Public Health; Aarhus University/VIA University College; Skejby Denmark
| | - Anita Haahr
- VIA University College; Bachelor programme in Nursing; Faculty of Health Sciences; VIA University College; Skejby Denmark
| | - Elisabeth Hall
- Section for Nursing; Department of Public Health; Aarhus University; Denmark
- Department of Nursing; Faculty of Natural and Health Sciences; University of the Faroe Islands; The Faroe Islands
| |
Collapse
|
35
|
Ågård AS, Egerod I, Tønnesen E, Lomborg K. From spouse to caregiver and back: a grounded theory study of post-intensive care unit spousal caregiving. J Adv Nurs 2015; 71:1892-903. [DOI: 10.1111/jan.12657] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Anne Sophie Ågård
- Department of Anesthesiology and Intensive Care; Aarhus University Hospital; Denmark
| | - Ingrid Egerod
- University of Copenhagen, Health & Medical Sciences; Copenhagen University Hospital Rigshospitalet; Trauma Center; Denmark
| | - Else Tønnesen
- Department of Anesthesiology and Intensive Care; Aarhus University Hospital; Denmark
| | - Kirsten Lomborg
- Faculty of Health Sciencies & Aarhus University Hospital; Aarhus University; Denmark
| |
Collapse
|
36
|
Haahr A, Norlyk A, Hall EO. Ethical challenges embedded in qualitative research interviews with close relatives. Nurs Ethics 2013; 21:6-15. [PMID: 23774032 DOI: 10.1177/0969733013486370] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nurse researchers engaged in qualitative interviews with patients and spouses in healthcare may often experience being in unforeseen ethical dilemmas. Researchers are guided by the bioethical principles of justice, beneficence, non-maleficence, respect for human rights and respect for autonomy through the entire research process. However, these principles are not sufficient to prepare researchers for unanticipated ethical dilemmas related to qualitative research interviews. We describe and discuss ethically challenging and difficult moments embedded in two cases from our own phenomenological interview studies. We argue that qualitative interviews involve navigation between being guided by bioethics as a researcher, being a therapist/nurse and being a fellow human being or even a friend. The researchers' premises to react to unexpected situations and act in a sound ethical manner must be enhanced, and there is a need for an increased focus on the researchers' ethical preparation and to continually address and discuss cases from their own interviews.
Collapse
Affiliation(s)
- Anita Haahr
- VIA University College, Bachelor Programme in Nursing, Denmark
| | | | | |
Collapse
|