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Lee J, Suh Y, Kim E, Yoo S, Kim Y. A Mobile App for Comprehensive Symptom Management in People With Parkinson's Disease: A Pilot Usability Study. Comput Inform Nurs 2024; 42:289-297. [PMID: 38261451 DOI: 10.1097/cin.0000000000001089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
There is an increasing need for highly accessible health management platforms for comprehensive symptoms of Parkinson disease. Mobile apps encompassing nonmotor symptoms have been rarely developed since these symptoms are often subjective and difficult to reflect what individuals actually experience. The study developed an app for comprehensive symptom management and evaluated its usability and feasibility. A single-group repeated measurement experimental design was used. Twenty-two participants used the app for 6 weeks. Monitoring of nonmotor symptoms, games to address motor symptoms, and medication management were incorporated in the app. Quantitative outcomes were self-assessed through an online questionnaire, and one-on-one telephone interviews were conducted to understand the user's point of view. The successful experience of self-monitoring had improved participants' self-efficacy ( Z = -3.634, P < .001) and medication adherence ( Z = -3.371, P = .001). Facilitators included a simple-to-use interface, entertaining content, and medication helps. Barriers included simple forgetfulness and digital literacy, including unfamiliarity with mobile phone manipulation itself. The study suggested insight into the app use related to acceptability of mobile technology. The preliminary effects on self-efficacy and medication adherence will guide future nursing interventions using mobile health. Our approach will contribute to improving the continuum of care for Parkinson disease by promoting self-monitoring of symptoms.
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Affiliation(s)
- JuHee Lee
- Author Affiliations: Mo-Im Kim Nursing Research Institute, Yonsei Evidence Based Nursing Centre of Korea: A Joanna Briggs Institute of Excellence, College of Nursing, Yonsei University (Dr Lee), Seoul; College of Nursing, Health Science & Human Ecology, Dong-Eui University (Dr Suh), Busan; and Graduate School, Brain Korea 21 FOUR Project, College of Nursing, Yonsei University (Mss E. Kim and Yoo); and Division of Nursing, Severance Hospital, Yonsei University Health System (Dr Y. Kim), Seoul, South Korea
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Chen YW, Huang CY, Chen JH, Hsiao CL, Hong CT, Wu CY, Chang EH. Living with Parkinson’s disease: disease and medication experiences of patients and caregivers. Int J Qual Stud Health Well-being 2022; 17:2018769. [PMID: 34978276 PMCID: PMC8740619 DOI: 10.1080/17482631.2021.2018769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose Symptoms and medication use in patients with Parkinson’s disease (PD) affect the quality of life of patients and caregivers, yet prior research seldom focused on their experiences with medications. This study explored comprehensive living and medication experience from patients with PD and their caregivers. Methods Patients diagnosed with PD for ≥2 years, with or without their caregivers, were recruited from an outpatient clinic in Taiwan. Semi-structured in-depth interviews were conducted based on the Common Sense Model. A qualitative content analysis was used to identify salient themes from verbatim transcripts. Results In total, 15 patients and eight caregivers were interviewed. Five themes were derived: (1) symptoms and help-seeking behaviours before a diagnosis, (2) emotional impacts and life adaptations after a PD diagnosis, (3) life affected by medications, (4) experiences of caregivers in taking care of PD patients, and (5) communication between doctors and patients. Conclusions Patients frequently adjusted their daily schedules to live with PD and the medication side effects. Caregivers struggle to overcome caring burdens and to stay positive to support patients. More attention on providing medication information, mental support, and communication between stakeholders is needed to improve the quality of life of patients and caregivers.
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Affiliation(s)
- Yi-Wen Chen
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Chu-Yun Huang
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Jo-Hsin Chen
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chi-Lien Hsiao
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chien-Tai Hong
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chen-Yu Wu
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Elizabeth H. Chang
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Research Center for Pharmacoeconomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
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Zaman MS, Ghahari S, McColl MA. Barriers to Accessing Healthcare Services for People with Parkinson's Disease: A Scoping Review. JOURNAL OF PARKINSON'S DISEASE 2021; 11:1537-1553. [PMID: 34308913 PMCID: PMC8609702 DOI: 10.3233/jpd-212735] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 12/18/2022]
Abstract
Parkinson's disease is a complex condition that affects many different aspects of a person's health. Because of its complexity, people with Parkinson's disease require access to a variety of healthcare services. The aim of the present study was to identify the barriers to access healthcare services for people with Parkinson's disease. We conducted a scoping review according to guidelines posed by Arksey & O'Malley (2005). A search of MEDLINE, Embase, CINHAL, and PsycINFO databases was conducted, and 38 articles were selected based on the inclusion criteria. The review findings identified person-level and system-level barriers. The person-level barriers included skills required to seek healthcare services, ability to engage in healthcare and cost for services. The system-level barriers included the availability of appropriate healthcare resources. Based on the existing barriers elucidated in the scope review, we have discussed potential areas in healthcare that require improvement for people with Parkinson's disease to manage their healthcare needs more equitably.
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Affiliation(s)
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
| | - Mary Ann McColl
- School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
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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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Imaging the Functional Neuroanatomy of Parkinson's Disease: Clinical Applications and Future Directions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052356. [PMID: 33670940 PMCID: PMC7967767 DOI: 10.3390/ijerph18052356] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/11/2021] [Accepted: 02/21/2021] [Indexed: 12/17/2022]
Abstract
The neurobiology of Parkinson’s disease and its progression has been investigated during the last few decades. Braak et al. proposed neuropathological stages of this disease based on the recognizable topographical extent of Lewy body lesions. This pathological process involves specific brain areas with an ascending course from the brain stem to the cortex. Post-mortem studies are of importance to better understand not only the progression of motor symptoms, but also the involvement of other domains, including cognition and behavior. The correlation between the neuropathological expansion of the disease and the clinical phases remains demanding. Neuroimaging, including magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emission computed tomography (SPECT), could help to bridge this existing gap by providing in vivo evidence of the extension of the disorders. In the last decade, we observed an overabundance of reports regarding the sensitivity of neuroimaging techniques. All these studies were aimed at improving the accuracy of Parkinson’s disease (PD) diagnosis and discriminating it from other causes of parkinsonism. In this review, we look at the recent literature concerning PD and address the new frontier of diagnostic accuracy in terms of identification of early stages of the disease and conventional neuroimaging techniques that, in vivo, are capable of photographing the basal ganglia network and its cerebral connections.
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Radder DL, Tiel Groenestege AT, Boers I, Muilwijk EW, Bloem BR. Mucuna Pruriens Combined with Carbidopa in Parkinson’s Disease: A Case Report. JOURNAL OF PARKINSONS DISEASE 2019; 9:437-439. [DOI: 10.3233/jpd-181500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Danique L.M. Radder
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Andreas T. Tiel Groenestege
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Inge Boers
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Eline W. Muilwijk
- Department of Pharmacy, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Bastiaan R. Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
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Lennaerts H, Groot M, Rood B, Gilissen K, Tulp H, van Wensen E, Munneke M, van Laar T, Bloem BR. A Guideline for Parkinson's Disease Nurse Specialists, with Recommendations for Clinical Practice. JOURNAL OF PARKINSONS DISEASE 2018; 7:749-754. [PMID: 28800338 DOI: 10.3233/jpd-171195] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Parkinson's Disease Nurse Specialists (PDNS) play an important role in the care for patients with Parkinson's disease (PD) and their caregivers. Until now, there were no nursing guidelines in PD, and interventions were based solely on daily clinical practice because there is no evidence to support the merits of nursing interventions. Consequently, there is little uniformity in current care delivery. OBJECTIVE Developing a guideline for PDNS. METHODS We developed a guideline based on a questionnaire among PDNS and a literature review, supplemented with expert opinion plus the input of patients and caregivers. The questionnaire was filled in by 97 PDNS and 51 generic nurses with knowledge of PD to identify barriers in PD nursing care. Subsequently, we did a systematic literature search and transformed these sources of information into practice recommendations, which were developed according to international standards for guideline development. RESULTS Based on the results of the questionnaire we identified seven specific core areas: defining the role of PDNS in terms of caseload, education, competences and care coordination; medication adherence; provision of information and education; coping; caregiver support; urogenital function and orthostatic hypotension. The systematic literature search identified 186 studies, of which 33 studies were finally analyzed. Furthermore, we developed practice recommendations based on good clinical practice for the following areas: self-care, mental functioning, mobility, nutrition, sexuality, work, sleep, palliative care and complementary (integrative) care. CONCLUSION This guideline provide ground to harmonize care delivery by PDNS in clinical practice, and offer a foundation for future research.
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Affiliation(s)
- Herma Lennaerts
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
| | - Marieke Groot
- Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Berna Rood
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
| | - Koen Gilissen
- Department of Neurology, Medical centre Alkmaar, Alkmaar, The Netherlands
| | - Hella Tulp
- Department of Neurology, Elkerliek Hospital, Helmond, The Netherlands
| | - Erik van Wensen
- Department of Neurology, Gelre Hospital, Apeldoorn, The Netherlands
| | - Marten Munneke
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
| | - Teus van Laar
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
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Shin JY, Pohlig RT, Habermann B. Beliefs About Use of Complementary Health Approaches for Parkinson's Disease. Holist Nurs Pract 2017; 31:290-294. [PMID: 28786886 PMCID: PMC5664950 DOI: 10.1097/hnp.0000000000000229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder in the United States, which requires ongoing medication therapy. Despite the high prevalence of complementary health approaches (CHA) being used among people with PD in several countries, little is known about the perceived effectiveness, safety, and risk related to use of CHA. The purpose of this study was to describe CHA users' beliefs about the effectiveness, safety, and risk of CHA. A subsample (n = 70) of participants who reported using CHA and who completed all 12 items of the section of participants' beliefs were taken from a larger study (n = 143) that described the proportion of individuals who used CHA to manage PD symptoms. Participants reported that CHAs are somewhat effective to control or manage PD symptoms and necessary for PD management. However, they disagreed on possible adverse effects of CHAs and their potential interactions with prescription medications. Participants were willing to share their CHA use with their doctors and/or nurses and had a neutral response to the costs of CHA. More scientific evidence on effectiveness and safety/risk of CHA is needed to assist individuals' informed decision about using CHA and allocation of their health care spending. Nurses and other health care professionals need to be aware of CHA users' beliefs about CHA used for PD and of the need for provision of adequate information and resources, including locating qualified CHA practitioners or databases of CHA.
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Affiliation(s)
- Ju Young Shin
- College of Health Sciences, University of Delaware, Newark
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Shin JY, Pohlig RT, Habermann B. Use of Complementary Health Approaches in Individuals With Parkinson's Disease. J Gerontol Nurs 2017; 43:46-54. [PMID: 27845808 DOI: 10.3928/00989134-20161109-04] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 09/16/2016] [Indexed: 02/04/2023]
Abstract
Parkinson's disease (PD) is neurodegenerative and requires ongoing therapy. The purpose of the current study was two-fold: to (a) describe the prevalence, types, and associated factors of complementary health approaches (CHA) used in individuals with PD; and (b) explore reasons for CHA use. A self-administered, cross-sectional survey was used. The response rate was 61.9% (N = 135), and 74.1% of participants used CHA for either PD or general health. The most widely used CHA included exercise, yoga, massage, vitamins, coenzyme Q10, and coconut oil. Higher levels of education and treatment by a movement disorder specialist were significantly related to CHA use. Nurses and other health care professionals may have a role in providing safe care for individuals with PD. Further studies on effectiveness and safety of commonly used CHA are warranted. [Journal of Gerontological Nursing, 43(2), 46-54.].
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