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Alizadeh N, Packer T, Chen YT, Alnasery Y. What we know about fatigue self-management programs for people living with chronic conditions: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 114:107866. [PMID: 37364380 DOI: 10.1016/j.pec.2023.107866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE The significant impact of fatigue on the lives of patients with chronic conditions has demanded a response. One response has been the development and testing of self-management programs. Little is known about what these programs have in common or how they differ. This scoping review compared the key components of fatigue self-management programs. METHODS Scoping review methodology was employed. Databases of CINAHL, Academic Search Premier, PsycINFO, Cochrane and Medline were searched to identify relevant sources. RESULTS Included fatigue programs were compared using a three-component framework: 1) self-management strategies; 2) active patient participation; and 3) self-management support. Although all programs included some aspects of these components, the extent varied with only a few domains of these components found across all programs. CONCLUSION The three self-management components employed in this study showed potential benefits in identifying similarities and differences across fatigue programs with comparable and distinct underlying theories. This three-component framework could facilitate identification of domains associated with positive outcomes. PRACTICE IMPLICATIONS It is essential that authors of programs provide detailed descriptions to enable inter-program comparison. The three-component framework chosen for this review was capable of describing and comparing fatigue self-management programs, paving the way for more effective interventions.
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Affiliation(s)
- Neda Alizadeh
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Tanya Packer
- School of Health Administration, Dalhousie University, Halifax, Canada; Department of Nursing, Umea University, Umea, Sweden.
| | - Yu-Ting Chen
- Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan
| | - Yaser Alnasery
- School of Occupational Therapy, Dalhousie University, Halifax, Canada; College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Alizadeh N, Packer TL, Sturkenboom I, Eskes G, Warner G. Managing Fatigue in Parkinson's Disease: Protocol for a Pilot Randomized Controlled Trial. Can J Occup Ther 2022; 89:180-189. [PMID: 35287487 PMCID: PMC9136370 DOI: 10.1177/00084174221085449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background. Fatigue is a disabling symptom of Parkinson’s disease (PD). Managing Fatigue: A Six-Week Energy Conservation Intervention was developed to improve the occupational performance of people with fatigue. Efficacy of this program has not been established in PD. Purpose. This study will assess feasibility of the Managing Fatigue: Individual Program (MFIP) delivered via videoconference, the Randomized Controlled Trial (RCT) protocol, and the preliminary effectiveness of the MFIP. Methods. A mixed-methods approach nested in a pilot RCT, randomizing 54 participants 1:1 to usual care or MFIP arms, will be employed to evaluate the feasibility and preliminary effectiveness of MFIP. Qualitative and quantitative data will be collected simultaneously. Implications. Results will identify evidence for establishing protocol requirements for a full-scale RCT. Knowledge of the effectiveness of the one-to-one videoconference delivery format of the program has the potential to enhance the accessibility and the quality of care of the PD population.
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Affiliation(s)
| | - Tanya L. Packer
- Neda Alizadeh, School of Occupational Therapy, 5869 University Ave, Halifax, NS B3H 4R2.
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Mantri S, Chahine LM, Nabieva K, Feldman R, Althouse A, Torsney B, Albert SM, Kopil C, Marras C. Demographic Influences on the Relationship Between Fatigue and Quality of Life in Parkinson's Disease. Mov Disord Clin Pract 2022; 9:76-81. [PMID: 35005068 DOI: 10.1002/mdc3.13360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/17/2021] [Accepted: 09/11/2021] [Indexed: 11/09/2022] Open
Abstract
Background Fatigue has a major impact on health-related quality of life (HR-QOL) in Parkinson's disease (PD). Objectives To determine whether demographic characteristics modify the relationship between fatigue and HR-QOL. Methods Patients with PD in the Fox Insight study completed the Parkinson Fatigue Scale (PFS-16) and Geriatric Depression Scale (GDS-15). Linear regression examined the relationship between the PFS-16 and Parkinson Disease Quality of Life, as modified by age, sex, and GDS-15. Results A total of 1029 participants (44% female, mean age 67.4 years, and mean disease duration 4.6 years) were included in this analysis. Multivariable regression modeling demonstrated a negative effect modification for age (β = -0.07, P < 0.001) and a positive effect modification for the GDS-15 (β = 0.057, P = 0.002), but not for sex (β = -0.021, P = 0.231). Conclusion The association between fatigue and worse HR-QOL is greater at younger ages and in individuals with more depressive symptoms. Targeted therapeutics for these individuals may provide the greatest impact on fatigue in PD.
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Affiliation(s)
- Sneha Mantri
- Department of Neurology Duke University School of Medicine Durham North Carolina USA
| | - Lana M Chahine
- Department of Neurology University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
| | - Karina Nabieva
- The Edmond J Safra Program in Parkinson's disease Toronto Western Hospital, University of Toronto Toronto Ontario Canada
| | - Robert Feldman
- Center for Clinical Trials and Data Coordination, Division of General Internal Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
| | - Andrew Althouse
- Center for Clinical Trials and Data Coordination, Division of General Internal Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA
| | - Benjamin Torsney
- Temple University College of Education and Human Development Philadelphia Pennsylvania USA
| | - Steven M Albert
- Behavioral and Community Health Sciences, Graduate School of Public Health University of Pittsburgh Pittsburgh Pennsylvania USA
| | | | - Connie Marras
- The Edmond J Safra Program in Parkinson's disease Toronto Western Hospital, University of Toronto Toronto Ontario Canada
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Mantri S, Klawson E, Albert S, Nabieva K, Lepore M, Kahl S, Daeschler M, Mamikonyan E, Kopil C, Marras C, Chahine LM. Understanding the Lexicon of Fatigue in Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2020; 10:1185-1193. [PMID: 32568110 PMCID: PMC7458521 DOI: 10.3233/jpd-202029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Fatigue in Parkinson’s disease (PD) is multifaceted and associated with reduced quality of life. In turn, the language used by people with PD to describe fatigue is variable and poorly understood. We sought to elucidate the lexicon of fatigue using a qualitative grounded theory approach. Objective: The objective of this study was to understand how patients with PD describe fatigue. Methods: A pre-study phase of online journaling (Phase 1) provided information regarding topics of importance to patients. Following this, two independent samples of fatigued subjects were studied. Individuals with PD participated in a telephone interview (Phase 2); interview transcripts were analyzed to develop a detailed codebook. To ensure trustworthiness of the findings, an online survey (Phase 3) was administered to individuals with self-reported PD participating in the online study Fox Insight. The survey included the following question: “How do you define fatigue? Please provide your definition in the space below.” The codebook developed from Phase 2 was applied to the Phase 3 responses. Results: Fifteen individuals participated in Phase 2 and 413 individuals completed Phase 3. Fatigue was subdivided into three domains: cognitive, emotional, and physical. Nearly all individuals experienced more than one domain of fatigue. The most common themes included tiredness, lack of energy, and negative motivation. Conclusion: Fatigue in PD is multidimensional. Questionnaires that only assess the physical impact of fatigue may not be adequate to capture the broad range of experiences of fatigue among people with PD.
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Affiliation(s)
- Sneha Mantri
- Department of Neurology, Duke University, Durham, NC, USA
| | - Emily Klawson
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven Albert
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Karina Nabieva
- The Edmond J Safra Program in Parkinson's disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario, USA
| | - Madeline Lepore
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen Kahl
- Tuck School of Business, Dartmouth College, Hanover, NH, USA
| | | | - Eugenia Mamikonyan
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Connie Marras
- The Edmond J Safra Program in Parkinson's disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario, USA
| | - Lana M Chahine
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
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The Impact of Living with Parkinson's Disease: Balancing within a Web of Needs and Demands. PARKINSONS DISEASE 2018; 2018:4598651. [PMID: 30151098 PMCID: PMC6087577 DOI: 10.1155/2018/4598651] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/19/2018] [Accepted: 07/02/2018] [Indexed: 11/17/2022]
Abstract
This study explores the impact of living with Parkinson's disease (PD). Nineteen persons (11 women) aged 55–84 diagnosed with PD 3–27 years ago participated. Data were collected through semistructured interviews, which were recorded, transcribed verbatim, and analysed by qualitative content analysis. Four categories represented the impact of living with PD: “Changed prerequisites for managing day-to-day demands,” “Loss of identity and dignity,” “Compromised social participation,” and “The use of practical and psychological strategies.” There was a shift from an internal to an external locus of control in managing, control, competence, relatedness, and autonomy. According to self-determination theory, a shift towards extrinsically motivated behaviours may occur when these basic needs are thwarted, leading to compensatory strategies or needs substitutes with negative consequences on health and well-being. We suggest a needs-based approach as an important starting point to better understand the consequences of living with PD and to explore the means for people with PD to acquire an improved quality of life on their own terms. In conclusion, our findings suggest for a shift in focus, from a biomedical to a needs-based approach to understand the impact of living with PD and facilitate more person-centred care and person-centred outcome measurement.
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Kluger BM. Fatigue in Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 133:743-768. [DOI: 10.1016/bs.irn.2017.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Dahodwala N, Pei Q, Schmidt P. Sex Differences in the Clinical Progression of Parkinson's Disease. J Obstet Gynecol Neonatal Nurs 2016; 45:749-56. [PMID: 27444842 DOI: 10.1016/j.jogn.2016.05.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To describe characteristics of Parkinson's disease by sex and determine if differences in disease progression exist. DESIGN Longitudinal, observational study. SETTING Twenty-one National Parkinson Foundation Centers of Excellence. PARTICIPANTS People (N = 4,679; 63% men and 37% women) with idiopathic Parkinson's disease. METHODS Demographic and clinical data at enrollment and after 1 year were collected. We defined progression as a 1-year change in the following functional health outcome measures: (a) health-related quality of life (Parkinson's Disease Questionnaire-39), (b) Timed Up and Go test, (c) cognitive function, and (d) number of medications. We compared baseline characteristics between men and women. Then, linear regression models were built to assess the independent contribution of sex to progression. RESULTS At baseline, women were significantly more likely to be older and have greater disease severity and more comorbidities than men despite similar duration of disease. This finding corresponded to worse function as assessed by the Parkinson's Disease Questionnaire-39 and Timed Up and Go test but not to number of medications and cognitive function. After 1 year, declines across all functional measures except delayed recall occurred. No significant changes in Parkinson's Disease Questionnaire-39, Timed Up and Go, number of medications, or verbal fluency between men and women occurred. Women had a more significant improvement in delayed recall than men. CONCLUSION Numerous small baseline differences occurred between men and women with PD, although differences in markers of progression were few. Findings suggest that clinical manifestations and prognosis appear similar by sex under the same treatment conditions.
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Whitehead LC, Unahi K, Burrell B, Crowe MT. The Experience of Fatigue Across Long-Term Conditions: A Qualitative Meta-Synthesis. J Pain Symptom Manage 2016; 52:131-143.e1. [PMID: 27233142 DOI: 10.1016/j.jpainsymman.2016.02.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 01/24/2016] [Accepted: 02/05/2016] [Indexed: 11/30/2022]
Abstract
CONTEXT Fatigue is a common and debilitating symptom associated with many long-term conditions and is reported to cause significant levels of distress for those individuals. There is a substantial body of literature related to the nature of fatigue; however, this has not been drawn together and compared across conditions. OBJECTIVES The aim of this review was to synthesize data on the nature of fatigue across long-term conditions. METHODS The review was designed as a qualitative meta-synthesis and followed the Joanna Briggs Institute guidelines for synthesizing qualitative research. The following databases were searched for the period January 1980 to January 2016, Ovid (Medline, Embase, CINAHL, and PsycINFO) and manual searching from the reference lists from articles identified by electronic search. Fifty-seven studies were included in the review, and findings related to the nature of fatigue were extracted and findings meta-synthesized. RESULTS The perceived nature of fatigue across long-term conditions was encompassed in one synthesis; the fatigue experience is without precedent, with four categories: a different fatigue to any experienced before, the intensity of fatigue is overwhelming, the trajectory of fatigue, and impact on sleep and sleep disturbance. Just over half of the participants in the included studies were diagnosed with cancer. Patterns in the experience of fatigue by condition were found for cancer-related fatigue and post-stroke fatigue where data were able to be synthesized. CONCLUSION Although similarities in the nature of the fatigue experienced were found across conditions, differences were also evident and could be mapped for cancer-related fatigue and post-stroke fatigue. Further qualitative research on the experience of fatigue across a wide range of chronic conditions would further contribute to understanding similarities and differences across conditions and inform both research and practice in relation to assessment and management.
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Affiliation(s)
- Lisa C Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
| | - Kirstin Unahi
- Southern District Health Board, Dunedin, New Zealand
| | - Beverley Burrell
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand
| | - Marie T Crowe
- Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand; Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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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: 26] [Impact Index Per Article: 3.3] [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.
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Olsson M, Nilsson C. Meanings of feeling well among women with Parkinson's disease. Int J Qual Stud Health Well-being 2015; 10:28730. [PMID: 26489404 PMCID: PMC4613899 DOI: 10.3402/qhw.v10.28730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 11/14/2022] Open
Abstract
We conducted a qualitative inquiry to describe the meanings of feeling well as experienced by women with Parkinson's disease. Nine women were interviewed and we analysed the interviews using a reflective lifeworld approach based on phenomenological epistemology. We present the analysis as five constituents: the body as unnoticed; being able to move on; feeling joy by being connected; finding peace and harmony; and being the director of one's own life. Our findings can be used to understand and promote well-being among women with Parkinson's disease. In care meetings, knowledge about the lived and experienced health processes supports the women's striving to not let illness dominate their experience of daily life.
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Affiliation(s)
- Malin Olsson
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden;
| | - Carina Nilsson
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
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Greer DB, Hermanns M, Cooper CM. Making Lemonade Out of Life’s Lemons: A View Into the World of Aging With Parkinson’s Disease. J Psychosoc Nurs Ment Health Serv 2015; 53:20-3. [DOI: 10.3928/02793695-20150623-03] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Soundy A, Stubbs B, Roskell C. The experience of Parkinson's disease: a systematic review and meta-ethnography. ScientificWorldJournal 2014; 2014:613592. [PMID: 25525623 PMCID: PMC4265687 DOI: 10.1155/2014/613592] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 11/03/2014] [Accepted: 11/06/2014] [Indexed: 11/17/2022] Open
Abstract
There has been little attempt to summarise and synthesise qualitative studies concerning the experience and perception of living with Parkinson's disease. Bringing this information together would provide a background to understand the importance of an individual's social identity on their well-being and hope. Three primary aims were identified (a) understanding the importance of social identity and meaningful activities on individuals' well-being, (b) identifying factors and strategies that influence well-being and hope, and (c) establishing a model that relates to an individual's hope and well-being. Three stages were undertaken including a traditional electronic search, a critical appraisal of articles, and a synthesis of studies. Qualitative articles were included that considered the experience of living with Parkinson's disease. Thirty seven articles were located and included in the review. Five themes were identified and the themes were used to inform development of a new model of hope enablement. The current review furthered understanding of how physical symptoms and the experience of Parkinson's disease affect the individual's well-being and hope. Social identity was established as a key factor that influenced an individual's well-being. Being able to maintain, retain, or develop social identities was essential for the well-being and hope of individuals with Parkinson's disease. Understanding the factors which prevent or can facilitate this is essential.
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Affiliation(s)
- Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Brendon Stubbs
- School of Health and Social Care, University of Greenwich, London SE9 2UG, UK
| | - Carolyn Roskell
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
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