J Parkinsons Dis. 2015;5(4):983-92. doi: 10.3233/JPD-150631.
Activity performance is marked by the degenerative nature of Parkinson's disease (PD), but few qualitative studies have focused on how people with PD perceive participation in life situations.
To identify and describe barriers and facilitators for participation from the perspective of people with PD.
Qualitative data was obtained by the focus group method using a semi-structured interview guide. Participants were recruited by purposeful sampling until saturation was reached. Homogeneity within each focus group was based on self-rated PD severity (mild, moderate, severe). Nine focus groups (three per PD severity level) included a total of 29 participants.
Complex dynamics between the individual and the physical and social environment create barriers and facilitators for participation as described in the four categories which emerged out of the focus group discussions. The category Ambiguity of attitudes and the support of others describes how attitudes and support of other people act both as facilitators and barriers for participation. PD specific complexity of the body and physical environment interaction describes barriers for participation. Facilitators emerged in the two categories PD expertise in health care and social services and Information and education foster PD specific understanding.
Our findings imply several potential means to facilitate participation for people with PD, taking the person as well as the environment into account in person-centred interventions. This involves aspects such as having access to PD specific expertise, increasing the knowledge and thereby the understanding of PD as well as providing support for maintained work-life.
帕金森病（PD）的活动表现具有退行性，但是很少有定性研究关注 PD 患者如何感知参与生活情境。
从 PD 患者的角度确定和描述参与的障碍和促进因素。
通过使用半结构化访谈指南的焦点小组方法获得定性数据。通过目的性抽样招募参与者，直到达到饱和。每个焦点小组内的同质性基于自我评估的 PD 严重程度（轻度、中度、重度）。9 个焦点小组（每个 PD 严重程度水平 3 个）共纳入 29 名参与者。
个体与物理和社会环境之间的复杂动态关系构成了参与的障碍和促进因素，这些障碍和促进因素体现在从焦点小组讨论中出现的四个类别中。类别“态度的模糊性和他人的支持”描述了态度和他人的支持如何既作为参与的促进因素，又作为参与的障碍。PD 对身体和物理环境相互作用的特异性描述了参与的障碍。在两个类别“医疗保健和社会服务中的 PD 专业知识”和“信息和教育促进 PD 特定理解”中出现了促进因素。
我们的研究结果表明，有几种潜在的方法可以促进 PD 患者的参与，在以人为中心的干预措施中既要考虑个人，也要考虑环境。这涉及到一些方面，例如获得 PD 专业知识、增加对 PD 的认识和理解，以及为维持工作和生活提供支持。
