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帕金森病患者向医疗保健提供者报告非运动症状的障碍。

Barriers to reporting non-motor symptoms to health-care providers in people with Parkinson's.

机构信息

Centre for Health Services Research, School of Health Sciences, City, University of London, EC1R 1UW, London, UK.

King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, Denmark Hill, SE5 8AF, London, UK; King's College Hospital NHS Foundation Trust, National Parkinson's Foundation International Centre of Excellence, Denmark Hill, London, SE5 9RS, UK.

出版信息

Parkinsonism Relat Disord. 2019 Jul;64:220-225. doi: 10.1016/j.parkreldis.2019.04.014. Epub 2019 Apr 20.

Abstract

BACKGROUND

Non-motor symptoms (NMS) are common in Parkinson's disease (PD) and cause significant distress. A high rate of non-declaration of NMS by patients to healthcare providers (HCP) means that many NMS remain untreated. Current understanding of the factors preventing disclosure of NMS to HCPs is limited. The present study aimed to i) further assess the prevalence of NMS and associated distress, ii) establish current rates of NMS reporting across a range of sources, and iii) explore overall and any symptom specific barriers to help-seeking for NMS.

METHODS

358 PD patients completed a cross-sectional survey of NMS severity, reporting and barriers to help-seeking. A series of Generalised Estimating Equations were used to determine whether barriers were symptom specific.

RESULTS

A mean of 10.5 NMS were reported by each patient. Rates of non-reporting of NMS ranged from 15 to 72% of those experiencing distressing symptoms. The most commonly reported barriers to help-seeking were acceptance of symptoms; lack of awareness that a symptom was associated with PD, and belief that no effective treatments were available. Symptom specific barriers were found for sexual dysfunction (embarrassment), unexplained pain and urinary problems (belief about lack of treatment availability).

CONCLUSION

A diverse range of barriers prevent PD patients reporting NMS to HCPs and these barriers differ between NMS. The study provides the foundations for developing interventions to increase reporting by targeting individual NMS. Increasing rates of help-seeking for NMS by patients to their Parkinson's healthcare providers will increase appropriate clinical care which may improve quality of life and well-being.

摘要

背景

非运动症状(NMS)在帕金森病(PD)中很常见,会导致患者产生较大的痛苦。由于患者向医疗保健提供者(HCP)报告 NMS 的比例较高,许多 NMS 仍未得到治疗。目前,对于导致患者不愿向 HCP 报告 NMS 的因素了解有限。本研究旨在:i)进一步评估 NMS 的患病率及其相关痛苦,ii)确定当前各种来源报告 NMS 的比率,以及 iii)探索寻求 NMS 治疗的总体和任何症状特异性障碍。

方法

358 名 PD 患者完成了一项关于 NMS 严重程度、报告和寻求帮助障碍的横断面调查。使用一系列广义估计方程来确定障碍是否与症状有关。

结果

每位患者报告了平均 10.5 种 NMS。报告 NMS 的患者比例从经历痛苦症状的患者的 15%到 72%不等。寻求帮助的最常见障碍是接受症状;缺乏对与 PD 相关的症状的认识,以及认为没有有效的治疗方法。对于性功能障碍(尴尬)、无法解释的疼痛和尿问题(关于缺乏治疗方法的信念),发现了特定于症状的障碍。

结论

各种障碍阻止 PD 患者向 HCP 报告 NMS,并且这些障碍在不同的 NMS 之间存在差异。该研究为开发干预措施提供了基础,这些干预措施可以通过针对特定的 NMS 来提高报告率。增加患者向其帕金森氏病医疗保健提供者报告 NMS 的比例,将增加适当的临床护理,这可能会改善生活质量和幸福感。

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