Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Discipline of Occupational Therapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Disabil Rehabil. 2022 Oct;44(20):6000-6008. doi: 10.1080/09638288.2021.1955983. Epub 2021 Jul 27.
To explore how perceptions of fall risk influence decisions to undertake activities in people with Parkinson's disease who have fallen, along with their care-partners.
This qualitative study used semi-structured interviews to collect data from eight people with moderate to severe Parkinson's Disease and freezing of gait (including those with cognitive impairments) and their care-partners. An inductive approach to thematic analysis was used to analyse the data.
Four main, interconnected themes emerged, and a framework was developed to illustrate these connections. reflected the constant tension between assessing the likelihood of falling and potential benefit of any activity; heightened the perceived risk resulting in a tendency to avoid or modify activities; heightened the perceived benefit of any activity, leading towards risk taking behaviour; provided the context in which the decision-making process took place, with the reality of a progressive disorder influencing choices and contributing to a belief that falls were inevitable.
There is a complex interaction between perceptions of fall risk and behaviour. An understanding of these interactions will assist therapists to tailor individualised fall prevention interventions.IMPLICATIONS FOR REHABILITATIONPeople are constantly weighing up the risks and benefits of activities while balancing fear of falling and a desire to lead a normal life in the context of Parkinson's disease.The resulting activity choices vary along a continuum from avoiding activities to taking risks, with a common approach to minimise the risk and then embrace the activity.Therapists can help people with Parkinson's and their care-partners to determine what level of risk is acceptable for them when balancing risk with quality of life.Understanding how people decide if they will undertake an activity that poses a risk of falling will allow therapists and patients to co-design fall prevention and management interventions based on the patient's values and priorities.
探讨有跌倒经历的帕金森病患者及其照护者对跌倒风险的感知如何影响其活动决策。
本定性研究采用半结构式访谈，从 8 名中重度帕金森病伴冻结步态（包括伴有认知障碍者）患者及其照护者中收集资料。采用归纳法对主题进行分析。
得出了 4 个主要的、相互关联的主题，并构建了一个框架来阐述这些关联。主题 1 反映了评估跌倒可能性和任何活动潜在获益之间的持续紧张关系；主题 2 凸显了感知到的风险增加，导致倾向于避免或修改活动；主题 3 凸显了任何活动的感知获益，导致冒险行为；主题 4 提供了决策过程发生的背景，即进行性疾病的现实影响了选择，并导致一种跌倒不可避免的信念。
跌倒风险感知与行为之间存在复杂的相互作用。了解这些相互作用将有助于治疗师为患者量身定制个体化的跌倒预防干预措施。
帕金森病患者在权衡活动的风险和获益时，需要平衡对跌倒的恐惧和过正常生活的愿望。由此产生的活动选择沿着从避免活动到冒险的连续体变化，常见的方法是尽量降低风险，然后接受活动。治疗师可以帮助帕金森病患者及其照护者在平衡风险与生活质量时，确定他们可以接受的风险水平。了解人们如何决定是否进行有跌倒风险的活动，将使治疗师和患者能够根据患者的价值观和优先事项共同设计跌倒预防和管理干预措施。
