Carmody Todd, Park Rebekah, Bennett Elisabeth, Kuret Emily, Klein Beyza, Costa Àngels, Messner Simon, Hursey Amelia
Gemic, New York, NY, USA.
Novartis Pharma AG, Basel, Switzerland.
Neurol Ther. 2024 Aug;13(4):1219-1235. doi: 10.1007/s40120-024-00632-7. Epub 2024 Jun 12.
Existing qualitative research on early-stage Parkinson's disease draws on patients' reported disease experience, aiming to capture the symptoms and impacts most relevant to patients living with the disease. As a complement to this research, the present study investigated the patient experience of early-stage Parkinson's disease from a holistic, ethnographic perspective. We explored the attitudes, beliefs, and social structures that shape how people understand and adapt to life with early-stage Parkinson's disease.
Researchers interviewed 30 people with early-stage Parkinson's disease, 10 relatives, and 10 neurologists and movement disorder specialists in the USA and Germany. Many of these interviews took place in-person, allowing researchers to spend time in participants' homes and witness their daily lives. A multidisciplinary team of social scientists, clinical researchers, and patient organization representatives led the mixed-methods study design and analysis. In-depth ethnographic interviews yielded qualitative insights, with a quantitative survey following to assess their prevalence in a larger sample of 150 patients.
In addition to developing a patient life experience pathway of early-stage Parkinson's disease, we identified five key thematic findings that provide insight into how the clinical features of the disease become meaningful to patients on the context of their daily lives, family relations, and subjective well-being: (1) People with early-stage Parkinson's disease start coming to terms with their disease before receiving a medical diagnosis; (2) Acceptance is not a finalized achievement, but a cyclical process; (3) People with early-stage Parkinson's disease "live in the moment" to make the future more manageable; (4) Slowing disease progression is an important goal driving the actions of people with early-stage Parkinson's; and (5) People with early-stage Parkinson's disease value information that is grounded in lived experience and relevant to their stage of disease progression.
This holistic, ethnographic approach to patient life experience provided five key thematic findings that complement insights from qualitative and quantitative datasets on early-stage Parkinson's disease. An enhanced understanding of how early-stage Parkinson's symptoms impact patients' health-related quality of life and their broader social lives can help us better understand how patients make decisions about their usage of healthcare services and therapies.
现有的关于早期帕金森病的定性研究借鉴了患者报告的疾病经历,旨在捕捉与该疾病患者最相关的症状和影响。作为这项研究的补充,本研究从整体的民族志视角调查了早期帕金森病患者的经历。我们探讨了塑造人们对早期帕金森病的理解和适应方式的态度、信念和社会结构。
研究人员在美国和德国采访了30名早期帕金森病患者、10名亲属以及10名神经科医生和运动障碍专家。许多访谈是面对面进行的,这使研究人员能够在参与者家中度过时间并观察他们的日常生活。一个由社会科学家、临床研究人员和患者组织代表组成的多学科团队主导了混合方法的研究设计和分析。深入的民族志访谈产生了定性见解,随后进行了定量调查,以评估这些见解在150名患者的更大样本中的普遍性。
除了制定早期帕金森病患者生活经历路径外,我们还确定了五个关键主题发现,这些发现有助于深入了解该疾病的临床特征如何在患者的日常生活、家庭关系和主观幸福感背景下对患者变得有意义:(1)早期帕金森病患者在接受医学诊断之前就开始接受自己的疾病;(2)接受不是一个最终完成的成就,而是一个循环过程;(3)早期帕金森病患者“活在当下”以使未来更易于掌控;(4)减缓疾病进展是驱动早期帕金森病患者行动的一个重要目标;(5)早期帕金森病患者重视基于生活经验且与他们疾病进展阶段相关的信息。
这种对患者生活经历的整体民族志方法提供了五个关键主题发现,补充了关于早期帕金森病的定性和定量数据集的见解。对早期帕金森病症状如何影响患者与健康相关的生活质量及其更广泛的社会生活的更深入理解,可以帮助我们更好地理解患者如何做出关于医疗服务和治疗使用的决策。