Florijn Barend W, van Zwet Erik W, Kaptein Ad A, van der Plas Anne A
Department of Neurology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Einthoven Laboratory for Vascular and Regenerative Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Neurol Res Pract. 2024 Aug 15;6(1):41. doi: 10.1186/s42466-024-00340-5.
Individuals with Parkinson's disease (PD) report a diminished perceived functional autonomy as their condition progresses. For those seeking emergency care, it is unknown whether the patient-physician relationship is instrumental in respecting patient autonomy. This study evaluated patient autonomy ideals in individuals with PD requiring emergency care and the perceived support for autonomy from emergency department physicians.
Individuals with PD (n = 36, average age 78.1 years) were surveyed using the Ideal Patient Autonomy questionnaire (IPA) and the Health Care Climate Questionnaire (HCCQ). A multivariable regression analysis assessed whether patients' Hoehn and Yahr stage and IPA questionnaire results predicted HCCQ items.
The IPA questionnaire revealed that individuals with PD in need of emergency care emphasize the significance of medical expertise (IPA 'doctor should decide' theme 0.71) in decision-making and their desire to be fully informed about all potential risks (IPA 'obligatory risk information' theme 0.71). The average HCCQ values showed a decreasing trend across Hoehn and Yahr stages 1 to 5: 6.19, 6.03, 5.83, 5.80, and 5.23, respectively. HY scale values also influenced HCCQ items related to the physician's role.
In our cohort, individuals with Parkinson's disease tend to rely on medical expertise for decision-making and prioritize complete risk information during emergency care. However, this autonomy support diminishes as functional disability levels increase.
帕金森病（PD）患者报告称，随着病情进展，他们感知到的功能自主性会降低。对于那些寻求紧急护理的患者而言，医患关系在尊重患者自主性方面是否发挥作用尚不清楚。本研究评估了需要紧急护理的帕金森病患者的自主性理想以及急诊科医生对自主性的感知支持。
使用理想患者自主性问卷（IPA）和医疗保健氛围问卷（HCCQ）对帕金森病患者（n = 36，平均年龄78.1岁）进行调查。多变量回归分析评估患者的Hoehn和Yahr分期以及IPA问卷结果是否能预测HCCQ项目。
IPA问卷显示，需要紧急护理的帕金森病患者强调医疗专业知识在决策中的重要性（IPA“应由医生决定”主题得分为0.71），以及他们希望充分了解所有潜在风险的愿望（IPA“强制性风险信息”主题得分为0.71）。HCCQ的平均得分在Hoehn和Yahr分期1至5中呈下降趋势：分别为6.19、6.03、5.83、5.80和5.23。HY量表值也影响了与医生角色相关的HCCQ项目。
在我们的队列中，帕金森病患者在紧急护理期间倾向于依靠医疗专业知识进行决策，并将完整的风险信息放在首位。然而，随着功能残疾水平的增加，这种自主性支持会减少。
