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      People with Parkinson’s perspectives and experiences of self-management: Qualitative findings from a UK study

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          Abstract

          Introduction

          Parkinson’s prevalence is growing, and more people are being impacted by the condition than ever before. Self-management has been proposed as one way to enable people living with the condition to improve or maintain their quality of life and wellbeing whilst living at home.

          Aim

          To explore the views and experiences of how people living with Parkinson’s self-manage their condition and identify areas needed to be incorporated into self-management resources or interventions.

          Method

          Twenty people with Parkinson’s from across London and Hertfordshire, UK took part in semi-structured interviews on self-management. Interviews were transcribed and analysed using thematic analysis to identify themes.

          Results

          Three main themes were identified: (1) Management of physical symptoms, which included engaging in physical activities, adapting their lifestyles, managing medication and using e-health resources; (2) Management of emotional impact, which involved using a range of cognitive and practical strategies, and seeking talking therapies and medication; and (3) barriers to self-management such as accessing accurate information, experiencing stigma towards their condition which impacted their self-esteem and identity, in turn impacting on their ability to self-manage.

          Conclusion

          Holistic and person-centred self-management programmes or interventions should be developed incorporating components such as medication and emotional support, individualised planning of exercise regimes, and accessible, timely and accurate information. Furthermore, more public health knowledge on Parkinson’s is needed to help reduce stigma.

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          Most cited references26

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          Using thematic analysis in psychology

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            Standards for reporting qualitative research: a synthesis of recommendations.

            Standards for reporting exist for many types of quantitative research, but currently none exist for the broad spectrum of qualitative research. The purpose of the present study was to formulate and define standards for reporting qualitative research while preserving the requisite flexibility to accommodate various paradigms, approaches, and methods.
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              Global, regional, and national burden of Parkinson's disease, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

              Summary Background Neurological disorders are now the leading source of disability globally, and ageing is increasing the burden of neurodegenerative disorders, including Parkinson's disease. We aimed to determine the global burden of Parkinson's disease between 1990 and 2016 to identify trends and to enable appropriate public health, medical, and scientific responses. Methods Through a systematic analysis of epidemiological studies, we estimated global, regional, and country-specific prevalence and years of life lived with disability for Parkinson's disease from 1990 to 2016. We estimated the proportion of mild, moderate, and severe Parkinson's disease on the basis of studies that used the Hoehn and Yahr scale and assigned disability weights to each level. We jointly modelled prevalence and excess mortality risk in a natural history model to derive estimates of deaths due to Parkinson's disease. Death counts were multiplied by values from the Global Burden of Disease study's standard life expectancy to compute years of life lost. Disability-adjusted life-years (DALYs) were computed as the sum of years lived with disability and years of life lost. We also analysed results based on the Socio-demographic Index, a compound measure of income per capita, education, and fertility. Findings In 2016, 6·1 million (95% uncertainty interval [UI] 5·0–7·3) individuals had Parkinson's disease globally, compared with 2·5 million (2·0–3·0) in 1990. This increase was not solely due to increasing numbers of older people, because age-standardised prevalence rates increased by 21·7% (95% UI 18·1–25·3) over the same period (compared with an increase of 74·3%, 95% UI 69·2–79·6, for crude prevalence rates). Parkinson's disease caused 3·2 million (95% UI 2·6–4·0) DALYs and 211 296 deaths (95% UI 167 771–265 160) in 2016. The male-to-female ratios of age-standardised prevalence rates were similar in 2016 (1·40, 95% UI 1·36–1·43) and 1990 (1·37, 1·34–1·40). From 1990 to 2016, age-standardised prevalence, DALY rates, and death rates increased for all global burden of disease regions except for southern Latin America, eastern Europe, and Oceania. In addition, age-standardised DALY rates generally increased across the Socio-demographic Index. Interpretation Over the past generation, the global burden of Parkinson's disease has more than doubled as a result of increasing numbers of older people, with potential contributions from longer disease duration and environmental factors. Demographic and potentially other factors are poised to increase the future burden of Parkinson's disease substantially. Funding Bill & Melinda Gates Foundation.
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                Author and article information

                Contributors
                Role: Formal analysisRole: Writing – original draft
                Role: Data curationRole: Formal analysisRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: Writing – review & editing
                Role: Formal analysisRole: Writing – review & editing
                Role: Formal analysisRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: Formal analysisRole: Project administrationRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                9 September 2022
                2022
                : 17
                : 9
                : e0273428
                Affiliations
                [1 ] Department of Primary Care and Population Health, University College London, London, United Kingdom
                [2 ] Institute of Neurology, University College London, London, United Kingdom
                Flinders University, AUSTRALIA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0001-6773-9393
                Article
                PONE-D-22-08863
                10.1371/journal.pone.0273428
                9462566
                36083947
                4a834481-ac53-4f21-916f-1c5a9c1f9b1c
                © 2022 Shah et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 25 March 2022
                : 8 August 2022
                Page count
                Figures: 1, Tables: 1, Pages: 14
                Funding
                Funded by: National Institute for Health Research (NIHR)
                Award ID: RP-PG-1016-20001
                Award Recipient :
                Funded by: National Institute for Health Research (NIHR)
                Award ID: RP-PG-1016-20001
                Award Recipient :
                Funded by: National Institute for Health Research (NIHR)
                Award ID: RP-PG-1016-20001
                Award Recipient :
                Funded by: National Institute for Health Research (NIHR)
                Award ID: RP-PG-1016-20001
                Award Recipient :
                Funded by: National Institute for Health Research (NIHR)
                Award ID: RP-PG-1016-20001
                Award Recipient :
                Funded by: National Institute for Health Research (NIHR)
                Award ID: RP-PG-1016-20001
                Award Recipient :
                Funded by: National Institute for Health Research (NIHR)
                Award ID: RP-PG-1016-20001
                Award Recipient :
                Funded by: National Institute for Health Research (NIHR)
                Award ID: RP-PG-1016-20001
                Award Recipient :
                All authors and this study is independent research funded by the National Institute for Health Research (NIHR) (Programme Grants for Applied Research, Personalised care for people with Parkinson’s Disease: PD-Care, RP-PG-1016-20001: https://fundingawards.nihr.ac.uk/award/RP-PG-1016-20001. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Neurodegenerative Diseases
                Movement Disorders
                Parkinson Disease
                Medicine and Health Sciences
                Neurology
                Neurodegenerative Diseases
                Movement Disorders
                Parkinson Disease
                Biology and Life Sciences
                Psychology
                Emotions
                Social Sciences
                Psychology
                Emotions
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Physical Fitness
                Exercise
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Exercise
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Exercise
                Medicine and Health Sciences
                Sports and Exercise Medicine
                Biology and Life Sciences
                Sports Science
                Sports and Exercise Medicine
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Biology and Life Sciences
                Physiology
                Biological Locomotion
                Walking
                Research and Analysis Methods
                Research Design
                Qualitative Studies
                Custom metadata
                The data were collected from people with Parkinson’s from London clinics and there is a possibility the full transcripts may identify the participants. Therefore, we are willing to share the data upon reasonable request to either the corresponding author (Megan Armstrong; megan.armstrong@ 123456ucl.ac.uk ), the Chief investigators (Kate Walters and Anette Schrag; k.walters@ 123456ucl.ac.uk and a.schrag@ 123456ucl.ac.uk ) or to the London Queen Square Research Ethics Committee at queensquare.rec@ 123456hra.nhs.uk (ref 18/LO/1470).

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