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Factors supporting self-management in Parkinson’s disease: implications for nursing practice

Authors

  • Lynn Chenoweth DRec, BA, MA, G Cert Tch/Lrn, MAdEd, PhD, RN,

  • Robyn Gallagher BN, MN, PhD, RN,

  • June N. Sheriff CM, DNE, BAppSc (AN), MHPEd, PhD, RN,

  • Judith Donoghue CM, BA, PhD, RN,

  • Jane Stein-Parbury BSc Nurs, MEd, PhD, RN


Lynn Chenoweth
South Eastern Sydney and Illawarra
Area Health Service
PO Box 222
Lindfield
NSW 2070
Australia
Telephone: +61-2-9369 0288
E-mail: lynnette.chenoweth@uts.edu.au or lynn.chenoweth@sesiahs.health.nsw.gov.au

Abstract

Aim.  To identify the factors associated with better self-management in people with moderate to high levels of Parkinson’s disease following an acute illness event.

Design and methods.  A prospective, descriptive study conducted with 75 persons with Parkinson’s disease over the age of 55, collected twice: within a week of an acute event and 1 month later, after resuming usual life at home. Participants completed a questionnaire on self-rated health status, self-efficacy, sense of coherence, symptom monitoring and medication and general self-management.

Background.  Parkinson’s disease is a chronic neurological condition that affects many dimensions of life, including threats to self-identity and confidence in self-management. Self-management has the potential to reduce costs through decreased hospital admissions, disease progression and avoidance of complications. While evidence for the relationships between self-management and self-efficacy and sense of coherence has been demonstrated in some chronic illness groups, this has not previously been demonstrated in Parkinson’s disease.

Results.  The independent predictors of better self-management were not being hospitalized in the last 6 months, more frequent symptom checking and better self-efficacy for self-management. The influence of other factors on self-management, such as sense of coherence, was mediated through self-efficacy. Support of family and others was associated with better self-efficacy both directly and through an improved sense of coherence.

Conclusions and relevance to nursing practice.  The presence of informal support plays an important role in sustaining self-efficacy and sense of coherence and hence self-management in persons with Parkinson’s disease. Since these attributes are amenable to change, nurses are in a good position to encourage participation in Parkinson’s support groups, teach self-management skills through regular symptom monitoring and to assess and promote self-efficacy and sense of coherence.

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