Welcome to this Current Awareness Bulletin on Parkinson's Disease for Clinical Nurse Specialists.
Many of the following articles are available online via the NHS Scotland Knowledge Network. Please use the links where provided and your ATHENS login. A complete list of available online journals and registration for ATHENS can be found at http://www.athensregistration.scot.nhs.uk
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This bulletin contains a selection of material gathered from a search of the evidence base, and is not intended to be comprehensive. Professional judgment should be exercised when appraising the material. The Library takes no responsibility for the wording, content and accuracy of the information supplied, which has been extracted in good faith from reputable sources. NHSGGC is not responsible for the content of external internet sites.
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MACE, C.Z., 2017. The complexities of advance care planning in patients with idiopathic Parkinson's disease. British Journal of Neuroscience Nursing, 13(4), pp. 178-186. The purpose of this article is to review current practice in terms of managing complex issues in the long-term condition of idiopathic Parkinson's disease (IPD). Particular focus will be on the optimum time to have end-of-life discussions and the complications that may be involved in cases of IPD. It will look at the nature of IPD, the different stages of the disease, and the right time for palliative conversations and advance care planning. The range of advanced communication skills needed to have effective conversations will be evaluated, alongside a review of why communication is made more difficult in patients with PD, the impact this has on family members, and the legal and ethical implications, so as to improve practice when making an advance care plan in a patient with IPD. Full text link here
THEED, R., et al, 2017. Experiences of caring for a family member with Parkinson's disease: a meta-synthesis. Aging & Mental Health, 21(10), pp. 1007-1016. Conclusion: The themes reflected different aspects of family caregivers’ lives that were affected as a result of caring for a relative diagnosed with PD and these raise challenges for more simplistic theories of family caring and appropriate support structures. The findings also highlight several recommendations for clinical practice. Full text link here.
Clinical Nurse Specialists (these articles will cover the CNS role in general or in other specialties).
KEEN, A. and LENNAN, E., 2017. Establishing a community of practice for clinical nurse specialists. Cancer Nursing Practice, 16(6), pp. 32-35.This article describes the development of a community of practice for more than 55 clinical nurse specialists in a large cancer centre. Supported by Macmillan Cancer Support, a year- long development programme addressed individual, organisational and policy requirements to create a community of practice with a clear direction and agreed metrics. The community of practice demonstrates the value of clinical nurse specialists to patients and healthcare organisations. Full text link here.
SHAHGHOLI, L., et al, 2017. Hospitalization and rehospitalization in Parkinson disease patients: Data from the National Parkinson Foundation Centers of Excellence. PLoS ONE [Electronic Resource], 12(7), pp. e0180425.CONCLUSION: Hospitalization and re-hospitalization were common in this cohort of people with PD. Our results suggest addressing caregiver burden, simplifying medications, and emphasizing primary and multidisciplinary care for comorbidities are potential avenues to explore for reducing hospitalization rates. Full text link here.
THOMAS, C., 2017. How we transformed the care of people with Parkinson's disease. Nursing Older People, 29(4), pp. 16-17. Cardiff and Vale University Health Board's (CVUHB) Parkinson's disease (PD) service cares for nearly 1,000 people who have the disease in Cardiff and parts of the Vale of Glamorgan in Wales. Full text link here.
VERNON, G.M., et al, 2017. Essential tremor & Parkinson disease: Recognizing the differences. Nurse Practitioner, 42(10), pp. 35-40. Tremor is a common movement disorder in adults and older adults. There are many different types of tremor and many conditions that present with tremor as a symptom. This article discusses the causes of tremor, and through the use of a case study, helps NPs understand the assessment of tremor and differentiate two common neurologic disorders that can present with tremor: essential tremor and Parkinson disease. Full text link here.
Coproduction of Care
LOVEGROVE, C.J., et al, 2017. The involvement of people with Parkinson's in designing a study of the lived experience of anxiety. British Journal of Occupational Therapy, 80(8), pp. 494-501. Conclusion: This patient and public involvement consultation round proved valuable and the participants' contributions will directly improve the design of future occupational therapy research exploring the lived experience of anxiety for people with Parkinson's.
PRIZER, L.P., et al, 2017. Using social exchange theory to understand non-terminal palliative care referral practices for Parkinson’s disease patients. Palliative medicine, 31(9), pp. 861-867. Conclusion: Physicians may be more likely to refer patients to non-terminal palliative care if (1) they work in interdisciplinary settings and/or (2) previous personal or patient experience with palliative care was positive. They may be less likely to refer if (1) they fear a loss of autonomy in patient care, (2) they are unaware of available programs, and/or (3) they believe they address palliative needs. Initiatives to educate neurologists on the benefits and availability of non-terminal palliative services could improve patient access to this care.
YORKSTON, K., et al, 2017. Incorporating the Principles of Self-Management into Treatment of Dysarthria Associated with Parkinson's Disease. Seminars in Speech & Language, 38(3), pp. 210-219. Principles of self-management are reviewed to address some of the shortcomings of current treatment approaches.
ZIZZO, N., et al, 2017. Examining chronic care patient preferences for involvement in health-care decision making: the case of Parkinson's disease patients in a patient-centred clinic. Health Expectations, 20(4), pp. 655-664. Conclusion Our results highlight the complexities of decision-making processes. Improved understanding of individual preferences could enhance respect for persons and make for patient-centred care that is truly respectful of individual patients' wants, needs and values.
Diagnosis & Treatment
OKUN, M.S., 2017. Management of Parkinson Disease in 2017: Personalized Approaches for Patient-Specific Needs. JAMA: Journal of the American Medical Association, 318(9), pp. 791-792.
The article discusses various aspects of the diagnosis and treatment of Parkinson's disease (PD) as of 2017, and it mentions personalized approaches for patient-specific needs, pharmacological therapy, and the use of deep brain stimulation (DBS) for PD patients with severe motor symptoms. Infusion therapy and surgical interventions are examined, as well as the therapeutic use of drugs such as levodopa, rasagiline, and pramipexole.
ORIMO, S., 2017. New development of diagnosis and treatment for Parkinson's disease. Rinsho Shinkeigaku - Clinical Neurology, 57(6), pp. 259-273. New methods for the diagnosis and new treatments for Parkinson's disease (PD) were explained. As imaging tools, neuromelanin imaging using brain MRI, meta-iodobenzylguanidine (MIBG) cardiac scintigraphy, dopamine transporter scintigraphy, and transcranial sonography were introduced. Olfactory dysfunction and REM sleep behavior disorders (RBD), which are important non-motor symptoms, and the new Clinical Criteria for PD launched by Movement Disorder Society (MDS) were also described. Investigative new medications and new anti-PD medications, which recently became available in Japan, were introduced. I explained the rationale of early treatment, strategy of initial treatment, the significance of continuous dopaminergic stimulation, strategy of treatment for advanced PD, and deep brain stimulation as a surgical treatment together with promising new treatments including gene therapy and cell transplantation.
Al-Busaidi, IS., Anderson, TJ, Alamri, Y. Qualitative analysis of Parkinson's disease information on social media, the case of Youtube. EPMA Journal 8(3):273-277. To our knowledge, this is the first study to assess the usefulness of PD information on the largest video-sharing website Youtube. In general, the overall quality of information presented in the videos screened was mediocre. Viewership of accurate vs misleading information was, however, very similar. Therefore, healthcare providers should direct PD patients and their families to the resources that provide reliable and accurate information. Full text link here.
TADDEI, R.N., et al, 2017. Management of Psychosis in Parkinson’s Disease: Emphasizing Clinical Subtypes and Pathophysiological Mechanisms of the Condition. Parkinson's Disease (20420080), , pp. 1-18. A literature review on the most recent knowledge with special focus on specific clinical subtypes and pathophysiological mechanisms will not only contribute to an up to date practical approach of this condition for the health care providers, but furthermore open up new ideas for research in the near future.
TIMMER, M.H.M., et al, 2017. What a neurologist should know about depression in Parkinson's disease. Practical Neurology (BMJ Publishing Group), 17(5), pp. 359-368.
Depression is a frequent non-motor symptom of Parkinson's disease. Its prevalence varies widely across studies (between 2.7% and 90%); around 35% have clinically significant depressive symptoms. Although depression can have an immense impact on the quality of life of affected patients and their caregivers, depressive symptoms in Parkinson's disease frequently remain unrecognised and, as a result, remain untreated. Here we overview the diagnostic challenges and pitfalls, including the factors contributing to the underdiagnosis of depression. We also discuss current ideas on the underlying pathophysiology. Finally, we offer a treatment approach based on currently available evidence.
Quality of Life
JONASSON, S.B., et al, 2017. Psychometric Evaluation of the Parkinson’s Disease Activities of Daily Living Scale. Parkinson's Disease (20420080), , pp. 1-7. PADLS revealed excellent data completeness, acceptable targeting, and external construct validity. It seems to be well suited as a rough estimate of ADL disability in people with PD.
MCAULIFFE, M.J., et al, 2017. Variables associated with communicative participation in Parkinson’s disease and its relationship to measures of health-related quality-of-life. International Journal of Speech-Language Pathology, 19(4), pp. 407-417. Conclusion: Communicative participation in PD is complex and influenced by both demographic and disease-based variables, necessitating a broader view of the communicative experiences of those with PD. Measurement of communicative participation as a separate construct to existing HRQoL measures is recommended.
TU, X., et al, 2017. Determinants of generic and specific health-related quality of life in patients with Parkinson's disease. PLoS ONE [Electronic Resource], 12(6), pp. e0178896.
CONCLUSIONS: The results suggest the importance of the evaluation and intervention focused on depressive symptoms and motor difficulties of daily living in patients with PD. In addition, the SF-36 seems more related to non-motor symptoms, while the PDQ-39 appears more associated with motor symptoms. This information is important for understanding results from these two instruments and for choosing which to use.
HUANG, Y., et al, 2017. Fatigue and Muscle Strength Involving Walking Speed in Parkinson's Disease: Insights for Developing Rehabilitation Strategy for PD. Neural plasticity, 2017, pp. 1941980.Conclusion. Fatigue and weakness of central origin were related to PD, while peripheral strength was important for walking ability. The results suggest that rehabilitation programs for PD should focus on improving both central and peripheral components of force.
ŠPONER, P., et al, 2017. The Outcomes of Total Hip Replacement in Patients with Parkinson’s Disease: Comparison of the Elective and Hip Fracture Groups. Parkinson's Disease (20420080), , pp. 1-7. Conclusions. Excellent pain relief with preserved walking ability without support of another person and acceptable complication profile was observed in Parkinson’s disease patients at 36 months after elective total hip arthroplasty. This procedure may be indicated in Parkinson’s disease patients after careful and individualized planning.
Screening / Comorbidities
CHOI, S., et al, 2017. The Association of Musculoskeletal Pain with Bone Mineral Density in Patients with Parkinson's Disease. European neurology, 77(3-4), pp. 123-129. CONCLUSION: PD patients with musculoskeletal pain have low BMD and are at risk for developing osteoporosis. If a PD patient has musculoskeletal pain and other risk factors related to low BMD, clinicians should consider screening for osteoporosis. Full text available here.
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