Experiences of health services and unmet care needs of people with late-stage Parkinson’s in England: A qualitative study


Autoři: Joy Read aff001;  Sarah Cable aff001;  Charlotte Löfqvist aff002;  Susanne Iwarsson aff002;  Gergely Bartl aff001;  Anette Schrag aff001
Působiště autorů: Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, United Kingdom aff001;  Department of Health Sciences, Lund University, Lund, Sweden aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226916

Souhrn

Aim

To explore experiences of health services and unmet care needs by people with late-stage Parkinson’s in England.

Method

Ten participants, at Hoehn and Yahr stage 4 or 5, were interviewed using semi-structured open-ended questions. Data were analysed using qualitative thematic analysis.

Findings

Participants reported that whilst under the treatment of specialist hospitals, the majority of care provision had shifted into the community, often because hospital-based services were felt to be difficult to access and have limited benefit to them. When using health-care services, participants frequently experienced having to ‘fit-in’ to service structures that did not always accommodate their complex needs. Despite high levels of disability, participants expressed their desire to maintain their identity, normality of interests and activities in their lives, including remaining in their own homes. This was facilitated by bespoke care and equipment, and positive relationships with care providers. Knowledge on disease management was a key factor in their perceived ability to remain in control. Family caregivers had a central role in facilitating care at home. There was uncertainty about and little planning for the future, and moving to a residential nursing home was perceived an undesirable but potentially necessary option for future care.

Conclusion

Unmet care needs identified by people with late stage Parkinson’s in England include greater flexibility of healthcare structures and bespoke service provision, to accommodate their individual complex needs. Support in their own homes and positive relationships with healthcare providers help People with Parkinson’s (PwP) to maintain a degree of normality and identity, and provision of information help them maintain some control. There is a need for more informed discussions on future care planning for this specific population.

Klíčová slova:

Allied health care professionals – Dementia – England – Hospitals – Nursing homes – Palliative care – Parkinson disease – Qualitative studies


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 12