Date of Award

6-2007

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Dr. Nickola W. Nelson

Abstract

Purpose. To compare the effects of Parkinson's Disease Collaborative Care (PDCC) and Parkinson's Disease Information Training (PDIT) patient education disease-management models on patients' (a) perceived self-efficacy in PD self-management, and (b) self-reported perceived PD-Health Related Quality of Life.

Methods. 41 middle-stage (Hoehn & Yahr Stages 2 & 3) patients (24 males & 17 females; age range 48-78; mean 67.59 years) were randomized to the PDCC (n = 21) or PDIT (n = 20) group. Prior to inception, 3 withdrew; after the first session, 3 more withdrew. Participants in both groups attended three consecutive weekly, 2-hour patient education sessions with presenters from multiple disciplines with expertise in PD. PDIT group received the traditional information sharing approach. PDCC group received a collaborative professional-patient empowerment model, with the addition of patient peer mentors who assisted participants in writing action plans. Participants responded to two questionnaires at three points in time: baseline (first session), posttest (last session), and follow-up (4 weeks later, 97% response rate). Dependent measures were the Self-Efficacy for Managing Chronic Disease 6 Item Scale (Stanford University) and PDQ-39: Parkinson's Disease Quality of Life Questionnaire (Jenkinson, Peto, & Fitzpatrick).

Results. Participants' mean number of years living with PD was 7.02 years (range 0-18 years); 85.4% (n = 35) participants reported having ≥6 additional comorbid illnesses. Analysis of group differences at pretest time verified that equivalent groups were achieved by randomization. Repeated measures ANOVA revealed no group differences on either dependent measure at baseline, postintervention, or 4-week follow-up, and no statistically significant changes in scores over time.

Conclusions. There was no significant statistical indication that one educational method was preferable to the other. Small sample size and missing data points on the PDQ-39 made it impossible to compute global PD-HRQOL scores for some participants across times. These factors resulted in reduced power and limited ability to assess the impact of educational intervention sessions on influencing patients' PD-HRQOL. The chronic, progressive nature of PD influences the rate at which changes in health status occurs, thereby impacting the stability of PD-HRQOL over time. Future studies should include a no-treatment control group.

Access Setting

Dissertation-Open Access

Download

Share

COinS