“I Wouldn’t Even Know What to Ask for”: Patients’ and Caregivers’ Experiences of Psychological Support for Huntington’s Disease in Italy

NeuroSci Pub Date : 2024-03-28 DOI:10.3390/neurosci5020007
Nicolò Zarotti, B. D’Alessio, Marta Scocchia, Melissa Casella, Ferdinando Squitieri
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Abstract

People with Huntington’s disease (HD) often experience psychological difficulties linked with disease progression and the adjustment to living with a chronic condition, which are also frequently shared by their informal caregivers (e.g., partners). Although limited, the current literature on psychological care for people with HD shows that interventions have the potential to drive improvements in mental health and quality of life. However, the experience of accessing and receiving psychological support for HD remains unclear across several countries. This study adopted a qualitative design to explore the experiences of psychological support for HD from the perspectives of patients and caregivers living in Italy. Semi-structured interviews were carried out with 14 participants—7 patients with early-manifest HD and 7 partners acting as their caregivers. The resulting data were analysed through thematic analysis. Four overarching themes were identified: (1) the availability of psychological support for HD, (2) barriers to accessing psychological support, (3) enablers to accessing psychological support, and (4) the future development of public psychological provision for HD. In Italy, patients and caregivers perceive public psychological support for HD as unavailable or inadequate, and private therapy is often seen as unaffordable. Barriers such as distrust in public healthcare and preconceptions about therapy may limit access, while advice from HD organisations and seeking therapy for other reasons may act as enablers. A strong emphasis is put on the need for accessible public psychological support throughout all the stages of the condition.
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"我甚至不知道该要求什么":意大利亨廷顿氏病患者和照顾者对心理支持的体验
亨廷顿氏病(HD)患者经常会遇到与疾病进展和适应慢性病生活相关的心理困难,他们的非正式照顾者(如伴侣)也经常会遇到同样的问题。尽管数量有限,但目前有关 HD 患者心理护理的文献表明,干预措施有可能改善患者的心理健康和生活质量。然而,在多个国家,HD 患者获得和接受心理支持的经历仍不明确。本研究采用定性设计,从居住在意大利的患者和护理人员的角度出发,探讨他们在获得 HD 心理支持方面的经验。研究人员对 14 名参与者进行了半结构化访谈,其中包括 7 名早期表现型 HD 患者和 7 名作为其护理者的伴侣。我们通过主题分析法对所得数据进行了分析。共确定了四个重要主题:(1) 是否存在针对 HD 的心理支持,(2) 获得心理支持的障碍,(3) 获得心理支持的有利因素,以及 (4) 针对 HD 的公共心理服务的未来发展。在意大利,患者和照护者认为针对 HD 的公共心理支持不存在或不充分,而私人治疗通常被认为是负担不起的。对公共医疗保健的不信任和对治疗的成见等障碍可能会限制患者获得治疗,而来自 HD 组织的建议和出于其他原因寻求治疗可能会起到促进作用。我们特别强调,在病情的各个阶段,都需要提供方便的公共心理支持。
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