Difficulties in activities of daily living are associated with stigma in patients with Parkinson’s disease who are candidates for deep brain stimulation

A. D. da Silva, V. P. Leal, Paulo R da Silva, F. C. Freitas, M. Linhares, R. Walz, L. Malloy-Diniz, A. Diaz, A. Palha
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引用次数: 14

Abstract

Objective: Parkinson’s disease (PD) is often accompanied by stigma, which could contribute to a worse prognosis. The objective of this study is to identify the variables associated with stigma in PD patients who are candidates for deep brain stimulation (DBS). Methods: We investigated sociodemographic and clinical variables associated with stigma in a sample of 54 PD patients indicated for DBS. The independent variables were motor symptoms assessed by the Movement Disorder Society‐sponsored revision of the Unified Parkinson Disease Rating Scale (MDS-UPDRS III), depressive symptoms measured by the Hospital Anxiety and Depression Scale, age, disease duration and the presence of a general medical condition. The Mobility, Activities of daily living and Emotional well-being domains of the 39-item Parkinson’s Disease Questionnaire (PDQ-39) were also investigated as independent variables, and the Stigma domain of the PDQ-39 scale was considered the outcome variable. Results: After multiple linear regression analysis, activities of daily living remained associated with the Stigma domain (B = 0.42 [95%CI 0.003-0.83], p = 0.048). The full model accounted for 15% of the variance in the Stigma domain (p = 0.03). Conclusions: Although causal assumptions are not appropriate for cross-sectional studies, the results suggest that ADL difficulties could contribute to greater stigma in PD patients with refractory motor symptoms who are candidates for DBS.
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帕金森病患者日常生活活动困难与耻辱感有关,这些患者是深部脑刺激的候选者
目的:帕金森病(PD)常伴有耻辱感,这可能导致较差的预后。本研究的目的是确定与耻辱感相关的变量在PD患者谁是候选人深部脑刺激(DBS)。方法:我们调查了54例接受DBS治疗的PD患者中与病耻感相关的社会人口学和临床变量。自变量包括由运动障碍学会赞助修订的统一帕金森病评定量表(MDS-UPDRS III)评估的运动症状,由医院焦虑和抑郁量表测量的抑郁症状,年龄,疾病持续时间和一般医疗状况的存在。同时,将帕金森病问卷(PDQ-39)的活动能力、日常生活活动能力和情绪幸福感域作为自变量进行研究,将PDQ-39量表的耻感域作为结果变量。结果:经多元线性回归分析,日常生活活动仍与柱头域相关(B = 0.42 [95%CI 0.003-0.83], p = 0.048)。整个模型占柱头域方差的15% (p = 0.03)。结论:虽然因果假设不适合横断面研究,但结果表明,ADL困难可能会导致具有难固性运动症状的PD患者更大的耻辱感,这些患者是DBS的候选者。
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