Investigation of factors influencing activity and participation in persons with Parkinson’s diseases

• Main Authors: Tzu-Chi Lin, 林子琪
• Other Authors: Shwn-Jen Lee
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/83j25u

碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 104 === Background: Parkinson’s Disease (PD) is a common neurodegenerative disorder. The prevalence rate of PD in Taiwan was higher than in more than Asia countries and increases steadily with age. Limitation in activities and restricting of participation was progressive with disease duration and severity. Previous studies focusing on P D patients’ disability relied on the single domain and subjective evaluation of a limited set of activities. Less studies relied on International Classification of Functioning, Disability and Health (ICF) approach, to define and describe a typical spectrum of problems in functioning of patients with each kind of health conditions during the daily activities and appreciate the role of environmental factors and personal factors in determining the disability of disease. Purpose: To investigate the influencing factors of activity and participation (A & P) in persons with PD Methods: This study was an exploratory cross-sectional study and 120 adults with PD were recruited from a medical center in northern Taiwan. Data collection includes interviews between August 2015 and December 2015. A&P, environmental and personal factors were collected by standard questionnaires based on ICF model. Demographic variables and disease related variables were also recorded. Descriptive statistic was used to provide the distribution and percentage of each domain of A&P. Chi-square tests, Spearman correlation analysis were used to study the association between contexture factors and A&P. Binominal logistic regression was performed to determine the important influencing factors of restriction in A&P. The significant level was set as 0.05. Results: 48.4% of subjects were in Hoehn and Yahr stage 2. Over half of them had moderate to severe difficulty in “Learning and applying knowledge (d1)”, “Communication (d3)”, “Mobility (d4)”, “Self-care (d5)” and “Domestic life (d6)”. The most relevant environmental facilitators were “Products and Technology (e1)” and “Support and Relationship (e3)”. In personal factors, disease severity (Hoehn and Yahr stages, H&Y stages) is the most common factor influencing in A&P (Odds ratio=OR=4.729, p=0.004 in mobility(d4); OR=4.102, p=0.00 in Self- care(d5)). Besides, motor complication would increase the risk of restrictions of A&P in interpersonal interactions and relationships (d7)(OR=1.638, p=0.008) and community, social and civic life(d9) (OR=1.656, p=0.006). Depression, frailty, increased levodopa daily dosage use, work status and marital status were also the influencing factors in some of domains of A&P. Conclusion & Implications: This study based on ICF approach to provide a full spectrum of functioning of persons with PD. The results showed that they have more difficulties in A&P and the contexture factors may significantly influence A&P in persons with PD. Understanding these influencing factors of A&P may reduce the risk of loss ability and preserve the independent functional ability. Keywords: Parkinson’s disease, ICF, activities, participations, environmental factors, personal factors.