Dissertation Defenses

Doctoral Dissertation Announcement

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Candidate: Lorraine Pearl-Kraus

Degree of: Doctor of Philosophy

Department: Interdisciplinary Health Studies

Title: Effects of Two Parkinson’s Disease Patient Education Models on Disease Self-Management and Quality of Life

Committee:
Dr. Nickola W. Nelson, Chair
Dr. William Fenn
Dr. John Butzer
Dr. Michael Scriven


Date: Friday, April 27, 2007 10:30 p.m. – 12:30 p.m.
College of Health and Human Services, Room 2024

Abstract:
The purpose of this study is to compare effects of Parkinson’s Disease Collaborative Care (PDCC) and Parkinson’s Disease Information Training (PDIT) patient education disease-management models on patients’ (1) perceived self-efficacy in PD self-management and (2) self-reported perceived PD-Health Related Quality of Life.
Forty-one 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, three withdrew; after the first session, three more withdrew. Participants in both groups attended three, two-hour patient education sessions (one week apart) with presenters from multiple disciplines with expertise in PD. The PDIT group received the traditional information sharing approach. The PDCC group received a collaborative professional-patient empowerment model, with the addition of patient peer mentors who assisted participants to write action plans. Participants responded to two questionnaires at three points in time: baseline (first session), post-test (last session), and follow-up (four weeks later, 97% response). Dependent measures were the Self-Efficacy for Managing Chronic Disease Six-Item Scale (Stanford University) and the  PDQ-39: Parkinson’s Disease Quality of Life Questionnaire (Jenkinson, Peto, & Fitzpatrick).
Participants’ mean number of years living with PD was 7.02 years (range 0 – 18 years); 85.4% (N = 35) participants reported having ≥ six additional comorbid illnesses. Analysis of group differences at pre-test time verified that equivalent groups were achieved by randomization. Repeated measures ANOVA revealed no group differences on either dependent measure at baseline, post-intervention, or four week follow up, and no statistically significant changes in scores over time.
The small sample size and missing data points on the PDQ-39 measure made it impossible to compute global PD-HRQOL scores at each time. These factors resulted in reduced power and made it difficult to assess the impact that the educational intervention sessions may have had on influencing the patients’ PD-HRQOL. The chronic, progressive nature of PD also influences the rate at which changes in health status occurs, thereby, influencing the stability of the PD patient’s QOL over time. A no-treatment control group should be added to future studies.