Assessment on Table of contents | report

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Table of Contents
INTRODUCTION.......................................................................................................................2
Search Strategy.......................................................................................................................2
PICO framework.................................................................................................................................2
Figure Prisma flow diagram ...............................................................................................................3
Screening............................................................................................................................................3
Eligibility.............................................................................................................................................3
Identification......................................................................................................................................3
Included.............................................................................................................................................3
...............................................................................................................................................3
...............................................................................................................................................3
...............................................................................................................................................3
Data extraction table..........................................................................................................................4
Discussion.............................................................................................................................11
Conclusion.............................................................................................................................15
References............................................................................................................................15
INTRODUCTION
A literature review was conducted to understand the role of nursing in Parkinson’s disease.
CINAHL database was used to search for peer-reviewed articles published in English and last
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five years. Keywords used for the database search are mentioned below. Google Scholar was
also used for researching. A manual review of the reference lists of retrieved articles was done.
Inclusion criteria:
 Population of people with confirmatory Parkinson’s disease
 Studies published within 10 years
 Studies published in English language
Exclusion criteria
 Outdated records
 irrelevant information
Search Strategy
PICO framework
Population People suffering from Parkinson’s disease
Intervention Nursing research
Comparison NA
Outcome Improved nursing care for people with Parkinson’s disease
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Figure Prisma flow diagram
4
Scre
eni
ng
Eligi
bility
Number of articles found in
database search
(n = 8,62,379 )
Additional Number of articles
found through other sources
(n = 0)
Number of articles after removal of duplicates
(n = 7,96,604)
Number of articles screened
(n = 65,775)
Number of articles
excluded (exclusion
criteria, screening titles
and abstracts)
(n = 65,769)
Number of full-text articles
checked for eligibility
(n =6)
Number of full-text
articles excluded, with
reasons
(n =0)
Final number of studies
included in the review
(n = 6)
Ide
ntifi
cati
on
Incl
ude
d
Number of articles
excluded after
qualitative assessment
(n = 0)

Data extraction table
Coun
try of
origin
Method
ology
Sample
size and
nature
Data
collection
method
Data
analysis
method
Limitations Key findings
Weerk
amp,
et al.
2014
Nethe
rland
s
Quantit
ative
5480
residents
from 100
nursing
homes
Medical
chart
diagnosis
from
nursing
home was
used to
identify
the
residents
with
parkinson
’s disease.
A list of
every
residents
who used
antiparkin
son
medicatio
On the
basis of
the
interview
and
comprehen
sive
neurologic
al
examinatio
n,
compariso
n was
drawn
between
admission
diagnosis
and
clinical
diagnosis
The study
identified the
importance of
improved
detection of
parkinsonism
in nursing ho
mes due to
the outcomes
for
management
and prognosis
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n was
obtained
from local
pharmacis
ts.
made in
the study.
Erikss
on,
Forsgr
en,
Harteli
us, &
Salder
t
2016
Swed
en
Quantit
ative
Five
dyads
which
consisted
of an
individua
l with
stroke-
induced
aphasia
or Parkin
son's
disease
living in
different
nursing h
omes and
his/her
A
replicated
single-
subject
design
with
multiple
baselines
across
individual
s
Interventio
n was
supervised
analysis of
video-
recorded
natural
interaction
in
daily nursi
ng situatio
ns and the
developme
nt of
personal
goals to
alter
specific
-Small
sample size
Using the
programme
led to
substantial
modifications
in the natural
interaction.
These
changes
contributed
significantly
to a
developing
knowledge
about
communicati
on partner
training.
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registered
nurse.
strategies
of
communic
ation.
Shin
&
Haber
mann
2017
USA System
atic
review
27
studies
Published
between
2006 and
2015
Limited
number of
studies
The most
studied topic
was family
caregiving,
then
symptom
management/
medication
compliance,
quality of
life, palliative
care, and
functional
status.
Tosin,
Camp
os,
Andra
de,
Brazi
l
Descrip
tive
quantita
tive
study
A
probabilis
tic,
simple
random
The
research
was
performed
in three
Absolute
frequency,
percentage
, means
and
The study is
limited by
the current
gap in the
empirical
The study
found that the
cross-
mapping
facilitated the
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Olivei
ra, &
Santan
a
2016
sample
including
67
records
of
patients
with
Parkinson
's disease
who took
participat
ion in a
rehabilita
tion
program,
from
March
2009 to
April
2013.
stages.
Nursing
terms
were
mapped to
natural
language
and
crossed
with the
Nursing
Interventi
ons
Classificat
ion (NIC).
standard
deviations
were
considered
for
analysis of
data.
scientific
knowledge
regarding
the efficacy
of nursing
intervention
s in this
population
as it is not
possible to
have such
comparative
data
because of
absence of
studies in
this area.
process to
compare the
existing
information
in the records
of patients
with
Parkinson’s
disease with
the regulated
interventions
of the NIC.
Lex,
Larkin
,
Austr
ia
mixed-
method
s
9
participan
ts from
Reliable
and valid
Parkinson’s
It analyzed
the medical
benefit along
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Osterb
rink,
&
Loren
zl
2018
explora
tory
study
nursing
and
residentia
l homes
disease and
palliative
care
evaluation
models
could not be
used
appropriatel
y for
patients
who were at
advanced
stages. So,
it was
difficult to
use an
advanced
statistical
method for
data
analysis.
Small
sample size
with the
benefits for
their
relatives. It is
mainly
because the
study
identified that
beneficial
end-of-life
care is
dependent on
thoughtful
nursing
practice and
on minor and
on-time
administratio
n of
medicine.
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Ellis,
et al.
2019
USA Simulat
ed
unfoldi
ng case
study
94 BSN
students
of
second-
degree
BSN 7
and
clinical
faculty
took
participat
ion in the
study.
Pretest
and post
test
results
A
compariso
n was
drawn
between
pretest/pos
ttest
results.
Small
sample size
An enhanced
understandin
g among
students and
faculty about
the effect of
medicinal
resolution
and the
timely
administratio
n of anti-
Parkinson's
medication
was
observed.
Discussion
Parkinson's disease is a leading cause neurodegenerative disease across the globe (Dorsey &
Elbaz, 2018). On conducting the review of the literature a range of themes emerged such as
diagnostic accuracy of Parkinson’s disease, good partnership between nurses, patient and
patient’s families, interaction of nurses, thoughtful nursing practice and timed administration of
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medications. For assessing the quality of the articles that were used CASP tool was utilized
which checked the focus, recruitment strategy, quality and quantity of sample size, suitability of
the methodology and research design, method of data collection, bias and ethical considerations.
Nurses have a crucial contribution in the rehabilitation process of patients who advance through
the neurodegenerative disease. Effective nursing care may bring about the opportunity for an
improved quality of life, recurrence of self-esteem, autonomy and inclusion of family. Timely
and accurate diagnosis is crucial for management of Parkinson’s disease in nursing homes. But
not much is known regarding the diagnostic correctness of the Parkinson’s disease
in nursing homes. One of the study included in the review reviewed this subject
among nursing home residents. The study changed or discarded the diagnosis for 20.5%
residents which meant around 20% of diagnoses in the parkinsonian scale were not accurate.
Particularly, no parkinsonism was found in 8.5% of all the residents with suspected parkinsonism
indicating that nearly 9% residents mistakably got diagnosed of parkinsonism. In 12% residents a
new diagnosis was established within the parkinsonian spectrum. So, the study identified the
need of improved recognition of parkinsonism in nursing homes due to the outcomes for
management and prognosis. Therefore, research in the field of nursing must also focus on
improvement in detection of Parkinson disease (Weerkamp, et al., 2014).
It must be understood that better diagnosis is related to good partnership between nurses and
patients (Vahdat, Hamzehgardeshi, Hessam, & Hamzehgardeshi, 2014). Since, Parkinson’s is a
neurological disability, collaboration of nurses with patient’s family also becomes vital. Majority
of the individuals with Parkinson's disease live at their own places among their family members.
Nurses have an edge of partnering with individuals and their family members to advance the
self-management of their disorder and overall better quality of life. One of the systematic review
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included in the review assessed the status of the knowledge of nursing research associated with
Parkinson’s disease for 10 year time period. The most studied topic was family caregiving, then
symptom management/medication compliance, quality of life, palliative care, and functional
status. Based on the outcomes, the study recommended for future studies in Parkinson’s disease
to develop and test interventions on the basis of theoretical frameworks in context of self-
management, symptom management, and function improvement among individuals with
Parkinson’s disease and for caregivers who care for individuals with advanced stage Parkinson’s
disease. It also recommended development of programs of research with multidisciplinary teams.
However, limited number of studies were reviewed for this study which will affect the
generalizability quality of the study (Shin & Habermann, 2017).
Good partnership is highly based on good communication between the health professionals and
the patients. It has been hypothesized that communication partner training has the ability of
improving communicative environment of people who have communication disorders. One study
was done to assess the impact of a communication partner training programme for registered
nurses who worked with individuals with communication disorders in nursing homes, using a
personalized approach. The result was evaluated through blinded evaluations of natural
interaction which were filmed and attained at baseline, intervention and follow-up. It
demonstrated an enhanced use of the target communication strategies. In addition, the subjective
evaluations of goal achievement by the registered nurses were in line with these outcomes.
Degrees of perceived functional communication for the individuals with impairments of
communication were chiefly positive. 80% of the participants who had communication
impairments and 40% registered nurses reported improvement in functional communication post
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intervention. However, the study has a small sample size, so the representativeness of the study
remains an issue (Eriksson, Forsgren, Hartelius, & Saldert, 2016).
Another study confirmed the interactive role of nurses in Parkinson’s management. Since nurses
are an important member of the rehabilitation process and the multidisciplinary team while
delivering care to people with Parkinson’s disease, it is vital to adopt a standardized nursing care
based on the legal, ethical, scientific and methodological premises to improve patient’s health
outcomes, prevent or manage complications, and adapt to the restrictions enforced by the
disorder. So, nursing care facilitates interactivity as there is relationships of nurses, other health
professionals, patient and family at the center of the practice (Pierce & Larsen, 2010). The study
found that the cross-mapping facilitated the process to compare the current data in patients’
records with Parkinson’s disease with the regulated interventions of the NIC. However, the study
is limited by the current gap in the empirical knowledge regarding the efficacy of nursing
interventions in this population as it is not possible to have such comparative data because of
absence of studies in this area. So, the study addressed the need of further studies with better
representative sample sizes so that possibility of error can be minimised (Tosin, Campos,
Andrade, Oliveira, & Santana, 2016).
One research also identified the benefits of living in a nursing home for individuals with
Parkinson’s disease in the final stages. Themes of intense closeness in the family, benefits of
living nursing home and fears about the future were emerged in the finding. It analyzed the
medical benefit along with the benefits for their relatives. It is mainly because the study
identified that beneficial end-of-life care is dependent on thoughtful nursing practice and on
minor and on-time administration of medicine. Another study confirmed these findings as it
found that attention and management of symptom were significant for people with Parkinson’s
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disease (Masel, et al., 2016). However, the study has limitations as reliable and valid Parkinson’s
disease and end-of-life care evaluation models could not be utilised appropriately for patients
who were at advanced stages. So, it was difficult to make use of an advanced statistical method
for data analysis. In addition, the sample size of the study was small and therefore had weak
representation (Lex, Larkin, Osterbrink, & Lorenzl, 2018).
People with Parkinson’s disease need strict compliance to a personalized, timely medication
regime of antiparkinsonian therapy. Interval between doses are specific for every patient due to
the complexity of the disorder (Grissinger, 2018). A simulated case study was done to raise the
awareness and provide education to UG nursing students and staff about the significance of
missed or skipped medicine of Parkinson’s disease at the time of care transitions. The study
focused on missed medication resolution and skipping of time-sensitive medicines among the
vulnerable population to enhance their quality and safety. An enhanced awareness among
students and staff about the effect of medicinal resolution and the administration of anti-
Parkinson's medicines on time was observed. Therefore, the study established the effectiveness
of timely administration of medications by nurses to people with Parkinson’s disease. However,
the findings of the study was limited by the small sample size (Ellis, et al., 2019).
Conclusion
Through the literature review, it can be concluded that nursing care holds immense significance
in management of Parkinson’s disease. Nurses fulfil several responsibilities of care along with
building good relationship with individuals with Parkinson’s disease and their families. They
also partner with other health professionals to offer adequate care to these patients and their
families based on therapeutic communication. However, majority of the studies on the issue had
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the limitation of small sample size, therefore the findings cannot be generalised to large
population. Therefore, further research with large sample sizes in the field of nursing care for
Parkinson’s disease is required.
References
Ellis, Hickey, Prieto, Doyle, Galvin, Vernon, & OʼConnor. (2019). Medication Safety of Patients
With Parkinson's Disease During Care Transitions: Educating Nursing Students. Nurs
Educ Perspect. doi:10.1097/01.NEP.0000000000000532
Eriksson, Forsgren, Hartelius, & Saldert. (2016). Communication partner training of enrolled
nurses working in nursing homes with people with communication disorders caused by
stroke or Parkinson's disease. Disabil Rehabil., 38(12), 1187-204.
doi:10.3109/09638288.2015.1089952
Lex, K. M., Larkin, P., Osterbrink, J., & Lorenzl, S. (2018). A Pilgrim's Journey—When
Parkinson's Disease Comes to an End in Nursing Homes. Front Neurol.
doi:10.3389/fneur.2018.01068
Masel, Kitta, Huber, Rumpold, Unseld, & Schur. (2016). What makes a good palliative care
physician? A qualitative study about the patient's expectations and needs when being
admitted to a palliative care unit. PLoS ONE. doi:e0158830. 10.1371/
Pierce, & Larsen. (2010). The Rehabilitation Nursing Foundation Celebrates 20+ Years of
Funded. Research. Rehabil Nurs, 35(4), 135–160.
Shin, & Habermann. (2017). Nursing Research in Parkinson's Disease From 2006 to 2015. Clin
Nurs Res., 26(2), 142-56. doi:10.1177/1054773816634912
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Tosin, M. H., Campos, D. M., Andrade, L. T., Oliveira, B. G., & Santana, R. F. (2016). Nursing
interventions for rehabilitation in Parkinson's disease: cross mapping of terms. Rev Lat
Am Enfermagem. doi:10.1590/1518-8345.0689.2728
Weerkamp, Tissingh, Poels, Zuidema, Munneke, Koopmans, & Bloem. (2014). Diagnostic
accuracy of Parkinson's disease and atypical parkinsonism in nursing homes.
Parkinsonism Relat Disord, 20(11), 1157-60. doi:10.1016/j.parkreldis.2014.07.017
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