Implementation of a multidisciplinary psychoeducational intervention for Parkinson's disease patients and carers in the community: study protocol

Background: Parkinson’s disease progressively limits patients at different levels and as a result family members play a key role in their care. However, studies show lack of an integrative approach in Primary Care to respond to the difficulties and psychosocial changes experienced by them. The aim of this study is to evaluate the effects of a multidisciplinary psychoeducational intervention focusing on improving coping skills, the psychosocial adjustment to Parkinson’s disease and the quality of life in patients and family carers in a Primary Care setting. Methods: This quasi-experimental study with control group and mixed methods was designed to evaluate a multidisciplinary psychoeducational intervention. Based on the study power calculations, 100 people with Parkinson’s disease and 100 family carers will be recruited and assigned to two groups. The intervention group will receive the ReNACE psychoeducational intervention. The control group will be given a general educational programme. The study will be carried out in six community-based health centres. The results obtained from the two groups will be collected for evaluation at three time points: at baseline, immediately after the intervention and at 6 months post-intervention. The results will be measured with these instruments: the Quality of Life Scale PDQ39 for patients and the Scale of Quality of Life of Care-givers SQLC for family carers, and for all participants the Psychosocial Adjustment to Illness scale and the Brief COPE Inventory. Focus groups will be organised with some patients and family carers who will have received the ReNACE psychoeducational intervention and also with the healthcare professionals involved in its development. Discussion: An important gap exists in the knowledge and application of interventions with a psychosocial approach for people with PD and family carers as a whole. This study will promote this comprehensive approach in Primary Care, which will clearly contribute in the existing knowledge and could reduce the burden of PD for patients and family carers, and also in other long-term conditions

Proximidad geográfica y homogamia matrimonial en la España del siglo XX

Uno de los factores que mayor influencia tiene en el funcionamiento de los mercados matrimoniales es la dimensión geográfica, el lugar donde se conocen los futuros cónyuges. A través de la Encuesta Sociodemográfica (1991) analizamos la homogamia territorial (peso de los matrimonios entre personas del mismo municipio), el efecto que este hecho tiene en la edad de las primeras nupcias y los factores que explican estas pautas nupciales. Las conclusiones más importantes son las siguientes: 1) se ha producido un descenso importante del grado de homogamia matrimonial territorial a lo largo del siglo; 2) hay marcadas diferencias entre provincias; 3) la edad de primonupcialidad entre matrimonios homógamos es menor que entre matrimonios heterógamos, si bien esta diferencia desaparece con el paso del tiempo; 4) los factores que mayor impacto tienen en el fenómeno de la homogamia (regresión logística multivariada) son la movilidad de ego y la repetición del patrón familiar.One factor that most influences the functionning ofthe marriage markets is the geographical dimension, so as to say the place where future spouses meet. On the basis ofthe data from the 1991 Spanish Sociodemographic Survey, the territorial homogamy is analyzed, as well as the effect ofthis fact on the age offirst nuptials,and the factors that explain these marriage patterns. The following are the most important conclusions of the survey: 1) an important decline in the degree of territorial matrimonial homogamy has occurred through the 2oth century; 2) differences among provinces are shown clearly marked; 3) the age of primonuptiality between 'homogam' marriages is smaller than between 'heterogam' marriages, although this difference disappears with the passing ofthe time; 4) the factors which ha ve the most impact on the phenomenon of the homogamy (multivariate logistic regression) are ego mobility and the recurrence ofthe familiar pattern.La dimension géographique, le lieu oU les futurs époux se sont connus, est l'un des facteurs qui influent le plus sur le fonctionnement des marchés matrimoniaux. En nous basant sur l'Enquéte Sociodémografique de 1991, nous analysons l'homogamie territoriale, c'est-<i-dire, l'effet de ce phénomene sur l'iige des premi€ res noces, ainsi que les facteurs qui expliquent ces patrons nuptiaux. Les conclusions les plus importantes tirées de cette analyse sont les suivantes: 1) une climinution importante du <legré d'homogamie matrimoniale territoriale s'est produite tout au long du xx"' siecle; 2) il y a de remarquables différences entre provinces; 3) l'iige de primonuptialité entre mariages homogames est inférieure a celle des mariages hétérogames, mais cette différence disparait avec le passage du temps; 4) la mobilité de l'ego et la répétition du patron familial sont les facteurs qui impactent le plus sur le phénomene de l'homogamie (régression logistique multivariée)

Proximidad geográfica y homogamia matrimonial en la España del siglo XX

Uno de los factores que mayor influencia tiene en el funcionamiento de los mercados matrimoniales es la dimensión geográfica, el lugar donde se conocen los futuros cónyuges. A través de la Encuesta Sociodemográfica (1991) analizamos la homogamia territorial (peso de los matrimonios entre personas del mismo municipio), el efecto que este hecho tiene en la edad de las primeras nupcias y los factores que explican estas pautas nupciales. Las conclusiones más importantes son las siguientes: 1) se ha producido un descenso importante del grado de homogamia matrimonial territorial a lo largo del siglo; 2) hay marcadas diferencias entre provincias; 3) la edad de primonupcialidad entre matrimonios homógamos es menor que entre matrimonios heterógamos, si bien esta diferencia desaparece con el paso del tiempo; 4) los factores que mayor impacto tienen en el fenómeno de la homogamia (regresión logística multivariada) son la movilidad de ego y la repetición del patrón familiar.One factor that most influences the functionning ofthe marriage markets is the geographical dimension, so as to say the place where future spouses meet. On the basis ofthe data from the 1991 Spanish Sociodemographic Survey, the territorial homogamy is analyzed, as well as the effect ofthis fact on the age offirst nuptials,and the factors that explain these marriage patterns. The following are the most important conclusions of the survey: 1) an important decline in the degree of territorial matrimonial homogamy has occurred through the 2oth century; 2) differences among provinces are shown clearly marked; 3) the age of primonuptiality between 'homogam' marriages is smaller than between 'heterogam' marriages, although this difference disappears with the passing ofthe time; 4) the factors which ha ve the most impact on the phenomenon of the homogamy (multivariate logistic regression) are ego mobility and the recurrence ofthe familiar pattern.La dimension géographique, le lieu oU les futurs époux se sont connus, est l'un des facteurs qui influent le plus sur le fonctionnement des marchés matrimoniaux. En nous basant sur l'Enquéte Sociodémografique de 1991, nous analysons l'homogamie territoriale, c'est-<i-dire, l'effet de ce phénomene sur l'iige des premi€ res noces, ainsi que les facteurs qui expliquent ces patrons nuptiaux. Les conclusions les plus importantes tirées de cette analyse sont les suivantes: 1) une climinution importante du <legré d'homogamie matrimoniale territoriale s'est produite tout au long du xx"' siecle; 2) il y a de remarquables différences entre provinces; 3) l'iige de primonuptialité entre mariages homogames est inférieure a celle des mariages hétérogames, mais cette différence disparait avec le passage du temps; 4) la mobilité de l'ego et la répétition du patron familial sont les facteurs qui impactent le plus sur le phénomene de l'homogamie (régression logistique multivariée)

Implementation of a multidisciplinary psychoeducational intervention for Parkinson's disease patients and carers in the community: study protocol

Background: Parkinson’s disease progressively limits patients at different levels and as a result family members play a key role in their care. However, studies show lack of an integrative approach in Primary Care to respond to the difficulties and psychosocial changes experienced by them. The aim of this study is to evaluate the effects of a multidisciplinary psychoeducational intervention focusing on improving coping skills, the psychosocial adjustment to Parkinson’s disease and the quality of life in patients and family carers in a Primary Care setting. Methods: This quasi-experimental study with control group and mixed methods was designed to evaluate a multidisciplinary psychoeducational intervention. Based on the study power calculations, 100 people with Parkinson’s disease and 100 family carers will be recruited and assigned to two groups. The intervention group will receive the ReNACE psychoeducational intervention. The control group will be given a general educational programme. The study will be carried out in six community-based health centres. The results obtained from the two groups will be collected for evaluation at three time points: at baseline, immediately after the intervention and at 6 months post-intervention. The results will be measured with these instruments: the Quality of Life Scale PDQ39 for patients and the Scale of Quality of Life of Care-givers SQLC for family carers, and for all participants the Psychosocial Adjustment to Illness scale and the Brief COPE Inventory. Focus groups will be organised with some patients and family carers who will have received the ReNACE psychoeducational intervention and also with the healthcare professionals involved in its development. Discussion: An important gap exists in the knowledge and application of interventions with a psychosocial approach for people with PD and family carers as a whole. This study will promote this comprehensive approach in Primary Care, which will clearly contribute in the existing knowledge and could reduce the burden of PD for patients and family carers, and also in other long-term conditions

Factors influencing psychosocial adjustment and quality of life in Parkinson patients and informal caregivers

Objective: The influence that social conditions and personal attitudes may have on the quality of life (QoL) of Parkinsons disease (PD) patients and informal caregivers does not receive enough attention in health care, as a result of it not being clearly identified, especially in informal caregivers. The aim of this study was to provide a comprehensive analysis of psychosocial adjustment and QoL determinants in PD patients and informal caregivers. Methods: Ninety-one PD patients and 83 caregivers participated in the study. Multiple regression analyses were performed including benefit finding, coping, disease severity and socio-demographic factors, in order to determine how these aspects influence the psychosocial adjustment and QoL in PD patients and caregivers. Results: Regression models showed that severity of PD was the main predictor of psychosocial adjustment and QoL in patients. Nevertheless, multiple regression analyses also revealed that coping was a significant predictor of psychosocial adjustment in patients and caregivers. Furthermore, psychosocial adjustment was significantly related to QoL in patients and caregivers. Also, coping and benefit finding were predictors of QoL in caregivers but not in patients. Conclusions: Multidisciplinary interventions aimed at improving PD patients QoL may have more effective outcomes if education about coping skills, and how these can help towards a positive psychosocial adjustment to illness, were included, and targeted not only at patients, but also at informal caregivers. © 2016, The Author(s)