Date of Award

1-1-2003

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Master of Nursing

School

School of Nursing and Public Health

Faculty

Faculty of Computing, Health and Science

First Supervisor

Dr Bronwyn Jones

Second Supervisor

Dr Yvonne Houck

Abstract

Parkinson's disease is a common progressive neurological illness for which there is no known cure. While the cardinal signs are tremor, bradykinesia or slowness of movement, muscle rigidity and postural instability (Jahanshahi & Marsden, 1998, p.3) the patient may face an extended number of years experiencing all, or any combination of, the many other manifestations of the disease process. These manifestations include changes to various aspects of communication including loss of voice volume, diminished body language and loss of facial expression. All of these affect both verbal and non verbal communication. Given the progressive nature of Parkinson's disease the patient may often require both physical and emotional support for many years. The long term partner or spouse often provides this care and support. There is a paucity of literature discussing the impact of communication changes or difficulties on the partner or spouse. Thus a study into the life experiences of the partners of people with Parkinson’s disease who demonstrate communication problems is needed. The aim of this study was to explore the experiences of partners of people with this neurological diagnosis and whose communication is affected. A phenomenological approach was utilised to explore the impact of communication changes on the partner of a person with Parkinson's disease. Five participants took part in his study. Four of the participants responded to an advertisement placed in the Western Australian Parkinson’s Association newsletter. The remaining participant volunteered to be part of the study while she and her husband were on holiday in Perth, Western Australia from overseas. All of the participants were female and their husbands had been diagnosed with Parkinson's disease for extended periods of time, ranging from five to fifteen years. In depth interviews were audio taped and transcribed verbatim. The data from these interviews were analysed using the method described by Colaizzi (1978). Data were described and interpreted and common themes were extrapolated and analysed. The three major themes emerging from the interviews were: The Partner/Carer Interface, Emotional Turmoil and Ways of Coping. The Partner/Carer Interface is made up of three sub themes, ‘life before diagnosis'', "the point of diagnosis" and "sharing the disease.'' The second theme, Emotional Turmoil, includes the sub themes "confronting the physical, ''the conditions always wins” and “social isolation”. The third theme addresses the skills necessary to cope with the future, or Ways of Coping. This theme encapsulates minor themes of ''knowing the beast", "sharing the burden”, and finally preparing for "the road ahead”. Based upon study findings recommendations are made in relation to care provision, patient education and community support. The need for further research has been identified, specifically into the diverse gender issues related to communication and the role of care giver. In addition the need for health professionals with an extensive knowledge base of this neurological condition has been identified as essential for quality nursing management.

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