Life with communication changes in Parkinson's disease
Life with communication changes in Parkinson's disease
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DOI：
10.1093/ageing/afj053
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发表时间：
2006-05-01
期刊：
影响因子：
6.7
通讯作者：
Burn, D
中科院分区：
文献类型：
--
作者：
Miller, N;Noble, E;Burn, D
背景：帕金森氏病（PD）患者语音的声学和感知变化已被广泛研究。关于个人对变化的感知、这些变化对他们的生活的影响以及应对这些变化的策略，存在很少的经验证据。目的：确定交流变化是否以及如何影响PD患者的生活。设计：内容定性分析的深度访谈。设置：社区。受试者：23名男性和14名女性PD患者。方法：参与者被有目的地抽样，以给出男性、女性、家庭环境、PD的阶段和持续时间以及言语症状的严重程度的混合。在家中对个人进行了访谈。采访记录已转录。确定了紧急主题，并反馈给参与者进行确认和澄清。结果：参与者确定了声音和发音的变化。语言的变化尤为突出。四个影响主题：（i）与他人的互动，（ii）对话问题，（iii）对可理解性的感觉和（iv）声音;以及四个相应的应对主题：（a）帮助他人理解，（B）管理对话，（c）监测和调整，（d）物理策略。主要关注的不是言语-声音-语言变化的性质，而是这些变化如何影响自我概念、家庭内外的参与和家庭动态。个人采用了一系列的流体应对策略，从背景撤回到前景strivingstrategies.Conclusions：语音和语言的变化PD影响个人和家庭生活前很长一段时间的坦率损害的清晰度是显而易见的。因此，早期转诊到言语和语言治疗的作用值得详细调查。
Background: acoustic and perceptual changes to speech in Parkinson's disease (PD) have been widely studied. Little empirical evidence exists concerning the individual's own perception of changes, the impact these have on their life and coping strategies to deal with them.Objective: to establish if, and how, changes in communication impact on the lives of people with PD.Design: in-depth interviews with qualitative analysis of content.Setting: community.Subjects: twenty-three men and 14 women with PD.Methods: participants were purposively sampled to give a mix of men, women, family circumstances, stage and duration of PD and severity of speech symptoms. Individuals were interviewed at home. Interviews were transcribed. Emergent themes were identified and fed back to participants for confirmation and clarification.Results: participants identified changes to voice and articulation. Language changes featured prominently. Four impact themes: (i) interaction with others, (ii) problems with conversations, (iii) feelings about intelligibility and (iv) voice; and four corresponding coping themes (a) helping others understand, (b) managing conversations, (c) monitoring and adjusting and (d) physical strategies emerged. Of main concern was not the nature of speech-voice-language changes, but how these affected self-concept, participation inside and outside the family and family dynamics. Individuals employed a range of fluid coping strategies moving from background withdrawal to foreground striving strategies.Conclusions: speech and language changes in PD impact upon individual and family life long before frank impairment of intelligibility is apparent. The role of early referral to speech and language therapy is therefore worthy of detailed investigation.