Experienced Respiratory Symptoms and the Impact on Daily Life from the Perspective of People with Parkinson's Disease: A Grounded Theory

J Parkinsons Dis. 2022;12(5):1677-1691. doi: 10.3233/JPD-213121.

Abstract

Background: Abnormal respiratory function tests can be observed early in the course of Parkinson's disease (PD). A better understanding of the impact of respiratory dysfunction on daily life in PD is needed to prevent later occurring complications as a (aspiration) pneumonia.

Objective: To explain which respiratory symptoms people with PD or a form of atypical parkinsonism experience and how these symptoms impact on their daily lives.

Methods: This qualitative study used a grounded theory approach. A purposeful sample strategy was used to capture information-rich cases. Data were collected in semi-structured interviews with participants diagnosed with either PD (n = 11) or atypical parkinsonism (n = 3), all of whom had confirmed respiratory symptoms. Data were analyzed using grounded theory analysis by creating codes, categories, theoretical themes, and, ultimately, a conceptual model.

Results: Four respiratory profiles emerged, describing different types of respiratory dysfunction, with various positive and negative influencing factors. First, a loss of breathing automatism was experienced. Second, episodes of breathlessness or a rapid, shallow breathing pattern were triggered by either physical exertion, fatigue, or postural deformities. Third, stress and anxiety also triggered episodes of breathlessness. Fourth, a decreased cough strength and frequent coughing. Based on these findings, we constructed a conceptual model that visualizes the relations between these four types of respiratory dysfunction and their impact on daily life, with 'discomfort' and 'avoidance of social activities' as crucial elements.

Conclusion: A tailored approach for each profile of respiratory dysfunction is recommended to improve respiratory dysfunction and to reduce its social impact in people with PD.

Keywords: Parkinson’s disease; Respiratory function; multidisciplinary; qualitative research; respiratory symptoms.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Female
  • Grounded Theory
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease* / complications
  • Parkinson Disease* / physiopathology
  • Parkinson Disease* / psychology
  • Respiration
  • Respiration Disorders* / physiopathology
  • Respiration Disorders* / prevention & control
  • Stress, Psychological