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'Movement and Voice' intervention for people with Parkinson's: Empirical study on the intervention and subjective well-being (ParBEST)

Background and aims

In Switzerland there are 15,000 people with Parkinson's disease, a degenerative disorder of the central nervous system that affects the motor system and the voice. The medical consequences of this disorder are far-reaching, and the effects in everyday life are wide ranging. Parkinson's limits the ability to perform movements and makes communication difficult, which leads to a tendency to withdraw. The symptoms of Parkinson's and the resulting social withdrawal cause a great deal of mental and emotional strain and distress, and it can be assumed that subjective well-being and quality of life are reduced (Mallien, 2019).

Based on the assumption that supportive activating measures have a stabilizing effect on the progressive course of the disease, the authors created an interdisciplinary course called 'Movement and Voice', combining the two areas of psychomotor and speech therapy. Novel aspects of the intervention are the linking of movement and voice and the group setting. The course has been offered since 2003 with success.

The goal is to strengthen the voice through movement support and to build basic trust in one's own communication. Previous positive evaluations indicate that the course changes participants' subjective well-being.

The aim of this research project is to investigate the extent to which the group intervention 'Movement and Voice' has an effect on the subjective well-being of people with Parkinson's.

Questions

An empirical study was conducted to address the following research question: Does the combination of movement and voice in a short-term resource-oriented group course have an effect on the subjective well-being of people with Parkinson's?

Methods

An empirical study was conducted to address the following research question: Does the combination of movement and voice in a short-term resource-oriented group course have an effect on the subjective well-being of people with Parkinson's? The data collection was qualitative as well as quantitative in a mixed methods design (Kuckartz, 2014). Assessment instruments used were the World Health Organization-5 (WHO-5) Well-being Index (WHO, 1998) and the Kurzfragebogen zum allgemeinen Wohlbefinden (FAHW-12; Wydra, 2014). To control confounding variables that result from the accompanying symptoms of Parkinson's, the study used specific items from the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39) in the German version (see Berger et al., 1999) and the Parkinson’s Well-Being MapTM (see UCB-Pharma AG, 2013 © UCB 2013). To verify the quantitative results and to obtain differentiated information on the effects of the course and the group atmosphere, and to identify impacts in everyday life, a guided interview was conducted in the experimental group (N = 11), which participated in the course. In the control group (N = 10), which did not participate in any comparable group course in the time period of the study, an interview was conducted to obtain information on the participants' personal background.

The two samples were similar in age, sex, education level, and disease duration. The data were collected at four or three measurement time points: For the experimental group, the pre-test, interim test, and post-test were conducted in the context of the Movement and Voice course, and the follow-up was conducted 4 weeks after the end of the course. In the control group, three surveys were conducted.

The questionnaire data were evaluated descriptively and statistically using IBM SPSS Statistics. The guided interviews were taped on audio equipment, transcribed, and then evaluated qualitatively using MAXQDA (Kuckartz, 2016). The quantitative results were compared with the qualitative assessment and analysed and discussed regarding the research question.

Results

As assessed by the WHO-5, the experimental group showed an increase in subjective well-being. The Friedman test (chi-square (3) = 11.90, p = .008, n = 9) and the post-hoc tests showed that the change in well-being in the experimental group was significant across the four time points. The effect sizes are large (r = .61 and r = .54), whereby well-being was higher at the fourth measurement time point. No such change in well-being was found in the control group. The statistical analysis thus confirmed the descriptive estimation of an increase in well-being in the experimental group on the WHO-5 questionnaire. For the control group, no such significant change was found. The positive effect of the multimodal group course on the participants' well-being was also supported by the qualitative study. The results showed that participants in the course successfully shifted their focus from the disease to their resources. However, as the samples were small and as the results of the other questionnaires (FAHW12 and PDQ-39) did not demonstrate any increase in well-being, these findings should be interpreted with caution.

In addition, the results of the qualitative investigation showed that the decisive factors in the increase in subjective well-being in the experimental group were social factors, such as doing things with others, the atmosphere in the group, and the open, resource-oriented approach.

The conclusion can be drawn that multimodal courses of this kind boost confidence in one's own abilities and improve subjective well-being in people with Parkinson's disease at least for a certain period of time.

Facts

Duration
08/2017-07/2019
No.
2_9

Project Management

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