From miracle to reconciliation: a hermeneutic phenomenological study exploring the experience of living with Parkinson's disease following Deep Brain Stimulation.

摘要

BACKGROUND: Deep Brain Stimulation for Parkinson's disease is a promising treatment for patients who can no longer be treated satisfactorily with L-dopa. Deep Brain Stimulation is known to relieve motor symptoms of Parkinson's disease and improve quality of life. Focusing on how patients experience life when treated with Deep Brain Stimulation can provide essential information on the process patients go through when receiving a treatment that alters the body and changes the illness trajectory. AIM: The aim of this study was to explore and describe the experience of living with Parkinson's disease when treated with Deep Brain Stimulation. DESIGN: The study was designed as a longitudinal study and data were gathered through qualitative in-depth interviews three times during the first year of treatment. PARTICIPANTS AND SETTING: Nine patients participated in the study. They were included when they had accepted treatment with Deep Brain Stimulation for Parkinson's disease. METHODOLOGY: Data collection and data analysis were inspired by the hermeneutic phenomenological methodology of Van Manen. RESULTS: The treatment had a major impact on the body. Participants experienced great bodily changes and went through a process of adjustment in three phases during the first year of treatment with Deep Brain Stimulation. These stages were; being liberated: a kind of miracle, changes as a challenge: decline or opportunity and reconciliation: re-defining life with Parkinson's disease. The course of the process was unique for each participant, but dominant was that difficulties during the adjustment of stimulation and medication did affect the re-defining process. CONCLUSION: Patients go through a dramatic process of change following Deep Brain Stimulation. A changing body affects their entire lifeworld. Some adjust smoothly to changes while others are affected by loss of control, uncertainty and loss of everyday life as they knew it. These experiences affect the process of adjusting to life with Deep Brain Stimulation and re-define life with Parkinson's disease. It is of significant importance that health care professionals are aware of these dramatic changes in the patients' life and offer support during the adjustment process following Deep Brain Stimulation.