Natalie E Allen, Annabel Darmali, Cecelia Koch, Sammi Tran, Serene S Paul, Colleen G Canning, Simone Edwards, Susan Harkness, Roslyn Savage, Lyndell Webster, Genevieve Zelma, Lina Goh
{"title":"Acceptability of a programme for safer mobility (INTEGRATE): Perspectives of people with Parkinson's disease and their care-partners.","authors":"Natalie E Allen, Annabel Darmali, Cecelia Koch, Sammi Tran, Serene S Paul, Colleen G Canning, Simone Edwards, Susan Harkness, Roslyn Savage, Lyndell Webster, Genevieve Zelma, Lina Goh","doi":"10.1177/02692155251365151","DOIUrl":null,"url":null,"abstract":"<p><p>ObjectiveThis study aimed to explore the acceptability and factors that influenced implementation of a multidomain, home-based fall prevention programme (<i>Integrate</i>) for people with Parkinson's disease who fall recurrently, and their care-partners.DesignQualitative, inductive thematic analysis of semi-structured interviews.SettingHomes of <i>Integrate</i> participants in Sydney, Australia.ParticipantsEighteen interviews with people with Parkinson's disease and/or their care-partner who were purposively sampled after completing <i>Integrate</i>.Intervention<i>Integrate</i> was delivered by occupational therapists and physiotherapists and included personally tailored home fall-hazard reduction, exercise (leg muscle strength, balance and freezing of gait) and safer mobility strategies delivered over 6 months.ResultsFive themes were identified: (a) the importance of personalisation, (b) a collaborative effort, (c) capacity building, (d) navigating fall risk with Parkinson's is complex and (e) the ease (or not) of making changes. Participants and their care-partners appreciated the personalised, home-based programme that involved shared decision-making and was delivered by expert therapists. They developed increased safety awareness and problem-solving skills. Making improvements, receiving ongoing support from therapists and care-partners and making change easier promoted sustained engagement. However, some participants faced emotional and psychological barriers to engagement including fatalistic beliefs about disease progression and a desire to avoid appearing 'disabled'. The reality of Parkinson's disease motivated participants to make changes but Parkinson's-related impairments such as apathy and motor fluctuations hindered this.ConclusionsPeople with Parkinson's disease who are recurrent fallers, and their care-partners, found the <i>Integrate</i> programme acceptable and were able to engage with it with guidance and support from therapists.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1378-1389"},"PeriodicalIF":2.9000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414106/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/02692155251365151","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/6 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
ObjectiveThis study aimed to explore the acceptability and factors that influenced implementation of a multidomain, home-based fall prevention programme (Integrate) for people with Parkinson's disease who fall recurrently, and their care-partners.DesignQualitative, inductive thematic analysis of semi-structured interviews.SettingHomes of Integrate participants in Sydney, Australia.ParticipantsEighteen interviews with people with Parkinson's disease and/or their care-partner who were purposively sampled after completing Integrate.InterventionIntegrate was delivered by occupational therapists and physiotherapists and included personally tailored home fall-hazard reduction, exercise (leg muscle strength, balance and freezing of gait) and safer mobility strategies delivered over 6 months.ResultsFive themes were identified: (a) the importance of personalisation, (b) a collaborative effort, (c) capacity building, (d) navigating fall risk with Parkinson's is complex and (e) the ease (or not) of making changes. Participants and their care-partners appreciated the personalised, home-based programme that involved shared decision-making and was delivered by expert therapists. They developed increased safety awareness and problem-solving skills. Making improvements, receiving ongoing support from therapists and care-partners and making change easier promoted sustained engagement. However, some participants faced emotional and psychological barriers to engagement including fatalistic beliefs about disease progression and a desire to avoid appearing 'disabled'. The reality of Parkinson's disease motivated participants to make changes but Parkinson's-related impairments such as apathy and motor fluctuations hindered this.ConclusionsPeople with Parkinson's disease who are recurrent fallers, and their care-partners, found the Integrate programme acceptable and were able to engage with it with guidance and support from therapists.
期刊介绍：
Clinical Rehabilitation covering the whole field of disability and rehabilitation, this peer-reviewed journal publishes research and discussion articles and acts as a forum for the international dissemination and exchange of information amongst the large number of professionals involved in rehabilitation. This journal is a member of the Committee on Publication Ethics (COPE)
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