Review Article

The Experience of Parkinson’s Disease: A Systematic Review and Meta-Ethnography

Table 1

The study characteristics of included studies.

Study Qualitative method Participants Sampling and settingData collection aims and focus

Anderson (2013) [27] Semistructured interviews13 (10♂) patients with Parkinson’s disease
Mean age: not given
Median age: 66.5 years (range, 44 to 80 years)
Time with illness: not obtained
Hoehn and Yahr stage
1 = stage 2
8 = stage 3
4 = stage 4
1 = stage 5
Sampling: purposive (those having surgery)
Setting: participants homes
Focus was on the preoperative experiences of care
14 surgeries, 10 = orthopaedic, 2 = cardiac, 1 = hernia, 1 = battery replacement

Andersson and Sidenvall (2001) [28]Case studies10 women with Parkinson’s disease
Mean age: 74.1 ± 4.1 years
Median age: 75 years (range, 67–80 years)
Mean time with illness: ≈8.7 ± 3.3 years
Median time with illness: ≈10 years (range 4–14 years)
Hoehn and Yahr stage: not given
Sampling: purposive or random (from geriatric and neurological clinic register)
Interviews location: participants homes
Identify how women with Parkinson’s disease managed to cook and shop and consider if their nutritional needs were met

Banks and Lawrence (2006) [29]One-to-one interviews (likely semistructured)24 (10♂) patients with Parkinson’s disease
Mean age: 51.6 years, no further details
Median age: not given (range, 43–61 years)
Mean time with illness: 4.2 years (in employment), 8.6 years (not in employment)
Hoehn and Yahr stage: not given
Sampling: purposive (selected on the basis of gender, employment, and time since diagnosis)
Interview location: not clear
Focus on assessing the impact on Parkinson’s on employment

Benharoch and Wiseman (2004) [62]Semistructured interviews, combined with a researcher diary and participant diary8 (4♂) patients with Parkinson’s disease
Mean age: 3 over 65 years, 7 under 65 years, no further details given
Median age: not given
Mean time with illness: 9.2 ± 5.9 years
Hoehn and Yahr stage: not given
Sampling: snowball sampling was used.
Interview location: not clear
Focus on participation in self-care and the use of occupations and the meaning ascribed to them

Bingham and Habermann (2006) [30]Individual and family semistructured interviews 56 participants with Parkinson’s disease and primary caregivers
Mean age of individuals with Parkinson’s disease: 71 years (range, 41–87 years)
Mean age of caregivers: 71 years (range, 44–88 years)
Mean time with illness: not given (range, 6–9 years)
Hoehn and Yahr stage
Either stage 3 or stage 4 (no further details given)
Sampling: maximum variation sample
Interview location: not clear
Consider if spirituality assists individuals with Parkinson’s in the management of the day to day experiences of the illness

Bramley and Eatough (2014) [31]Case study1 female
Age: 62 years
Hoehn and Yahr stage 4
Sampling: case study
Interview location: not identified
Three interviews consider life history, impact of diagnosis, issues of medication, and the future

Brigersson and Edberg (2004) [32]Semistructured interviews 6 couples or 12 individuals (6 = ♂) (6 with Parkinson’s disease, 3 = ♂)
Mean age of individuals with Parkinson’s: 71.2 ± 5.8 years (range, 61–75 years)
Mean age of spouse: 74.3 ± 4.7 years (range, 66–82 years)
Mean duration of illness: 11.8 ± 8.2 years
Hoehn and Yahr stage not given
Sampling: purposive sample of couples (married or cohabiting)
Interview location: respondents homes
Consider the support experience of individuals with Parkinson’s disease and their partner

Buetow et al. (2012) [33]Semistructured interviews22 individuals (13 with Parkinson’s disease, 9 = ♂)
Mean age: not given
Median age: not given (range not provided, age groupings, 6 = <65 years, 12 = 65–74 years, 4 = 75+ years)
Means time with illness: 11.0 ± 5.6 years
Hoehn and Yahr stage: not given
Sampling: maximum variation through national advertisement
Interview location: telephone interviews
Explore the meaning and significance of patient safety events in individuals with Parkinson’s disease.
Site locations 15 = hospital or general practice, 7 = other places

Caap-Ahlgren et al. (2002) [34]Semistructured interviews8 women with Parkinson’s disease
Mean age: 70 years (range, 63–80)
Mean time since diagnosis: not given (range, 5–15 years)
Hoehn and Yahr stage
Stage 1 = 1
Stage 2 = 2
Stage 3 = 3
Stage 4 = 1
Stage 5 = 1
Sampling: purposive sample of couples (range of age, duration of illness, civil status, and dwelling)
Interview location: respondents homes
Explore experience of women living with Parkinson’s disease.

Charlton and Barrow (2002) [35]Semistructured interviews8 (3 = ♂) participants with Parkinson’s disease
Mean age: 62 years (range, 62–86)
Mean duration of illness: 3 years (range, = 3–8 years)
Hoehn and Yahr stage: not given
Sampling: convenience sample
Interview location: respondents homes, except one who was interviewed in hospital interview room
Consider the consequences of living with Parkinson’s disease. Coping methods were considered that help psychological distress and if coping was related to group membership

Davis et al. (2003) [36]Focus group interviews9 individuals (6 = ♂) with Parkinson’s disease
Mean age: 70.6 ± 10.8 years (range, 51–85 years)
Mean duration of illness: 9.8 ± 5.4 years (range, 3–20 years).
Hoehn and Yahr stage: not given
Sampling: convenience sample (advertisement in local hospitals, outpatients rehabilitation, and community Parkinson’s groups)
Interview location: local church where the Parkinson’s support group held their meetings
Focus on challenges to walking, the loss of balance and falls experience, general mobility, and exercise

Delaney et al. (2012) [37]Semistructured interviews10 individuals (7 = ♂) with Parkinson’s disease
Mean age: 56.8 ± 8.1 years (range, 49–70 years)
Mean duration of illness: 8.4 ± 3.5 years (range, 4–15 years)
Hoehn and Yahr stage: not given
Sampling: purposive with a focus on individuals with impulse control behaviours
Interview locations: unclear
Consider the perspective of individuals with Parkinson’s on impulse control behaviours

Den Oudsten et al. (2011) [38]Focus group interviews38 (24 = ♂) individuals with Parkinson’s disease, 8 (6 = ♂) caregivers, and 8 (3 = ♂) health care professionals
Patients with Parkinson’s disease
Pooled mean age: 67.4 ± 6.6 years
Mean duration of illness:
caregivers
Pooled mean age: 55.0 ± 6.4 years
Health care professionals
Pooled mean age: 40.5 ± 7.5 years
Hoehn and Yahr stage: not given
Sampling: purposive (adults 18–65 years) identified by neurologist
Interview locations: multiple including educational facilities, outpatient clinics, and hospitals
Consider a qualitative understanding of what quality of life means for individuals with Parkinson’s disease

Drey et al. (2012) [39]Semistructured interviews15 (9 = ♂) individuals with Parkinson’s disease, 3 (? = ♂) carers
Mean age: not given (range, 44–74 years)
Mean duration with illness: not given (range, 1–17 years)
Hoehn and Yahr stage: not given
Sampling: purposive (those responsible for managing their own medication with help of a carer)
Interview location: hospital setting following routine clinic appointment
Consider the role and value of Parkinson’s nurses for patients and some carers

Elliott and Velde (2005) [40]Semistructured interviews 7 individuals (3 = ♂) with Parkinson’s disease
Mean age: not given (range, 55–79 years old)
Mean duration of illness: not given (range, 3–18 years)
Hoehn and Yahr stage: not given
Sampling: purposive and nominated sampling from Parkinson’s support group
Interview location: not clear
Consideration to the changes in lifestyle, the impact of Parkinson’s on an individual’s occupation and habits, and how occupation is integrated in to life

Fleming et al. (2004) [41]Descriptive case studies19 women with Parkinson’s disease
Mean age: 44 years (range, 34–56 years)
Mean duration of illness: not given (range 18 months–27 years).
Hoehn and Yahr stage: not given
Sampling: snowball (women with Parkinson’s from four clinics who would then identify other potential participants)
Interview location: study centre location (educational facility)
Experiences and adjustment made by women to Parkinson’s in relationship to womanhood.

Habermann (1996) [43]Semistructured interviews 16 (9 = ♂) individuals with Parkinson’s disease
Mean age: 48 years (range, 42–59 years)
Mean duration of illness: not given (range not given, age groupings;
5 = < years, 4 = 5–10 years, 1 = 16 years, no other details given)
Hoehn and Yahr stage
“majority” stages 2-3.
Sampling: purposive (restricted aged range of individuals from “various” neurological practices)
Interview location: not detailed
Consider the day-today experiences of middle aged individuals with Parkinson’s

Harberman (1999) [44]Semistructured interviews16 (9 = ♂) individuals with Parkinson’s disease
Mean age: 48 years (range, 42–59 years)
Mean duration of illness: not given (range, 1–16 years).
Hoehn and Yahr stage
“majority” stages 2-3
Sampling: purposive (restricted age range)
Interview location: not detailed
Consider the challenge of Parkinson’s to an individual’s sense of self and ability to cope

Hermanns (2011) [45]Interviews undertaken14 (7 = ♂) individuals with Parkinson’s disease
Mean age: 68.4 years (range, 38–82 years)
Mean duration of illness: not given (range, not given).
Hoehn and Yahr stage
Stage 1 = 2
Stage 2 = 2
Stage 3 = 3
Stage 4 = 6
Stage 5 = 1
Sampling: purposive (early onset and either over or under 60 years of age)
Interview location: within a “support group community location” (presumably)
Consider the daily experience of Parkinson’s disease

Hodgson et al. (2004) [46]Semistructured interviews20 individuals
10 (6 = ♂) individuals with Parkinson’s disease
Mean age: 61.8 years (range, 46–79 years)
Caregiver mean age: 62.4 years (range, 52–79 years)
Mean duration with illness: 7.5 years (range, 2–20 years)
Hoehn and Yahr stage
Stage 1 = 2
Stage 2 = 6
Stage 4 = 2
Sampling: purposive (couples with Parkinson’s)
Interview location: at couple home, except one couple who opted for a business location
Consider the impact of Parkinson’s on the relationship of a couple

Hurt et al. (2012) [47]Semistructured interviews37 individuals with Parkinson’s disease
Mean age: not given
Mean duration with illness: not given
Hoehn and Yahr stage:
not detailed
Sampling: purposive (nondepressed and depressed individuals age matched across groups)
Interview location: not detailed
Experience and perception of Parkinson’s disease and its relationship to depression within nondepressed, mild depressed, and moderate-severe depressed individuals.

Jones et al. (2008) [48]Semistructured interviews20 (12 = ♂) individuals with Parkinson’s disease
Mean age: 65 years (range, 50–80 years)
Mean duration of illness: 10 years (range, 2.5–20 years).
Hoehn and Yahr stage
Stages 1–4 identified (no further details given)
Sampling: purposive (Hoehn and Yahr stage 1–4, no dementia, no severe dyskinesias, no long period making table testing difficult, no severe comorbidity, <80 years old, no medical or joint problems affecting mobility)
Interview location: not detailed
The challenges faced by individuals with Parkinson’s when attempting to walk each day

Liao et al. (2013) [49]In-depth interviews15 (9 = ♂) individuals with Parkinson’s disease
Mean age: 73 years (range, 65–80 years)
Mean duration of illness: not given (range, 2–15 years).
Hoehn and Yahr stage
Stage 1 = 3
Stage 2 = 5
Stage 3 = 4
Stage 4 = 3
Sampling: purposive
Interview location: not detailed
To consider the experiences of older Taiwanese individuals during different stages of Parkinson’s disease

Lindgren (1996) [50]Semistructured interview6 (3 = ♂) individuals with Parkinson’s disease
Mean age: not given (range, 66–78 years)
Mean duration of illness: not given (two reported a range of 2–4 years, four reported a range of 11–25 years).
Hoehn and Yahr stage:
not given
Sampling: purposive
Interview location: not detailed
Identify long term grief or chronic sorrow experienced by individuals

Marr (1991) [51]Interview (type not given)6 (3 = ♂) individuals with Parkinson’s disease
Mean age: not given (range, 53–79 years)
Mean duration of illness: not given (range, 2–15 years).
Hoehn and Yahr stage
Stages 1–2 “some” 
Stages 3-4 “a few”
Sampling: purposive (Parkinson’s disease for at least a year, being able to understand English, independently ambulatory)
Interview location: own homes
Considered the experience of living with Parkinson’s disease

Miller et al. (2006) [52]Semistructured interviews37 (23 = ♂) individuals with Parkinson’s disease
Mean age: 70.9 ± 9.6 years (range, 50–88 years)
Mean duration of illness: 9.5 ± 7 years (range, 3–38 years).
Mean Hoehn and Yahr stage: 2.67 ± 0.9 (range, 1–5)
Sampling: purposive (sample had speech and swallowing problems)
Interview location: own homes
Consideration of the onset and impact of speech changes and the strategies used to manage changes

Mshana et al. (2011) [53]In-depth interviews and focus groups34 individuals (32 = ♂)
28 (? = ♂) individuals with Parkinson’s disease,
28 carers, 4 health workers, and 2 traditional healers (no further information given on these groups)
Mean age: not given (range, 45–90 years)
Mean duration of illness: not given
Hoehn and Yahr stage: not given
Sampling: convenience/purposive (individuals within one district)
Interview location: within community location (no further details given)
Perceptions and experiences of Parkinson’s disease

Oehlberg et al. (2008) [54]Semistructured interview38 (32 = ♂) individuals with Parkinson’s
Mean age: 65.5 ± 12.1 (range, not given)
Mean duration of illness: not given
Hoehn and Yahr stage: not given
Sampling: convenience (individuals within one centre for Parkinson’s disease that had depression)
Interview location: not clear
Consideration for the preference of Parkinson’s patient of the etiology of and preferred treatment strategies for depression

Olsson et al. (2013) [55]Semistructured interview11 women with Parkinson’s disease
Mean age: not give
Median age: 59 years (range, 45–64 years)
Mean duration of illness: not given
Median duration of illness: 7 years (range, 1–13 years)
Hoehn and Yahr stage: not given
Sampling: convenience (women identified from one hospital location)
Interview location: 9 in own homes, 2 at university
Women’s experiences of living with Parkinson’s and fatigue

Pretzer-Aboff et al. (2009) [63]Semistructured interview3 (? = ♂) individuals with Parkinson’s
Mean age 78.7 ± 3.5 (range, 75–82 years)
Mean duration of illness: 7.3 ± 7.0 years (range, 1–17 years)
Sampling: purposive (individuals identified from the local community)
Interview location: a quite private place of an individual chosen
Learn about the barriers, facilitators, and help techniques used by individuals with Parkinson’s to aid their functioning

Soleimani et al. (2014) [56]Semistructured interview11 (7 = ♂) with Parkinson’s disease
Mean age: 71 ± 10.5 years (range, 60–90 years)
Mean duration of illness: 5.4 ± 4.2 years (range, 1–16 years)
Hoehn and Yahr stage: 2.4 ± 1.1 years (range, 1–5)
Sampling: purposive (individuals identified from one hospital location)
Interview location: in individuals own homes
Consider the effects of Parkinson’s on social connections

Stanley-Hermanns and Engebretson (2010) [57]Participant observation and in-depth interviews14 (7 = ♂) with Parkinson’s disease
Mean age: 68.4 years (range, 38–82 years)
Mean duration of illness: not identified
Hoehn and Yahr stage:
Stage 1 = 2
Stage 2 = 2
Stage 3 = 3
Stage 4 = 6
Stage 5 = 1
Sampling: purposive (individuals selected to represent a variation in severity of their disease and ability to articulate)
Interview location: in individuals own homes
Consider how individuals with Parkinson’s manage living with their illness on a day-to-day basis and how individuals construct their illness

Todd et al. (2010) [58]Semistructured interview8 (7 = ♂) with Parkinson’s disease
Mean age: 70.5 ± 5.6 years (range, 63–79 years)
Mean duration of illness: 10.0 ± 4.5 years (range, 3–19 years)
Hoehn and Yahr stage: not given
Sampling: purposive (individuals identified as most appropriate to answer question with experiences of delusions in past 12 months)
Interview location: in individuals own homes
Consider the meaning of delusions that occur as part of Parkinson’s disease

Tolson et al. (2002) [59]Individual interviews, supported by diaries, books poems, and newsletters19 women with Parkinson’s disease
Mean age: 47 years (range, 34–56 years)
Mean duration of illness: 10.0 ± 4.5 years (range, 3–19 years)
Hoehn and Yahr stage: not given
Sampling: purposive (women with gynaecological problems)
Interview location: study centre
Consider how women adjust to womanhood following Parkinson’s and experience and cope with menstruation and gynaecological problems

van der Eijk et al. (2011) [60]Focus groups discussions60 individuals
40 (30 = ♂) with Parkinson’s disease,
20 (5 = ♂) carers
Patients with Parkinson’s mean age: 70.5 ± 5.6 years (range, not given)
Carers mean age: 63.0 ± 1.8 years (range, not given)
Mean duration of illness: 6 ± 5 years (range, not given)
Hoehn and Yahr stage: all within stages 1–3.
Sampling: convenience (identified by online web request and from six hospitals)
Interview location: not clear
Consider the quality of care received by patients with Parkinson’s disease and their carers

Whitehead (2010) [61] Semistructured interview8 individuals
4 (3 = ♂) with Parkinson’s disease,
4 (1 = ♂) carers
Patients with Parkinson’s mean age: 64.3 years (range, not given)
Carers mean age: 61.0 years (range, not given)
Duration of illness: all >5 years (range, not given)
Sampling: purposive (identified from local Parkinson’s disease society website)
Interview location: not clear
Explore the perspectives of individuals with Parkinson’s disease and their spouses on the difficulty with communication