Cognition, compassion and wellbeing among people with Parkinson's

Sowter, Natalie and Eccles, Fiona and Spokes, Terry (2019) Cognition, compassion and wellbeing among people with Parkinson's. PhD thesis, Lancaster University.

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Abstract

This thesis considers some of the cognitive, social and psychological factors which impact upon the wellbeing of people with Parkinson’s. Section One reports a systematic literature review of the relationship between anxiety and cognition for people with Parkinson’s. The electronic databases CINAHL, Medline, PsycINFO and Web of Science were searched and 39 eligible studies were identified. The findings suggested that higher anxiety is associated with worse global cognition and worse performance in specific cognitive domains (attention, working memory, executive functioning, memory, language, semantic verbal fluency and visuospatial skills) among people with Parkinson’s. However, several studies did not identify significant relationships. Studies varied in design and quality, several having small samples. Relationships between anxiety and cognition among people with Parkinson’s appear to be complex and may be influenced by other factors. Implications for clinical practice are discussed. Section Two describes a quantitative, cross-sectional, observational study into the relationships between self-compassion, stigma and psychological distress among people with Parkinson’s. Participants were 138 people with Parkinson’s, who completed questionnaires measuring self-compassion, enacted and felt stigma, and depression, anxiety and stress. All variables were found to correlate significantly in the expected directions. The stigma variables were significant mediators in the relationships between self-compassion and the three outcome variables - depression, anxiety and stress. Part of the relationship between self-compassion and psychological distress appears to occur via the internalisation of stigma. These findings may be relevant to individualised and societal interventions with the aim of improving the psychological wellbeing of people with Parkinson’s. Section Three provides a critical appraisal of the thesis. This includes a summary of the main findings, consideration of language and concepts, a discussion of some of the issues relating to each paper and suggestions for further research.