Study explores factors that shape patients’ quality of life

Clinical and demographic factors, not coping strategies, are key determinants

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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People with Parkinson’s disease tend to have different coping strategies depending on factors such as age, gender, and education, a new study shows.

Findings suggest that differences in demographic and clinical factors, but not differences in coping strategies, are the main factors that determine patients’ quality of life, according to the study “Determinants of coping styles of people with Parkinson’s Disease,” published in npj Parkinson’s Disease.

Coping strategies refer to actions that people take in order to deal with stressful situations. Coping strategies can be very broadly characterized as active or passive. Active strategies, such as asking for help, aim to confront the stressful problem head-on, whereas passive strategies such as avoidance or denial aim to distance the person from the problem.

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Prior studies of Parkinson’s patients have suggested that patients who use more passive strategies tend to report worse life quality. However, people don’t develop coping strategies out of nowhere. The strategies a person uses to deal with stress are informed by a lifetime of unique experiences, and there hasn’t been much research into which factors tend to be associated with different coping strategies for Parkinson’s patients.

Scientists in Europe conducted a study to learn more.

“It is unknown to what extent the choice of a coping strategy depends on how someone assesses the situation (s)he is confronted with and the available resources and the influence of the severity of their PD [Parkinson’s disease],” the researchers wrote. “We therefore aimed to assess the interplay of coping behavior of people with PD with different social demographics and disease-related characteristics. The second aim was to investigate to what extent the choice of coping strategy affects the health-related quality of life (QoL) of a person with PD.”

The scientists analyzed data from 935 people with Parkinson’s disease. The average patient age was 71 years, and 39% identified as women. The majority of patients were retired, most were married and/or living with a partner, and most had received some education beyond high school.

Ways of Coping Questionnaire

To evaluate coping strategies, the participants completed a standardized assessment called the Ways of Coping Questionnaire (WCQ). The researchers then used statistical analyses to cluster the WCQ scores, looking for groups of patients that reported broadly similar strategies.

Results revealed five general groups of coping strategies, which the researchers dubbed “taking action and emphasizing the positive,” “distancing and fantasizing,” “goal oriented and planful problem solving,” “seeking social support,” and “avoidance and acceptance.”

Analyzing the data

Further analyses showed these groups varied according to demographic factors such as age, gender, and education level, as well as mental health factors like anxiety and depression. For example, patients who were younger or reported more anxiety were more likely to fall into support-seeking strategies, whereas patients with more formal education were more likely to report goal-oriented behaviors. Women were more likely to distance themselves.

Patients’ quality of life was assessed via the Parkinson’s disease questionnaire (PDQ-39). The researchers used statistical models to look for factors associated significantly with life quality scores. Results showed relatively minimal associations between coping strategies and PDQ-39 scores. Instead, life quality scores showed stronger associations with demographic characteristics and measures of Parkinson’s severity.

“Overall [quality of life] is more strongly determined by clinical and demographic factors than coping styles,” the researchers concluded. They noted that associations between life quality and coping strategies were stronger when measures of anxiety and depression were excluded from the statistical models, which they said makes sense given that people with anxiety and/or depression may be more prone to certain coping strategies.

The researchers noted several limitations in this study. For example, patients were assessed at only one point in time, and the analyses did not include data on important factors like cognitive function, social support, and severity of non-motor symptoms.

The team highlighted a need for further research into how Parkinson’s patients cope with stress. “Knowing an individual’s choice of coping strategy makes it easier for health care professionals to tailor care to the unique needs of a person with PD,” they said.