title: Patients' perceptions of life shift after deep brain stimulation for primary dystonia--A qualitative study.
abstract: Studies of deep brain stimulation for dystonia have shown significant motor improvement. However, patients' perceptions of surgery and its effects have been less studied. We aimed to explore perceptions of changes in life in patients with primary dystonia after deep brain stimulation. Thirteen patients underwent thematic interviews 8-60 months after pallidal deep brain stimulation. Interviews were transcribed verbatim and analyzed with grounded theory. Patients described a profound impact of dystonia on daily life. After surgery, physical changes with a more upright posture and fewer spasms translated into an easier, more satisfying life with greater confidence. Notwithstanding this positive outcome, the transition from a limited life before surgery to opportunities for a better life exhibited obstacles: The "new life" after deep brain stimulation was stressful, including concern about being dependent on the stimulator as well as having to deal with interfering side effects from deep brain stimulation. The whole coping process meant that patients had to quickly shift focus from struggling to adapt to a slowly progressive disorder to adjustment to a life with possibilities, but also with new challenges. In this demanding transition process, patients wished to be offered better professional guidance and support. Even though deep brain stimulation provides people with primary dystonia with a potential for better mobility and more confidence, patients experienced new challenges and expressed the need for support and counseling after surgery. Grounded theory is a useful method to highlight patients' own experience and contributes to a deeper understanding of the impact of deep brain stimulation on patients with dystonia.
authors.affiliation: Department of Community Medicine and Rehabilitation, Occupational Therapy, Umeå University, Umeå, Sweden. gun-marie.hariz@neuro.umu.se
authors.forename: Gun-Marie
authors.initials: GM
authors.lastname: Hariz
authors.forename: Patricia
authors.initials: P
authors.lastname: Limousin
authors.forename: Stephen
authors.initials: S
authors.lastname: Tisch
authors.forename: Marjan
authors.initials: M
authors.lastname: Jahanshahi
authors.forename: Anncristine
authors.initials: A
authors.lastname: Fjellman-Wiklund
mesh_terms: D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D006233:Persons with Disabilities; D020821:Dystonic Disorders / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception / Q000502:physiology*; D011788:Quality of Life; D016896:Treatment Outcome