title: Time intervals in diagnosing Parkinson's disease: The patients' views.
abstract: OBJECTIVE
  To explore patients' views on their pathway to the diagnosis of Parkinson's disease (PD).
  
  
  METHODS
  A qualitative study of 52 essays written by patients with PD, using comparative content analysis.
  
  
  RESULTS
  Patients divide their diagnostic pathway into three time intervals: recognition of the symptoms; the decision to seek help; and the process of diagnosing PD. Patients have difficulties recognizing the prodromal symptoms of PD (their knowledge is based on public figures with advanced PD) and mention their general practitioners do as well. The decision to seek help is influenced by the patient's attitude toward health care and by their significant others. More than half of the patients believe their diagnosis was delayed. However, the majority of all patients are satisfied with their diagnostic trajectory.
  
  
  CONCLUSIONS
  The pathway to diagnosing PD is an iterative process influenced by patient-, health care provider- and disease-related factors. Despite possible delay in diagnosis, patients are content with their pathway.
  
  
  CONCLUSIONS
  In order to facilitate earlier diagnosis and timely therapeutic intervention (in particular with regard to future possibilities for disease modifying therapy), effort is required to increase the recognition of prodromal symptoms of PD by patients, their significant others and health care providers.
authors.affiliation: Department of Primary and Community Care, Radboud university medical center Nijmegen, The Netherlands. Electronic address: Annette.Plouvier@radboudumc.nl.
authors.forename: Annette O A
authors.initials: AO
authors.lastname: Plouvier
authors.affiliation: Department of Primary and Community Care, Radboud university medical center Nijmegen, The Netherlands.
authors.forename: Tim C
authors.initials: TC
authors.lastname: Olde Hartman
authors.affiliation: Department of Primary and Community Care, Radboud university medical center Nijmegen, The Netherlands.
authors.forename: Leontien P W
authors.initials: LP
authors.lastname: Boots
authors.affiliation: Department of Neurology and Parkinson Centre Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center Nijmegen, The Netherlands.
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
authors.affiliation: Department of Primary and Community Care, Radboud university medical center Nijmegen, The Netherlands; Australian Primary Health Care Research Institute, Australian National University, Canberra, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: van Weel
authors.affiliation: Department of Primary and Community Care, Radboud university medical center Nijmegen, The Netherlands.
authors.forename: Antoine L M
authors.initials: AL
authors.lastname: Lagro-Janssen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000523:psychology; D010468:Perceptual Disorders / Q000175:diagnosis / Q000209:etiology; D062706:Prodromal Symptoms; D036301:Qualitative Research; D013997:Time Factors
keywords: Diagnostic pathway; Parkinson's disease; Patient's perspective; Qualitative research