title: Barriers and Facilitators for Participation in People with Parkinson's Disease.
abstract: BACKGROUND
  Activity performance is marked by the degenerative nature of Parkinson's disease (PD), but few qualitative studies have focused on how people with PD perceive participation in life situations.
  
  
  OBJECTIVE
  To identify and describe barriers and facilitators for participation from the perspective of people with PD.
  
  
  METHODS
  Qualitative data was obtained by the focus group method using a semi-structured interview guide. Participants were recruited by purposeful sampling until saturation was reached. Homogeneity within each focus group was based on self-rated PD severity (mild, moderate, severe). Nine focus groups (three per PD severity level) included a total of 29 participants.
  
  
  RESULTS
  Complex dynamics between the individual and the physical and social environment create barriers and facilitators for participation as described in the four categories which emerged out of the focus group discussions. The category Ambiguity of attitudes and the support of others describes how attitudes and support of other people act both as facilitators and barriers for participation. PD specific complexity of the body and physical environment interaction describes barriers for participation. Facilitators emerged in the two categories PD expertise in health care and social services and Information and education foster PD specific understanding.
  
  
  CONCLUSIONS
  Our findings imply several potential means to facilitate participation for people with PD, taking the person as well as the environment into account in person-centred interventions. This involves aspects such as having access to PD specific expertise, increasing the knowledge and thereby the understanding of PD as well as providing support for maintained work-life.
authors.forename: Maria H
authors.initials: MH
authors.lastname: Nilsson
authors.forename: Susanne
authors.initials: S
authors.lastname: Iwarsson
authors.forename: Björg
authors.initials: B
authors.lastname: Thordardottir
authors.forename: Maria
authors.initials: M
authors.lastname: Haak
mesh_terms: D000368:Aged; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D036301:Qualitative Research; D012720:Severity of Illness Index; D058992:Social Participation / Q000523:psychology*
keywords: Activities; education; environment; falls; family; knowledge; patient involvement; self-help devices; transportation; work