Biobehavioral Framework of Symptom and Health Outcomes of Uncertainty and Psychological Stress in Parkinson Disease.
Parkinson disease (PD) is a debilitating, progressive neurodegenerative disorder characterized by complex motor and nonmotor symptoms that fluctuate in onset, severity, level of disability, and responsiveness to treatment. The unpredictable nature of PD and the inability to halt or slow disease progression may result in uncertainty and psychological stress. Uncertainty and psychological stress have important implications for symptom and health outcomes in PD. Uncertainty and psychological stress have been shown to worsen symptoms, functional capacity, and quality of life in chronic illnesses; however, the causal mechanisms have yet to be elucidated. We propose a biobehavioral framework for examining uncertainty and psychological stress in PD. The framework considers factors that may contribute to uncertainty and neuroendocrine-immune mechanisms of uncertainty and psychological stress that may influence symptom and health outcomes in PD, for the ultimate purpose of improving symptom and disease progression, functional capacity, and quality of life.
Questions or comments about this article may be directed to Kim W. Austin, MSN RN, at kim@kwaustin.net. She is a PhD Candidate, School of Nursing, Virginia Commonwealth University, Richmond, VA. Suzanne W. Ameringer, PhD RN, Associate Professor, Department of Family and Community Health Nursing, School of Nursing, Virginia Commonwealth University, Richmond, VA. Angela R. Starkweather, PhD ACNP-BC, Professor and Director, Center for Advancements in Managing Pain, School of Nursing, University of Connecticut, Storrs, CT. Leslie J. Cloud, MD MSc, Assistant Professor of Neurology, School of Medicine, Virginia Commonwealth University, Richmond, VA. Jamie L. Sturgill, PhD, Assistant Professor, Department of Family and Community Health Nursing, School of Nursing; Director, Behavioral Laboratory Services, Virginia Commonwealth University, Richmond, VA. Ronald K. Elswick, Jr., PhD, Professor, Department of Family and Community Health Nursing, School of Nursing; Director of Biostatistics and Data Services, Virginia Commonwealth University, Richmond, VA.
Kim W
KW
Austin
Suzanne W
SW
Ameringer
Angela R
AR
Starkweather
Leslie J
LJ
Cloud
Jamie L
JL
Sturgill
Ronald K
RK
Elswick
D018450:Disease Progression; D006801:Humans; D010300:Parkinson Disease / Q000175:diagnosis / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications*; D035501:Uncertainty