Empowering safer mobility behaviour for fall prevention in people with Parkinson's disease: A qualitative study
Daniel Cheung, Serene S. Paul, Lynette Mackenzie, Jacqueline Wesson, Natalie E. AllenObjective
To understand the perspectives of clinicians and researchers on the nature of safer mobility behaviour and how it is applied to fall prevention in people with Parkinson's disease.
Design
A qualitative study using focus group discussions with reflexive thematic analysis.
Setting
An international cohort participated in the study online via video conference.
Participants
Nineteen physiotherapists, occupational therapists and/or researchers (median 18 years of experience) were included across five focus groups.
Results
Empowerment was the central theme underpinning the promotion of safer mobility behaviour. Empowerment meant enabling people towards safe, effective and meaningful task engagement. This was embedded across three sub-themes. Firstly, a contextual approach was needed to understand the complex nature of mobility behaviour involving the combination of physical, cognitive, psychological and Parkinson's disease (e.g. disease progression and fluctuations) related influences. Secondly, an individual approach was needed to provide a holistic assessment evaluating the impact of these influences as well as tailoring interventions to address them. Thirdly, a collaborative approach was needed between clinicians, individuals and care-partners to ensure shared problem solving and goal setting.
Conclusions
A novel approach to fall prevention was described in this study. It recognised a person's autonomy and dignity of risk through a balanced consideration of safety during meaningful activities. It also highlighted the role of expert clinicians to work alongside individuals and care-partners for safer strategy development. This study provides the foundation for the development and implementation of safer mobility behaviour strategies for fall prevention in people with Parkinson's disease.