Consensus on Feedback Statements That Create Responsibility Among People With Parkinson’s Disease: A Delphi Study

Abstract

AbstractImportance: Sense of agency is associated with a sense of responsibility, which is essential to performing goal-directed occupations.Objective: To reach consensus on a set of extrinsic feedback statements that have the potential to create a sense of responsibility among patients with neurological disorders in the course of performing daily or social occupations.Design: Anonymous Delphi study with two rounds with international experts and one round with Irani patients with Parkinson’s disease (PD).Setting: Electronic survey.Participants: One hundred experts and 73 patients with idiopathic PD.Outcomes and Measures: Experts and patients anonymously rated (5 = strongly agree/very effective, 4 = agree/effective, 3 = neither agree nor disagree/uncertain, 2 = disagree/ineffective, 1 = strongly disagree/very ineffective) their level of agreement with each survey statement and the effectiveness of each statement in creating a sense of responsibility in the course of performing daily or social occupations. Consensus was set as an interquartile range of ≤1 and ≥70% agreement in two adjacent categories of a Likert scale.Results: In the experts’ first round, consensus was reached on the level of agreement and effectiveness of 18 statements. In the second round, final consensus was achieved on all statements. In the one patient round, patients reached consensus on all statements. Finally, 34 statements were rated as 4 or 5 in terms of agreement and effectiveness, based on the opinions of experts and patients.Conclusions and Relevance: This study has produced a collection of feedback statements that might be useful in occupation-based interventions.What This Article Adds: Extrinsic responsibility feedback delivered while administering occupation-based interventions may increase volition, motivation, and engagement.