Occupations to Enhance Responsibility Among Patients With Parkinson’s Disease: An International Delphi Study

Abstract

AbstractImportance: The ability to perform voluntary actions is disrupted in Parkinson’s disease (PD). Voluntary activities play a critical role in generating sense of agency, which underpins the concept of responsibility for people’s daily occupations and their outcomes. According to this concept, the dearth of research regarding the concept of responsibility in rehabilitation hampers practitioners in delivering evidence-based care.Objective: To generate a list of occupations that enhance an inherent sense of responsibility among people with PD that is based on consensus among experts.Design: An anonymous and iterative Delphi study with two rounds.Setting: Electronic survey.Participants: One hundred sixteen experts participated in the first round of the study, and 95 participated in the second round.Outcomes and Measures: Panelists rated the level of inherent responsibility in each occupation and the importance of types of patient-related information on a 5-point Likert scale. Consensus was defined as reaching an interquartile range of >1.Results: In the first round, consensus was reached on 19 occupations and all 38 types of patient-related information. Also, an additional 15 occupations and 16 types of patient-related information were added to the lists. Consensus was reached for all occupations and patient-related information presented in the second round.Conclusions and Relevance: Our results indicate that 61 occupations were deemed to enhance a moderate to a very high inherent sense of responsibility among people with PD. In addition, a wide range of patient-related information is considered very important or important while these occupation-focused interventions are delivered.What This Article Adds: Subjective knowledge of one’s actions and their consequences lies behind people’s daily occupations. Considering this knowledge when administering occupation-focused interventions can be beneficial for individuals with PD.