Parkinson Hastalığı Olan Bireylerde Salya Akması Sıklığı ve Şiddeti, Salya Akmasıyla İlgili Yaşam Kalitesi ve Bakım Veren Yükü Arasındaki İlişki: Kesitsel Bir Çalışma

Abstract

Amaç: Salya akması, Parkinson Hastalığı (PH) olan bireylerin yaşam kalitesini ve bakım veren yükünü olumsuz etkiler. Bu nedenle amacımız, salya akması yaşayan bireylerin yaşam kalitesini ve bakım veren yükünü incelemektir. Gereç ve Yöntem: 65 PH olan bireyi ve 65 bakım vereni içeren prospektif bir çalışma yürütülmüştür. Parkinson hastalığı olan bireyler için Siyalore Klinik Ölçeği (PH-SKÖ) ve Salya Akması Sıklığı ve Şiddeti Ölçeği (SASŞÖ) kullanılarak değerlendirilirken, bakım verenler Zarit Bakım Veren Yükü Ölçeği (ZBVYÖ) ile değerlendirilmiştir. Ek olarak, PH’ler hastalık şiddeti ve süresine göre gruplandırılmış ve salya akmasıyla ilişkili yaşam kaliteleri ve bakım veren yükleri karşılaştırılmıştır. Bulgular: PH-SKÖ, SASŞÖ ve ZBVYÖ arasında orta ila yüksek düzeylerde pozitif ve anlamlı korelasyonlar bulunmuştur (p<0,05). Daha uzun hastalık süresi ve daha yüksek şiddete sahip gruptaki katılımcılar, daha kısa hastalık süresi ve daha düşük şiddete sahip gruptaki katılımcılara kıyasla sonuç ölçüm araçlarında (PH-SKÖ, SASŞÖ ve ZBVYÖ) daha yüksek puanlar göstermiştir (p<0,01). Hiç salyası olmayan grupta, orta düzeyde salyası olan ve şiddetli salyası olan gruplar karşılaştırıldığında, şiddetli salyası olan gruptaki katılımcılar diğer iki gruba kıyasla sonuç ölçüm araçlarında daha yüksek puanlar bulunmuştur (p<0,01). Sonuç: Mevcut çalışmada salya akmasıyla yaş, hastalık süresi ve hastalık şiddeti gibi faktörler arasında ilişki bulunmuştur. Bu faktörler salya akması sıklığını ve şiddetini etkileyerek hem PH olan bireylerin salyayla ilgili yaşam kalitesini hem de bakım veren yükünü olumsuz yönde etkilemektedir. Bu nedenle, salyayla ilgili yaşam kalitesini değerlendirmenin yanı sıra bakım veren yükü de ayrıntılı olarak değerlendirilmelidir.

Keywords

• parkinson hastalığı
• salya akması
• siyalore
• bakım veren yükü

The Relationship between Drooling Frequency and Severity, Drooling-Related Quality of Life and Caregiver Burden in Individuals with Parkinson's Disease: A Cross-Sectional Study

Abstract

Objective: Drooling negatively impacts the quality of life of individuals with Parkinson's Disease (IwPD), and imposes a burden on caregivers. Therefore, our aim is to examine the quality of life and caregiver burden of IwPD experiencing drooling. Materials and Methods: A prospective study was conducted involving 65 IwPD and their caregivers. IwPD were assessed using the Sialorrhea Clinical Scale for Parkinson's Disease (SCS-PD), and Drooling Frequency and Severity Scale (DFSS), while caregivers were assessed via Zarit Burden Interview (ZBI). Additionally, IwPD were grouped based on disease severity and duration, and their drooling-related quality of life and caregiver burden were compared. Results: Moderate to high positive and significant correlations between SCS-PD, DFSS, and ZBI were found (p<0.05). Participants in the group with longer disease duration and greater severity exhibited higher scores on the outcome measurement tools (SCS-PD, DFSS, ZBI) compared to those in the group with shorter disease duration and lower severity (p<0.01). When comparing the groups with no drooling, moderate drooling, and severe drooling, participants in the severe drooling group showed higher scores on the outcome measurement tools compared to the other two groups (p<0.01). Conclusion: In the present study, relationships were found between drooling and factors such as age, disease duration, and disease severity. These factors influence the drooling frequency and severity, thereby negatively affecting both the drooling-related quality of life of IwPD and the caregiver burden. Therefore, in addition to assessing drooling-related quality of life, caregiver burden should also be evaluated in detail.

Keywords

• parkinson
• drooling
• sialorrhea
• caregiver burden

References

1. Arboleda-Montealegre, G. Y., Cano-de-la-Cuerda, R., Fernández-de-Las-Peñas, C., Sanchez-Camarero, C., & Ortega-Santiago, R. (2021). Drooling, swallowing difficulties and health related quality of life in Parkinson’s disease patients. International Journal of Environmental Research and Public Health, 18(15), 8138. https://doi.org/10.3390/ijerph18158138
2. Armstrong, M. J., & Okun, M. S. (2020). Diagnosis and treatment of Parkinson disease: a review. Jama, 323(6), 548-560. https://doi.org/10.1001/jama.2019.22360
3. Balestrino, R., & Schapira, A. (2020). Parkinson disease. European Journal of Neurology, 27(1), 27-42. https://doi.org/10.1111/ene.14108
4. de Araújo, S. R. S., Castelo, P. M., Said, A. d. V., Fernandes, J. P. S., Neves, C. R., Diaféria, G. L. A., & Bommarito, S. (2023). Orofacial myofunctional assessment and quality of life of individuals with Parkinson's disease. Special Care in Dentistry, 43(4), 425-434. https://doi.org/10.1111/scd.12787
5. Fasano, A., Visanji, N. P., Liu, L. W., Lang, A. E., & Pfeiffer, R. F. (2015). Gastrointestinal dysfunction in Parkinson's disease. The Lancet Neurology, 14(6), 625-639. https://doi.org/10.1016/S1474-4422(15)00007-1
6. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198. https://doi.org/10.1016/0022-3956(75)90026-6
7. Genç, G., & Atalar, M. S. (2023). Reliability and Validity Study of a Turkish Version of the Sialorrhea Clinical Scale for Parkinson’s Disease (SCS-TR). Archives of Neuropsychiatry, 60(1), 49. https://doi.org/10.29399/npa.28053
8. Goetz, C. G., Poewe, W., Rascol, O., Sampaio, C., Stebbins, G. T., Counsell, C., . . . Wenning, G. K. (2004). Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations the Movement Disorder Society Task Force on rating scales for Parkinson's disease. Movement Disorders, 19(9), 1020-1028. https://doi.org/10.1002/mds.20213

9. Goetz, C. G., Tilley, B. C., Shaftman, S. R., Stebbins, G. T., Fahn, S., Martinez‐Martin, P., . . . Dodel, R. (2008). Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): scale presentation and clinimetric testing results. Movement Disorders: Official Journal of the Movement Disorder Society, 23(15), 2129-2170. https://doi.org/10.1002/mds.22340
10. Grün, D., Pieri, V., Vaillant, M., & Diederich, N. J. (2016). Contributory factors to caregiver burden in Parkinson disease. Journal of the American Medical Directors Association, 17(7), 626-632. https://doi.org/10.1016/j.jamda.2016.03.004
11. Kalf, J., De Swart, B., Borm, G., Bloem, B., & Munneke, M. (2009). Prevalence and definition of drooling in Parkinson’s disease: a systematic review. Journal of Neurology, 256, 1391-1396. https://doi.org/10.1007/s00415-009-5098-2
12. Kalf, J. G., Munneke, M., van den Engel‐Hoek, L., de Swart, B. J., Borm, G. F., Bloem, B. R., & Zwarts, M. J. (2011). Pathophysiology of diurnal drooling in Parkinson's disease. Movement Disorders, 26(9), 1670-1676. https://doi.org/10.1002/mds.23720
13. Kalf, J. G., Smit, A. M., Bloem, B. R., Zwarts, M. J., & Munneke, M. (2007). Impact of drooling in Parkinson’s disease. Journal of Neurology, 254, 1227-1232. https://doi.org/10.1007/s00415-007-0508-9
14. Karakoc, M., Yon, M. I., Cakmakli, G. Y., Ulusoy, E. K., Gulunay, A., Oztekin, N., & Ak, F. (2016). Pathophysiology underlying drooling in Parkinson’s disease: oropharyngeal bradykinesia. Neurological Sciences, 37, 1987-1991. https://doi.org/10.1007/s10072-016-2708-5
15. Leibner, J., Ramjit, A., Sedig, L., Dai, Y., Wu, S. S., Jacobson IV, C., . . . Fernandez, H. H. (2010). The impact of and the factors associated with drooling in Parkinson's disease. Parkinsonism & related disorders, 16(7), 475-477. https://doi.org/10.1016/j.parkreldis.2009.12.003
16. Macchi, Z. A., Koljack, C. E., Miyasaki, J. M., Katz, M., Galifianakis, N., Prizer, L. P., . . . Kluger, B. M. (2020). Patient and caregiver characteristics associated with caregiver burden in Parkinson's disease: a palliative care approach. Ann Palliat Med, 9(Suppl 1), S24-33. https://10.21037/apm.2019.10.01
17. Mao, C., Xiong, Y., Wang, F., Yang, Y., Yuan, W., Zhu, C., . . . Liu, C. (2018). Motor subtypes and other risk factors associated with drooling in Parkinson's disease patients. Acta Neurologica Scandinavica, 137(5), 509-514. https://doi.org/10.1111/ane.12893
18. Miller, N., Noble, E., Jones, D., Deane, K. H., & Gibb, C. (2015). Survey of speech and language therapy provision for people with Parkinson's disease in the United Kingdom: patients' and carers' perspectives. International Journal of Language & Communication Disorders, 1-10. https://doi.org/10.3109/13682822.2010.484850
19. Mosley, P. E., Moodie, R., & Dissanayaka, N. (2017). Caregiver burden in Parkinson disease: a critical review of recent literature. Journal of Geriatric Psychiatry and Neurology, 30(5), 235-252. https://doi.org/10.1177/0891988717720302
20. Nascimento, D., Carmona, J., Mestre, T., Ferreira, J. J., & Guimarães, I. (2021). Drooling rating scales in Parkinson's disease: A systematic review. Parkinsonism & Related Disorders, 91, 173-180. https://doi.org/10.1016/j.parkreldis.2021.09.012
21. Nienstedt, J., Buhmann, C., Bihler, M., Niessen, A., Plaetke, R., Gerloff, C., & Pflug, C. (2018). Drooling is no early sign of dysphagia in Parkinson′ s disease. Neurogastroenterology & Motility, 30(4), e13259. https://doi.org/10.1111/nmo.13259
22. Ou, R., Guo, X., Wei, Q., Cao, B., Yang, J., Song, W., . . . Shang, H. (2015). Diurnal drooling in Chinese patients with Parkinson's disease. Journal of the Neurological Sciences, 353(1-2), 74-78. https://doi.org/10.1016/j.jns.2015.04.007
23. Ozdilek, B., & Gunal, D. I. (2012). Motor and non-motor symptoms in Turkish patients with Parkinson’s disease affecting family caregiver burden and quality of life. The Journal of Neuropsychiatry and Clinical Neurosciences, 24(4), 478-483. https://doi.org/10.1176/appi.neuropsych.11100315
24. Özer, N., Yurttaş, A., & Akyıl, R. Ç. (2012). Psychometric evaluation of the Turkish version of the Zarit Burden Interview in family caregivers of inpatients in medical and surgical clinics. Journal of Transcultural Nursing, 23(1), 65-71. https://doi.org/10.1177/1043659611423830
25. Perez Lloret, S., Pirán Arce, G., Rossi, M., Caivano Nemet, M. L., Salsamendi, P., & Merello, M. (2007). Validation of a new scale for the evaluation of sialorrhea in patients with Parkinson's disease. Movement Disorders, 22(1), 107-111. https://doi.org/10.1002/mds.21152
26. Politis, M., Wu, K., Molloy, S., G. Bain, P., Chaudhuri, K. R., & Piccini, P. (2010). Parkinson's disease symptoms: the patient's perspective. Movement Disorders, 25(11), 1646-1651. https://doi.org/10.1002/mds.23135
27. Rajiah, K., Maharajan, M. K., Yeen, S. J., & Lew, S. (2017). Quality of life and caregivers' burden of Parkinson's disease. Neuroepidemiology, 48(3-4), 131-137. https://doi.org/10.1159/000479031
28. Razali, R., Ahmad, F., Abd Rahman, F. N., Midin, M., & Sidi, H. (2011). Burden of care among caregivers of patients with Parkinson disease: a cross-sectional study. Clinical Neurology and Neurosurgery, 113(8), 639-643. https://doi.org/10.1016/j.clineuro.2011.05.008
29. Santos‐García, D., & De la Fuente‐Fernández, R. (2015). Factors contributing to caregivers' stress and burden in Parkinson's disease. Acta Neurologica Scandinavica, 131(4), 203-210. https://doi.org/10.1111/ane.12305
30. Sham, F., Yusoff, Y., Shukri, N. F. H., & Morris, M. (2022). Perceived Social Support, Caregiving Appraisal and Quality of Life among Caregivers of Individuals with Parkinson Disease. https://doi.org/10.26181/20071676.v1
31. Srivanitchapoom, P., Pandey, S., & Hallett, M. (2014). Drooling in Parkinson's disease: a review. Parkinsonism & Related Disorders, 20(11), 1109-1118. https://doi.org/10.1016/j.parkreldis.2014.08.013
32. Thomas-Stonell, N., & Greenberg, J. (1988). Three treatment approaches and clinical factors in the reduction of drooling. Dysphagia, 3, 73-78. https://doi.org/10.1007/bf02412423
33. van Wamelen, D. J., Leta, V., Johnson, J., Ocampo, C. L., Podlewska, A. M., Rukavina, K., . . . Chaudhuri, K. R. (2020). Drooling in Parkinson’s disease: prevalence and progression from the non-motor international longitudinal study. Dysphagia, 35, 955-961. https://doi.org/10.1007/s00455-020-10102-5
34. Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20(6), 649-655. https://doi.org/10.1093/geront/20.6.649