Factors Associated With Demoralization in Patients With Parkinson's Disease

Parkinson's disease is a chronic, progressive neurodegenerative disorder commonly affecting adults. Demoralization refers to a state characterized by feelings of hopelessness, helplessness, existential distress, a persistent sense of inadequacy, or a perceived inability to meet personal or societal expectations.

This study aimed to identify factors associated with demoralization in patients with Parkinson's disease.

We conducted a cross-sectional study using consecutive sampling. Participants were recruited from the neurology ward and outpatient neurology clinic of a single medical center in Taiwan. A total of 120 patients with Parkinson's disease and their caregivers were enrolled. Psychological well-being was assessed using the Demoralization Scale (DS), the Hospital Anxiety and Depression Scale-Depression subscale, the Hospital Anxiety and Depression Scale-Anxiety subscale, the Brief Fatigue Inventory, and the Explanatory Model Interview Catalogue.

Of the 120 patients, 58.3% were male. Higher levels of depression (P = 0.032) and anxiety (P = 0.021) in patients, as well as higher anxiety levels in caregivers (P = 0.015), were significantly associated with demoralization. Structural equation modeling revealed that patient depression severity was significantly associated with both patient anxiety (P < 0.001) and caregiver anxiety (P < 0.001). In addition, both patient and caregiver anxiety were significantly associated with the severity of demoralization in patients (P < 0.001).

Early identification and management of factors related to demoralization may help reduce existential distress, improve coping strategies, and enhance the overall quality of life for patients with Parkinson's disease.