Joanne Harmon

Background: Pain in Parkinson's disease (PD) manifests clinically in a variety of ways and several pain types have been identified, however, their characteristics have not been extensively studied. Objective: To describe the characteristics of common pain types in people with PD. Methods: A survey of people with PD that experience pain symptoms was conducted. Participants were recruited using a combination of sampling methods. The survey questions focused on collecting information about the topographical, sensory, and temporal characteristics of pain. Descriptive statistics were used to report results. Results: Two hundred and sixteen participants were included in the data analyses. A median of 5 (interquartile range [IQR] 4–7) pain types were experienced by participants. Pain was commonly localized in the lower limbs but often affected several different body segments. Acute attacks of pain were characteristic for many participants in most pain types and were typically frequent (two to six times per week or more) and prolonged (minutes to hours). Periods of pain accentuation were most likely to occur in the morning, evening, and night and appear to be associated with PD medication pharmacology and a variety of exacerbating and ameliorating factors. Fluctuations in pain were found to range from mild to severe in all pain types. Conclusions: This study makes a valuable contribution to the existing literature by providing the most detailed assessment of the topographical, sensory, and temporal characteristics of common PD pain types to date that may be used to guide clinical diagnosis and treatment.

Purpose: Pain is a common, debilitating, and complex non-motor symptom of Parkinson’s disease (PD), often requiring input from healthcare providers across various disciplines for effective management. The aims of this study were to explore the perspectives of people with PD on the provision of pain care services. Methods: A qualitative descriptive research methodology employing a maximum variation sampling strategy was used to recruit people with PD, living in Australia. Data were collected using individual, semi-structured interviews and analyzed thematically. To ensure trustworthiness, the study was conducted and reported in accordance with the Standards for Reporting Qualitative Research guidelines. Results: Eighteen participants (10 female), with a median age of 71 years (IQR 68– 77), shared their perceptions of the provision of PD pain care services. Thematic analysis of interview data resulted in five themes: empathy and understanding (care); acknowledging needs and concerns (listening); explaining diagnoses and treatment options (explaining); expertise in PD (knowledge); and responding to needs with tailored solutions (individualization). Participants’ experiences were influenced by the presence, or the lack thereof, of these elements during clinical encounters. Furthermore, participants noted that these features were expressed to varying extents by different types of healthcare providers (neurologists, general practitioners, allied health professionals, and PD nurse specialists), which led to differing perceptions of the quality of pain care services. Conclusion: The findings show that perceptions of pain care are influenced by a healthcare provider’s ability to address both the emotional and physical needs of PD patients. The variability observed in participants’ experiences highlights the need to ensure that all healthcare providers involved in PD pain care are equipped to deliver empathetic, individualized, patient-centered care that addresses the complex and multifaceted needs of this population.

Background: While Parkinson’s disease (PD) is primarily recognized for its motor symptoms, several non‐motor symptoms may also be present. Among these, pain is one of the most common and debilitating, arising from complex neurophysiological mechanisms that often interact with motor symptoms and comorbidities, leading to a diverse range of clinical presentations. Although a variety of pharmacological and nonpharmacological therapies are used to manage pain in PD, the factors influencing treatment practices remain underexplored, particularly within the Australian healthcare context. This study, therefore, aimed to explore, from the patients’ perspective, factors that influence pain management practices among people with PD living in Australia. Methods: A qualitative descriptive research methodology using a maximum variation sampling strategy was used to recruit people with PD, living in Australia. Data were collected using individual, semistructured interviews and thematically analyzed. Results: 18 participants shared their perspectives on the factors that influenced their pain management practices. Thematic analysis of interview data resulted in four themes: (1) recommendations from trusted sources; (2) explorative experimentation and solution seeking; (3) intervention and service provider characteristics; and (4) personal beliefs and abilities; and several subthemes. These findings highlight the complex nature of therapeutic decision‐making from the perspective of people with PD, underscoring the interaction between external and internal influences. Conclusion: There is complexity and nuance in how people with PD make decisions about managing their pain. External and internal factors seem to influence therapeutic decision‐making, while also highlighting notable gaps in the provision of PD pain care services. Understanding these complexities will be critical in developing accessible, effective, and patient‐centered approaches to pain management within this population.

The article “Coronavirus disease 2019 (COVID-19) Critical Care Essentials course for nurses: development and implementation of an education and implementation of an education program for healthcare professionals” reviews the learning experience of rapidly upskilling registered nurses (RNs) for redeployment into critical care duties during the COVID-19 pandemic, via online education. Whilst respondents were favourable to the online educational model, Jordan et al. (2020) have overlooked the reality and importance of synthesising learning in the clinical practice environment when transitioning RNs into critical care for the first time. Redeployed nurses may feel under-prepared despite online education prior to redeployment. In response to: Jarden R, Scanlon A, Bridge N, McKeever S, Turner R, Prescott H, et al. Coronavirus disease 2019 Critical care Essentials course for nurses: development and implementation of an educational program for healthcare professionals. Aust J Adv Nurs. 2022;39(1):34-43. Available here: https://doi.org/10.37464/2020.391.423

Aims This study presents an ethnographic insight into the older hospitalized persons’ experiences on how nurses provide pain care provision. The older persons’ perceptions of culturally mediated barriers and facilitators are presented. Design Focused ethnography. Methods Multi‐site across eight acute care units within two tertiary referral hospitals on the east coast of Australia collected over a one‐year period from 2014 to 2015. Semi‐structured interviews (n = 12) of older persons (11 hr). Twenty‐three (23) semi‐structured interviews with nine (9) registered nurses (12 hr 38 min). Participant observation (1,041 hr) during day, night and evening shifts. Results The older person experienced disjunction within pain assessment by the reliance of nurses on objective measurement gained during functional task completion. Tension emerged during pain management when the older person was not included and/or options provided were not deemed effective. For some older persons this meant they undertook a decision to exclude their nurse from involvement in pain management. A thread woven throughout was a lack of communication, continuity of care and input from the older person. Conclusion This study has implications for the provision of nursing care of the older hospitalized person. Dissonance within pain care provision for the older person occurs during episodes of missed pain care. Understanding and insight is gained into aspects of missed communication opportunities between nurses and the experiences of missed pain care of the older person.