Psychosocial interventions affecting global perceptions of control in people with Parkinson’s disease: a scoping review

Figures & data

Table 1. Overview of adopted search terms and identified items per database.

Search terms

(Parkinson* disease AND Adaptive control) OR (Parkinson* disease AND Control belief*) OR (Parkinson* disease AND Learn* helplessness) OR (Parkinson* disease AND Loc* of control) OR (Parkinson* disease AND Mastery) OR (Parkinson* disease AND Perceived control) OR (Parkinson* disease AND Perception* of control) OR (Parkinson* disease AND Personal control) OR (Parkinson* disease AND Primary control) OR (Parkinson* disease AND Secondary control) OR (Parkinson* disease AND Self-efficacy) OR (Parkinson* disease AND Symptom* control)

Figure 1. PRISMA diagram for selection of studies.

Vertical flow chart depicting the processes of identification, screening, eligibility, and inclusion of the papers in the review. From 4388 total identified records, 2377 are screened by title and abstract. Following this, 39 full-texts are assessed for eligibility, and 12 are finally included in the review.

Table 2. Operational definitions of intervention types.

Intervention Type	Operational Definition
Cognitive	Interventions which aim to improve individuals’ health-related behaviours and well-being by either: Addressing unhelpful or maladaptive ways of thinking (‘cognitions’) related to one’s beliefs about the world, the self, others, and the future [85,86]. Targeting impairments of specific cognitive processes (e.g., memory, attention) in order to rehabilitate loss of function or develop compensatory strategies, and ultimately improve thoughts, emotions, and behaviours [87].
Educational	Interventions which aim at developing and/or improving patients’ understanding of their own condition (and themselves in relation to it) by providing accessible and digestible information which is then used to build exercises aimed at improving feelings of empowerment, health literacy and promotion, self-monitoring, disease management, and ultimately well-being [88–90].
Mindfulness-based	Interventions which aim to improve individuals’ health-related behaviours and well-being by implementing either one of the following: A tailored programme where mindfulness is adopted both with the intent to (a) promote the self-regulation of attention and its focus on the immediate experience in order to increase one’s awareness of the present moment; (b) change one’s attitude towards the present moment, with the aim to develop qualities such as curiosity, openness, and acceptance [91]. A standardised and already well-established mindfulness-based programme (e.g., Mindfulness-based Stress Reduction, Mindfulness-based Cognitive Therapy; [81,92]).
Physical	Interventions which aim to improve individuals’ health-related behaviours and well-being by promoting the engagement with a range of body activities and exercises, carried out individually or in groups, which involve large and/or fine motor skills for creative, recreational, or fitness purposes [93].

Table 3. Key characteristics of included studies.

Study	Category	Country	Aim	Design	Sample	Intervention	Relevant outcome	Type of outcome	Relevant measures	Type of measure	Key results
[56]	Cognitive	UK	Examine the appropriateness and feasibility of cognitive rehabilitation for people with Parkinson-related dementia	RCT	I: 10 RT: 10 TAU: 9	Goal‐orientated cognitive rehabilitation	Self-efficacy	Secondary	GSE	General	Significant improvement for self-efficacy in the intervention group compared to RT at post-intervention not maintained at 6 months. No change compared to TAU.
[57]	Educational	USA	Test the effects of Chronic Care Model-based Parkinson’s management on quality of care	RCT	I: 162 C: 166	Care Coordination for Health Promotion and Activities in Parkinson’s Disease (CHAPS)	Self-efficacy	Secondary	GSE	General	No significant changes in self-efficacy between groups or within-participants at post-intervention.
[58]	Mindfulness- based	Australia	Test the effects of a mindfulness-based lifestyle program on function and wellbeing of PwP	RCT	I: 35 C: 37	Mindfulness-based lifestyle program	Locus of control	Secondary	MHLC Form B	Multi-domain	Significant difference between groups observed only in internal locus of control at post-intervention, but small effect size (Cohen’s d = 0.28) and not maintained at 6-month follow-up. Relatively high attrition – samples reduced from 35–37 at baseline to 24–33 at post-intervention and 23–25 at 6-month at follow-up.
[59]	Physical	USA	Compare individual and group exercise plus chronic disease self-management on depression in PwP	RCT	I: 15 C: 15	Enhanced EXerCisE thErapy for PD (EXCEED)	Self-efficacy	Secondary	GSE	General	No significant changes in self-efficacy between groups or within-participants at post-intervention.
[60]	Mindfulness- based	Australia	Explore the experiences of PwP participating in a facilitated, group mindfulness-based lifestyle program	Qualitative (thematic – part of Advocat et al. 2016)	12	Mindfulness-based lifestyle programme	General perceived control	N/A	N/A	General	Perceived control identified as a fundamental and pervasive theme. Some PwP suggested they developed a more achievable view of control following the programme. At follow-up, some PwP reported a renewed view of control as part of taking responsibility and ownership over thoughts through mindfulness training.
[61]	Educational	USA	Explore the influence of the Stanford Chronic Disease Self-Management Program on social support in PwP	Non-randomised trial Qualitative (thematic)	I: 27 C: 19	Stanford Chronic Disease Self-Management Program (CDSMP)	Self-efficacy	Secondary	CDSES	Multi-domain	No significant changes in self-efficacy at post-intervention. Increased self-efficacy in accessing resources and addressing disease-related challenges reported by PwP in qualitative interviews.
[63]	Educational	UK	Explore the impact of the First Steps program on the stories of PwP	Qualitative (phenomenological)	18	Peer-led Educational Intervention (‘First Steps’)	General perceived control	N/A	N/A	General	Importance of perceived control, particularly taking control and action to enable living with Parkinson’s, emerged as a subtheme.
[65]	Physical	Norway	Examine the impact of a brief rehabilitation program on functional status, general self-efficacy, and quality of life and related change factors in PwP	Uncontrolled pre-post	83	Rehabilitation programme based on Parkinson Wellness Recovery^®	Self-efficacy	Primary	GSE	General	Significant improvement in self-efficacy of PwP at post-intervention, but small effect size (Cohen’s d = 0.28).
[66]	Physical	USA	Test the effect of a dance program on cognition, depression, and self-efficacy functioning in PwP following a dance program	Uncontrolled pre-post	6	Dance programme (‘Let’s Dance!’)	Self-efficacy	Primary	GSE	General	No significant changes in self-efficacy of PwP at post-intervention.
[68]	Physical	Australia	Evaluate the feasibility and subjective impact of online dance therapy for PwP	Qualitative (thematic)	13	Online dance therapy (ParkinDANCE Online)	Mastery	N/A	N/A	N/A	Increased sense of mastery reported by participants as result of the programme.
[69]	Physical	USA	Explore the potential rehabilitative effect of art therapy in PwP	Uncontrolled pre-post	I: 15 C: 12	Art therapy	Self-efficacy	Secondary	PROMIS SEMCC	Multi-domain	No significant changes in self-efficacy for PwP post-intervention.
[94]	Physical	Canada	Explore the perceived influence of a community-based therapeutic dance program on physical, social and emotional well- being of PwP, and participants’ reasons for attending	Qualitative (content analysis)	10	Therapeutic dance programme	General perceived control Locus of control	N/A	N/A	N/A	Increased sense of control over life and disease and shift to more internal locus of control reported by PwP following the programme.

C: control; CDSES: Chronic Disease Self-Efficacy Scale; GSE: General Self-Efficacy Scale; I: intervention; MHLC Form B: Multidimensional Health Locus of Control Form B; PROMIS SEMCC: Patient-Reported Outcomes Measurement Information System Self-Efficacy for Managing Chronic Conditions; RCT: randomised controlled trial; RT: relaxation training; TAU: treatment as usual.

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