Parkinson's, employment & quality of life

Parkinson’s is a progressive, neurological condition generally viewed as a disease of the elderly although a large proportion are of working age when diagnosed (15% diagnosed before age 50). Scant attention has been given to employment concerns in the Parkinson’s psychosocial literature. The aim of this research was to explore the work experience of people with Parkinson’s using qualitative and quantitative approaches. The first study comprised interviews with six individuals with Parkinson’s who were working full-time, part-time, or had recently left the workforce. Using a grounded theory approach, the role of work emerged as extremely important in maintaining social participation, a daily routine and sense of purpose. Fatigue, job demands, control, self efficacy and social support (both positive and negative) were identified as the factors most influencing the experience of people with Parkinson’s at work. The second study tested the application of the Job Strain Model (Karasek,1979) to people with Parkinson’s and incorporated these factors as work and personal characteristics specific to this population. One hundred and sixteen working Australians with Parkinson’s (age M = 53.61 years) completed an online survey in relation to their employment subsequent to diagnosis. As predicted, job demands, job control, social support from family and friends, negative social support and self-efficacy were associated with depression. It was hypothesised that, after controlling for age, disease severity and fatigue, the constructs of job demands, job control, self-efficacy and social support (both positive and negative) would predict quality of life and depression. The hypothesis was only partially supported with job demands and self-efficacy emerging as predictors of depression. Self-efficacy buffered the effects of job demands on depression but, contrary to the second and third hypotheses, no other interactive effects were evident. This version of the Job Strain Model adapted to people with Parkinson’s did not fully explain the employment experience of this population but emerged as a valuable tool for future research. The occurrence of depression in people with Parkinson’s who were working was much lower than that found generally in Parkinson’s populations. It was concluded that interventions to improve and maintain employment for people with Parkinson’s need to be targeted at increasing self-efficacy rather than decreasing job demands.