Mental health challenges in Parkinson’s disease: a mixed-methods systematic review of experiences in care home settings

Background: Parkinson's disease (PD) encompasses a range of neuropsychiatric symptoms, including depression, anxiety, and cognitive decline, which significantly impair the quality of life for both patients and their families. Despite the increasing awareness of these issues, nursing practice frequently lacks the integration of advanced care models that address the physical and mental health challenges faced by individuals with PD, particularly in nursing home environments.<br/>Methods: A mixed-methods systematic review was conducted, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In September 2024, a comprehensive search of six electronic databases was undertaken. Studies focusing on neuropsychiatric symptoms in individuals with PD residing in nursing homes were included. The initial search yielded 1,192 studies, of which 139 were fully screened, and 12 met the inclusion criteria. Data extraction and quality appraisal were carried out, followed by a narrative synthesis to identify key themes related to nurse-led care models addressing neuropsychiatric symptoms in PD.<br/>Results: Four overarching themes emerged from the systematic review: (1) Prevalence and Impact of Neuropsychiatric Symptoms, (2) Quality of Life and Care Needs, (3) Challenges in Care Provision, and (4) Treatment and Management Outcomes. Neuropsychiatric symptoms were found to be highly prevalent, with many residents experiencing multiple symptoms. Cognitive impairment was noted in over half of the patients, correlating with increased severity of symptoms and caregiver burden. The quality of life was significantly affected by non-motor symptoms, and care needs were substantial, with residents often presenting at more advanced stages of the disease. Key challenges in care provision included insufficient emotional support and limited staff knowledge regarding PD-specific issues.<br/>Discussion: The high prevalence of neuropsychiatric symptoms and cognitive impairment necessitates the development of comprehensive assessment tools and tailored interventions that address both motor and non-motor symptoms.