1053 — Cognitive, Affective, and Behavioral Dimensions of the Lower Urinary Tract Symptom Experience in Men with Parkinson's Disease

Moriarty HJ (Philadelphia VAMC), Robinson JP (College of Nursing, Rutgers, The State University of New Jersey), Bunting-Perry L (Parkinson's Disease Research, Education, and Clinical Center, Philadelphia VAMC), Dowling-Castronovo AM (College of Nursing, Rutgers, The State University of New Jersey )

Objectives:
Extensive research has focused on motor symptoms of Parkinson’s disease (PD), while nonmotor symptoms, such as lower urinary tract symptoms (LUTS), have received scant attention. Thus, knowledge of LUTS in PD is in a primitive state. To address this gap, we conducted a cross-sectional study using mixed methods to examine the LUTS experience in men with PD.

Methods:
Qualitative findings will be presented that describe cognitive, affective, and behavioral aspects of the LUTS experience in this population. Participants (N=88) were recruited from a PD Center in a VA Medical Center. Eligibility criteria included: self-reported LUTS, diagnosis of PD or parkinsonism, and score of > 25 on the Mini Mental Status Exam. Maximum variation sampling was used to select a diverse subsample (n=11) to participate in audiotaped open-ended interviews concerning their understanding, experience, and management of LUTS. Field notes recorded comments from 5 additional participants and support group members. The template organizing analytic approach was used to glean cognitive, affective, and behavioral aspects of the LUTS experience from transcribed interviews/field notes. Several methods were used to support the trustworthiness of the interview data.

Results:
Participants attributed LUTS to aging, medications, and effects of motor symptoms on their ability to respond to the urge to void. There was little awareness of neurologic contributions of PD to LUTS, and most viewed LUTS as “something that you have to put up with.” Negative effects of LUTS on self-esteem were noted, which jeopardized relationships, participation in social activities, and travel. Affective responses to LUTS, particularly embarrassment, had a profound impact on quality of life. Behavioral strategies to manage LUTS focused on “being prepared to go when you need to go” and consisted mostly of trial and error efforts.

Implications:
Misconceptions about LUTS among men with PD may result in underreporting, missed opportunities for professional assistance, and diminished quality of life.

Impacts:
There is a need to develop and test nursing interventions to improve understanding and management of LUTS in this population.