Abstract
In order to establish effective public health nurse support, the present study assessed motivation during the early stage in patients with Parkinson's disease or spinocerebellar degeneration living at home; 7 patients were interviewed individually in a semi-structured manner. Based on verbatim transcriptions of the interviews, qualitative and descriptive analyses were performed. The results indicated that, among the 9 subcategories of patients, including "patients accept their current disease status and situation," "patients continue to maintain a relationship with others and society," and "patients attempt to carry out their role and responsibilities as much as possible," the patients demonstrated 3 levels of motivation: "As the disease worsens, the patient actively deals with the situation," "The patient is involved socially and interacts with others," and "The patient tries to achieve self-realization by discovering the meaning of the disease." The early-stage patients tried to understand the reality of having an intractable disease and attempted to cope with the presence of the disease through different approaches. These results suggest that such patients should be supported through symptom management, identifying the limitations imposed by their impaired functions, creating opportunities for interaction with others, including patients with the same disease, and by helping the patients find new meaning in their lives, so as to be able to live with their disease. It is necessary to conduct a comprehensive assessment of these patients' motivation. Continuous support measures should be implemented for in-home patients in the early stage of illness, based on the content and level of their motivation.
