Date of Award


Degree Name

Doctor of Nursing Science


Coping mechanism, nursing, Parkinson's Disease, quality of life, Tolcapone


There is evidence that adjustment to chronic illnesses such as Parkinson's disease (PD) may be affected by psychological factors especially how patients appraise and cope with the stress of their illness. There has been limited research available examining the role of illness impact or appraisal in adjustment to chronic illness. No studies were found dealing with the interrelationship of illness impact, adjustment and pharmacological treatment. The purpose of this study was to determine whether the quality of life (as conceptualized by impact of illness and adjustment) was improved by treatment with tolcapone in persons with Parkinson's disease. This study was done in parallel with a double-blind placebo controlled study of the efficacy and safety of tolcapone. Quality of life was measured by the Sickness Impact Profile (SIP) and adjustment to Parkinson's disease by the Psychosocial Adjustment to Illness Scale (PAIS-SR). Illness impact and adjustment to Parkinson's disease were improved across all treatment groups when compared to patients who received placebo. Total illness impact was significantly improved (p =.003), physical illness impact was significantly improved (p =.05) and psychosocial illness impact was significantly improved (p =.007) in patients who received tolcapone when compared to placebo. Adjustment to illness was not significantly different in the tolcapone group when compared to patients receiving placebo. However a dose related improvement response was found.

Document Type

Dissertation: Open Access



Included in

Nursing Commons