Health-related quality of life in PD patients in northeastern Sicily, Italy

Bronfenbrenner's ecological systems theory emphasizes the development of a series of nested environment systems with which an individual interacts.

These systems interact with the individual, and also affect the development of the individual. The theory is that the natural environment is the major source influencing human development, which is often ignored by scholars in the laboratory. U Brofenbrenner saw the individual's experience "as a set of nested structures, each inside the next, like a set of Russian dolls". In other words, the individual develops in the middle of several environmental systems from the immediate environment (like the family) to indirect environmental (like broad culture) or nested therein.

This ecological framework can provide a better understanding of the implications of Parkinson's disease. Parkinson's disease has a negative impact on health-related quality of life in Parkinson's disease patients. Depression, cognitive impairment, coping strategies, dyskinesia, gait disorders and complications of dopaminergic drugs are the variables that most affect health-related quality of life. Letteria Spadaro and colleagues from Italy applies the ecological model of human development which focuses attention on both individual and social environmental factors as targets for health interventions. Their results suggest a potential compounding effect of ecological intrapersonal and interpersonal levels on health-related quality of life outcomes. Gender, self-evaluated autonomy and family size significantly impacted health-related quality of life. If quality of life is used as an indicator of treatment outcomes, an ecological perspective of the case history will be important to disclose relevant prognostic information and trigger personalized health care interventions. These research achievements were published in the Neural Regeneration Research (Vol. 8, No. 17, 2013).