International Journal of Nursing Studies 41 (2004) 515–524 Changing perceptions of womanhood: living with Parkinson’s Disease $ Valerie Fleming*, Debbie Tolson, Elgin Schartau School of Nursing, Midwifery and Community Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, Scotland, UK Received 10 May 2003; received in revised form 7 November 2003; accepted 2 December 2003 Abstract This study adopted a multiple case study design to develop our understanding of the experiences and adjustments made by women with Parkinson Disease in relation to womanhood. Nineteen women participated in this investigation telling their stories through a combination of individual interviews, group interviews, reflective diaries, reflective tapes and creative writing. Data were analysed using the framework of Intrapersonal, Interpersonal, Extrapersonal and Metapersonal health proposed by Boddy and Rice (Perspectives on Health and Illness, Dunsmore Press, Palmerston North, 1992). Women reported that major changes were required in their lives in each of these aspects of health. In particular women reported labile emotions, changing body images, changing lifestyles, changing relationships with partner, family and friends, increasing dependence, decreasing role fulfillment and the need for support versus increasing isolation. The findings are of particular relevance to nurses and other health professionals involved with women with Parkinson’s Disease as well as social services and voluntary agencies. r 2004 Elsevier Ltd. All rights reserved. Keywords: Parkinson’s Disease; Case study; Body image; Relationships; Dependence 1. Introduction and background Parkinson’s Disease is a degenerative neurological condition characterised by slowness of movement, rigidity, abnormalities of posture and tremor of the limbs whilst at rest (Bulpitt et al., 1985). These symptoms frequently give rise to chronic health pro- blems, which require affected individuals to make many adjustments to their lifestyles. Until recently, the condition was commonly regarded as a disease of the elderly. However, in the UK, Parkinson’s Disease is estimated to affect 1 in 500 people in the general population, rising to 1 in 100 in the population aged over 65 years and 1 in 50 people aged over 80 years (Parkinson’s Disease Society, 2001). Parkinson’s Disease has stimulated much medically driven research with research into women with Parkin- son’s focusing mainly on menstruation (Gray et al., 1995) or sexual function (Brown et al., 1990). Research into hormonal influences on Parkinson’s Disease is also emerging but remains inconclusive. Conversely the affects of the condition upon families, particularly those diagnosed under the age of 50 years, are under reported. This has particularly been the case when examining the affects of Parkinson’s Disease upon women of child- bearing age. This phase in any woman’s life is associated with the prospect of intimate relationships, thoughts of fertility and motherhood and other aspects of woman- hood. A survey of 352 American women with Parkinson’s Disease and naturally occurring menstrual cycles sug- gests that hormone changes are a common and ARTICLE IN PRESS $ This study was supported by a grant from The Parkinson’s Disease Society. *Corresponding author. Tel.: +44-141-331-3473; fax: +44- 141-331-8312. E-mail address: v.fleming@gcal.ac.uk (V. Fleming). 0020-7489/$ - see front matter r 2004 Elsevier Ltd. All rights reserved. doi:10.1016/j.ijnurstu.2003.12.004