CUIDADOS DE ENFERMAGEM EM IDOSOS COM DOENÇA DE PARKINSON: UMA REVISÃO SISTEMÁTICA COM METANÁLISE

Abstract

Population aging has accelerated worldwide and in Brazil, leading to a substantial increase in the number of older adults and a corresponding shift in disease patterns, characterized by a growing burden of chronic noncommunicable and neurodegenerative conditions. Among these, Parkinson’s disease (PD) is the second most prevalent neurodegenerative disorder in later life and is associated with functional impairment, reduced quality of life, and increasing dependence. In this context, nurses play a pivotal role in care coordination, health education, rehabilitation, and support for people living with PD and their caregivers. However, evidence regarding the effectiveness of nursing interventions remains fragmented. This study aimed to evaluate the effectiveness of nursing interventions for older adults with Parkinson’s disease on clinical, functional, and quality-of-life outcomes through a systematic review and metaanalysis. A systematic review with meta-analysis was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA Statement. The protocol was registered in PROSPERO (CRD420251007372). Searches were performed in CENTRAL, MEDLINE/PubMed, EMBASE, CINAHL, and Web of Science. Study selection, data extraction, and methodological procedures were conducted independently by two reviewers. Quantitative synthesis was performed using random-effects models, with assessment of heterogeneity, publication bias, and subgroup analyses. Meta-analyses were conducted in R software using standardized mean differences (SMDs). Twelve studies published between 2002 and 2024 were included, representing diverse healthcare settings. The identified nursing interventions were grouped into five main categories: telenursing and remote monitoring, home-based care with interdisciplinary coordination, educational and psychosocial interventions, rehabilitation-focused care aimed at improving functional performance, and advance care planning and palliative care. Meta-analysis demonstrated a moderate and statistically significant effect of nursing interventions on motor function (SMD = −0.59; 95% CI: −0.93 to −0.25; p < 0.001), with no observed statistical heterogeneity (I² = 0%). No statistically significant effects were found for quality of life (SMD = 0.02; 95% CI: −0.09 to 0.13; p = 0.707) or depressive symptoms (SMD = −0.19; 95% CI: −0.52 to 0.14; p = 0.252), although heterogeneity remained low (I² = 0%). Nursing interventions appear to improve motor function in older adults with Parkinson’s disease, particularly when delivered through structured, continuous, and person-centered care models. However, their effects on quality of life and depressive symptoms remain inconclusive. Further studies with greater methodological standardization and more robust intervention protocols are needed to strengthen the evidence base for nursing care in Parkinson’s disease.