Unveiling the Multilevel Drivers of Presenteeism in Emergency Nursing: A Qualitative Inquiry Into Health, Work, and Organizational Dynamics.

Parkinson's is the fastest‐growing neurological disorder (Ben‐Shlomo et al. ) and the second most common acquired neurodegenerative disease in the world (Ou et al. ). According to a 2018 Parkinson's UK report based on Clinical Practice Research Datalink primary care data from 2015, approximately 137,000 people in the UK were living with Parkinson's, a number projected to rise to over 168,000 by 2025 (Parkinson's UK ). Hypokinetic dysarthric features are common in Parkinson's, typically characterised by a monotonous speech pattern, reduced loudness, a breathy or hoarse voice quality, an increase in speech rate, rapid repetition of phonemes, and imprecision in consonant production (Atalar et al. ). Additional communication challenges can result from interrelated changes in cognition (Rohl et al. ), language (Liu et al. ) and pragmatics (Montemurro et al. ). Self‐perception ratings suggest around 90% of people living with Parkinson's (plwP) experience some degree of speech‐language change (Miller ). Conversations become difficult because of these communication changes, which often arise in combination with each other (Saldert and Bauer ). Communication difficulties related to Parkinson's impact on people's social communication (Sharma et al. ), and quality of life (Kavya et al. ). Furthermore, family members of plwP describe changes in family roles, decreased wellbeing and increased carer‐burden as a result of Parkinson's‐related communication difficulties (Mach et al. ). Communication difficulties in Parkinson's, therefore, are wide ranging with significant effects—both on plwP and their family members (Thilakaratne et al. ; Wylie et al. ).