Trend Patrick, Kaye Julie, Gage Heather, Owen Charles, Wade Derick
Royal Surrey County Hospital, Guildford, UK.
Clin Rehabil. 2002 Nov;16(7):717-25. doi: 10.1191/0269215502cr545oa.
To evaluate the short-term effectiveness of an intensive multidisciplinary rehabilitation programme for people with Parkinson's disease and their carers.
Observational, with assessments before and after intervention.
An elderly care day unit in a district general hospital in south-east England.
One hundred and eighteen people with Parkinson's disease and no cognitive impairment, and their carers.
Participants attended the day hospital in groups of six patients with their carers for one day per week over six consecutive weeks. After assessment, they received individual treatment from a specialist team. Weekly group activities included relaxation and talks from experts.
Patients and carers were assessed for: health-related quality of life, psychological well-being, social services need, perceptions of the programme. Patients were additionally assessed for mobility, gait and speech. Carers were assessed for strain.
After treatment significant improvements were recorded in patients' mobility and gait (p < 0.05), speech (p < 0.001), depression (p = 0.029), health-related quality of life (p = 0.001). People with more advanced disease at baseline gained significantly more from treatment (p < or = 0.04). Carers were less depressed and had higher health-related quality of life than patients at baseline (p < 0.001) and no improvements in these indicators were recorded after treatment. A high unmet need for social services was identified in 31% of participants, and 10% of carers were found in danger of being unable to continue caring. Participants reported knowledge gains and high levels of satisfaction with both individual therapies and group activities.
This intensive co-ordinated programme provided immediate benefits to people with Parkinson's disease and their carers.
评估针对帕金森病患者及其照料者的强化多学科康复计划的短期效果。
观察性研究，在干预前后进行评估。
英格兰东南部一家区综合医院的老年护理日间病房。
118名无认知障碍的帕金森病患者及其照料者。
参与者以每组6名患者及其照料者的形式，连续六周每周一天到日间医院就诊。评估后，他们接受了专家团队的个体化治疗。每周的小组活动包括放松练习和专家讲座。
对患者和照料者进行以下评估：与健康相关的生活质量、心理健康、社会服务需求、对该计划的看法。此外，对患者的行动能力、步态和言语进行评估。对照料者的压力进行评估。
治疗后，患者的行动能力、步态（p < 0.05）、言语（p < 0.001）、抑郁（p = 0.029）、与健康相关的生活质量（p = 0.001）均有显著改善。基线时病情较重的患者从治疗中获益更多（p ≤ 0.04）。与基线时的患者相比，照料者的抑郁程度较低，与健康相关的生活质量较高（p < 0.001），治疗后这些指标未出现改善。31%的参与者表示对社会服务有较高的未满足需求，10%的照料者面临无法继续照料的风险。参与者表示在知识方面有所收获，对个体化治疗和小组活动都非常满意。
这一强化协调计划为帕金森病患者及其照料者带来了即时益处。
