社区居住的帕金森病患者接受专科康复治疗师和康复护理助理联合支持与单纯专科康复治疗及常规护理的比较：一项随机对照试验研究方案。

A comparison of specialist rehabilitation and care assistant support with specialist rehabilitation alone and usual care for people with Parkinson's living in the community: study protocol for a randomised controlled trial.

机构信息

Dept of Economics, University of Surrey, Guildford, Surrey GU2 7XH, UK.

出版信息

Trials. 2011 Nov 23;12:250. doi: 10.1186/1745-6215-12-250.

DOI:10.1186/1745-6215-12-250

PMID:22112960

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3261836/

Abstract

BACKGROUND

Parkinson's Disease is a degenerative neurological condition that causes movement problems and other distressing symptoms. People with Parkinson's disease gradually lose their independence and strain is placed on family members. A multidisciplinary approach to rehabilitation for people with Parkinson's is recommended but has not been widely researched. Studies are needed that investigate cost-effective community-based service delivery models to reduce disability and dependency and admission to long term care, and improve quality of life.

METHODS

A pragmatic three parallel group randomised controlled trial involving people with Parkinson's Disease and live-in carers (family friends or paid carers), and comparing: management by a specialist multidisciplinary team for six weeks, according to a care plan agreed between the professionals and the patient and carer (Group A); multidisciplinary team management and additional support for four months from a trained care assistant (Group B); usual care, no coordinated team care planning or ongoing support (Group C). Follow up will be for six months to determine the impact and relative cost-effectiveness of the two interventions, compared to usual care. The primary outcomes are disability (patients) and strain (carers). Secondary outcomes include patient mobility, falls, speech, pain, self efficacy, health and social care use; carer general health; patient and carer social functioning, psychological wellbeing, health related quality of life. Semi structured interviews will be undertaken with providers (team members, care assistants), service commissioners, and patients and carers in groups A and B, to gain feedback about the acceptability of the interventions. A cost - effectiveness evaluation is embedded in the trial.

DISCUSSION

The trial investigates components of recent national policy recommendations for people with long term conditions, and Parkinson's Disease in particular, and will provide guidance to inform local service planning and commissioning.

TRIAL REGISTRATION

ISRCTN: ISRCTN44577970.

摘要

背景

帕金森病是一种退行性神经疾病，会导致运动问题和其他不适症状。帕金森病患者逐渐失去独立性，给家庭成员带来压力。建议对帕金森病患者采取多学科康复方法，但尚未对此进行广泛研究。需要研究具有成本效益的基于社区的服务提供模式，以减少残疾和依赖，减少长期护理入院，并提高生活质量。

方法

一项实用的三平行组随机对照试验，涉及帕金森病患者和住家护理人员（家庭朋友或付费护理人员），比较以下三组：由专业多学科团队管理 6 周，根据专业人员和患者和护理人员之间达成的护理计划（A 组）；多学科团队管理和来自经过培训的护理助理的 4 个月额外支持（B 组）；常规护理，没有协调的团队护理计划或持续支持（C 组）。随访 6 个月，以确定两种干预措施相对于常规护理的影响和相对成本效益。主要结局是残疾（患者）和压力（护理人员）。次要结局包括患者的移动能力、跌倒、言语、疼痛、自我效能、健康和社会护理使用；护理人员的一般健康；患者和护理人员的社交功能、心理幸福感、健康相关生活质量。将对 A 组和 B 组的提供者（团队成员、护理助理）、服务专员以及患者和护理人员进行半结构化访谈，以获得对干预措施的可接受性的反馈。试验中嵌入了成本效益评估。