Nursing Division, Singapore General Hospital, Singapore.
Int J Nurs Stud. 2014 Jan;51(1):166-74. doi: 10.1016/j.ijnurstu.2013.03.009. Epub 2013 Apr 20.
To conduct a systematic review and critically evaluate the literature on the effectiveness of multidisciplinary interventions to improve quality of life for people with Parkinson's disease.
An electronic search of the following publication databases was performed for records from 1995 to 2011: CINAHL PLUS (EBSCO), Joanna Briggs Institute, Pubmed, Web of Science (ISI), psycINFO, Scopus and Cochrane library. The keywords used were Parkinson's disease, nursing, allied health, doctor, intervention, quality of life, rehabilitation, multidisciplinary team and their various combinations. Key terms were matched to MeSH subject headings and exploded where relevant to include all subheadings and related terms to each key term used. 1808 articles were initially identified based on our selection criteria and the reference list of these articles was hand searched. Nine studies were included after this sifting process and critiqued by two reviewers.
Three randomised controlled trials and 6 non-randomised cohort studies were included. For these studies the level of evidence ranged from the Scottish Intercollegiate Network (SIGN) level of 1- to 2-. The outcome measures assessed were heterogeneous, including measures of disability of disease, stage of disease and various quality of life measures.
The evidence quantifying positive and sustained effects of multidisciplinary interventions to improve quality of life for people with Parkinson's disease is inconclusive. There has been relative lack of controlled experimentation to quantify therapy outcomes. The studies reviewed were varied and lacked long-term follow-up to quantify retention of the intervention. It is recommended that interventions to improve quality of life are tested in randomised controlled trials using standardised outcome measures, adequately powered samples and longer follow-up periods to assess intervention sustainability.
系统评价并批判性评估有关多学科干预措施改善帕金森病患者生活质量的文献。
对以下出版物数据库进行电子检索，以获取 1995 年至 2011 年的记录：CINAHL PLUS（EBSCO）、 Joanna Briggs 研究所、PubMed、Web of Science（ISI）、PsycINFO、Scopus 和 Cochrane 图书馆。使用的关键词是帕金森病、护理、辅助健康、医生、干预、生活质量、康复、多学科团队及其各种组合。将关键词与 MeSH 主题词匹配，并在相关情况下展开，以包括每个关键词的所有副标题和相关术语。根据我们的选择标准，最初确定了 1808 篇文章，并对这些文章的参考文献进行了手工搜索。经过筛选过程，有 9 项研究被纳入并由两位评审员进行了评估。
纳入了 3 项随机对照试验和 6 项非随机队列研究。这些研究的证据水平从苏格兰校际网络（SIGN）的 1 级到 2 级不等。评估的结果指标各不相同，包括疾病残疾程度、疾病阶段和各种生活质量指标。
量化多学科干预措施改善帕金森病患者生活质量的积极和持续效果的证据尚无定论。相对缺乏控制试验来量化治疗效果。综述的研究各不相同，缺乏长期随访来量化干预措施的保留。建议使用标准化的结果测量、充足的样本量和更长的随访期，在随机对照试验中测试改善生活质量的干预措施，以评估干预措施的可持续性。
