多学科综合护理对帕金森病患者健康相关生活质量和帕金森病统一评定量表的影响的荟萃分析。
A meta-analysis of the effect of multidisciplinary comprehensive care on health-related quality of life and Unified Parkinson's Disease Rating Scale in Parkinson's disease.
机构信息
School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, China.
Emergency Department,The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China.
出版信息
Adv Clin Exp Med. 2023 Jun;32(6):623-631. doi: 10.17219/acem/157241.
INTRODUCTION
According to many reports, multidisciplinary comprehensive care alleviates Parkinson's disease (PD) more frequently than any other standard care, though the results were found to vary greatly.
MATERIAL AND METHODS
A systematic literature search up to July 2022 was performed and 1234 related studies were evaluated. The chosen studies comprised 1115 subjects with PD who participated in baseline trials; 633 of them were under multidisciplinary comprehensive care, while 482 were under standard care. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (95% CIs) were calculated to measure the results of multidisciplinary comprehensive care for PD by the contentious and dichotomous approaches with a random or fixed influence model employed.
RESULTS
The use of multidisciplinary comprehensive care resulted in significantly better health-related quality of life (HRQL) (MD: -3.17; 95% CI: -5.98--0.35, p = 0.03) and Unified Parkinson's Disease Rating Scale (UPDRS) score (MD: -5.25; 95% CI: -10.14--0.37, p = 0.04) compared to the standard care for subjects with PD. Nevertheless, no significant difference was found between multidisciplinary comprehensive care and standard care for subjects with PD regarding medication dosage (MD: 0.31; 95% CI: -0.72-1.34, p = 0.56) and caregiver strain (MD: -0.51; 95% CI: -1.69-0.67, p = 0.40).
CONCLUSION
Outpatient multidisciplinary comprehensive care models may improve patient-reported HRQL and UPDRS score; nevertheless, no significant difference was found in terms of medication dosage and caregiver strain compared to the standard care for subjects with PD. The small sample size of 2 out of 7 analyzed studies and the small number of studies in certain comparisons requires attention when analyzing the results.
简介
根据许多报告，多学科综合护理比任何其他标准护理更能缓解帕金森病（PD），尽管结果差异很大。
材料和方法
系统地检索了截至 2022 年 7 月的文献，并评估了 1234 项相关研究。所选研究包括 1115 名参加基线试验的 PD 患者；其中 633 名接受多学科综合护理，482 名接受标准护理。采用随机或固定影响模型，通过有争议的和二分法方法计算比值比（ORs）和均数差值（MDs）及其 95%置信区间（95%CI），以衡量多学科综合护理对 PD 的效果。
结果
与标准护理相比，多学科综合护理可显著改善 PD 患者的健康相关生活质量（HRQL）（MD：-3.17；95%CI：-5.98--0.35，p=0.03）和统一帕金森病评定量表（UPDRS）评分（MD：-5.25；95%CI：-10.14--0.37，p=0.04）。然而，对于 PD 患者，多学科综合护理与标准护理在药物剂量（MD：0.31；95%CI：-0.72-1.34，p=0.56）和照顾者负担（MD：-0.51；95%CI：-1.69-0.67，p=0.40）方面无显著差异。
结论
门诊多学科综合护理模式可能会改善患者报告的 HRQL 和 UPDRS 评分；然而，与 PD 患者的标准护理相比，在药物剂量和照顾者负担方面没有显著差异。在分析结果时，需要注意 7 项分析研究中有 2 项研究的样本量较小，某些比较研究数量较少。
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