Evaluation of a nurse-led multidisciplinary neurological rehabilitation programme using the Nottingham Health Profile

Abstract

Objective: To ascertain whether or not an inpatient multidisciplinary treatment programme for patients with Parkinson's disease or multiple sclerosis resulted in a measurable change in patients' health-related quality of life (HRQL).

Design: Assessments of HRQL were made one week before adm ssion and approximately one month post discharge.

Setting: Six-bed Neurological Rehabilitation Unit at Worthing Hospital on the south coast of England.

Subjects: Fifty-eight patients with Parkinson's disease and 33 patients with multiple sclerosis.

Interventions: All patients received an individually adapted, multidisciplinary rehabilitation programme. The programmes lasted from 5 to 10 days.

Main outcome measures: HRQL scores on the Nottingham Health Profile Part 1 (NHP-1).

Results: Overall post-treatment NHP-1 scores were significantly better than overall pretreatment scores for both the Parkinson's group (z= 2.6, p <0.01) and the multiple sclerosis group (z = 2.1, p <0.05). Sixty-four per cent of patients perceived an overall improvement. The strongest improvement was in 'physical mobility' in the multiple sclerosis group (z = 3.0, p <0.01) and in 'emotional reactions' in the Parkinson's group (z = 2.9, p <0.01).

Conclusions: These results suggest that the multidisciplinary inpatient approach in neurological rehabilitation has identifiable short-term benefits for the majority of patients. A randomized trial with longer follow-up is required to confirm this.