| Learning Objective #1: Gain some insight into the background of the NDT | |||
| Learning Objective #2: Explore the main issues in relation to conducting a study on nursing interventions and apply the effects of the NDT-approach |
Methods: In a prospective, non-randomised, parallel group design, 324 consecutive patients with stroke from 12 Dutch hospitals were included in the study. In the experimental group (N=223), nurses and physical therapists used the NDT-therapy when caring for the patients, whereas conventional therapy was used in the control group (N=101). Functional status was assessed with the Barthel Index; shoulder pain was assessed with a Visual Analogue Scale (VAS), depression was assessed with the Center of Epidemiological Depression Scale and Quality of Life was assessed with the SF-36, SA–SIP 30 and the VAS.
Results: At 12 months 59 (27%) patients in the NDT group had a poor outcome and 24 (24%) in the non-NDT group (corresponding adjusted OR: 1.7, 95% CI 0.8–3.5). At discharge the adjusted odds ratio was 0.8 (95% CI 0.4-1.5) and after six months 1.6 (95% CI 0.8-3.2). No differences in Quality of Life and shoulder pain were found between the treatment groups. After one year less patients were depressed in the NDT group (23%) than in the non NDT group (43%) (adjusted odds ratio 0,56; 95% CI 0.32-0.98).
Conclusion: The current evidence indicates that the NDT-therapy is not beneficial in the acute stage of stroke. Efforts should be undertaken to develop an evidence based rehabilitation method not only focussing on physical functioning of the patient, but also on his psychosocial and behavioural experiences. The effects of such a new approach should be properly assessed prior to the implementation on a large scale.