Impact of surgical and orthotic intervention on the quality of life of people with profound intellectual and multiple disabilities and their carers

The increasing analysis of quality of life issues for people with disabilit ies has not been paralleled in relation to people with profound intellectua l and multiple disabilities (PIMDs). This is nowhere more the case than wit h regard to the impact of health status on their quality of life. In additi on, people with PIMDs, and the interventions which they require, have not b een included within wider considerations of the economics of healthcare and its relation to rational decision-making regarding medical provision. The present exploratory study considered the impact of a wide range of surgical and orthotic interventions on the quality of life of 27 children and adult s with PIMDs. These were explored on a pre-post-test basis with respect to: (1) the economic costs associated with surgical and orthotic interventions ; (2) clinical assessment of function and behaviour; (3) the participants' and carers' quality of life; and (4) carer satisfaction with the interventi ons. The results are presented with respect to these individual areas and t he extent to which the findings are congruent. The need for the development of these measures to meet the specific requirements of this population and the development of a more formal model integrating these steps are conside red.