SEARCH · Search PubMed
Results for “Home Visits”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Child-focused single home visiting.
Home visiting is a central, long-standing, and yet theoretically underdeveloped public health nursing process. The general aim of this study was to expand and refine a preliminary model of home visiting. A stylized field research investigation was conducted in the area of maternal-child health with one nurse in a visiting nurse association in New England. A specific type of home visiting, identified as child focused, emerged, with phases labeled as surveying and designating; selling and scheduling; approaching the home and the visit; entering the home; gaining permission to ask questions and access the infant--starting with the mother's expressed concerns; making the caregiving judgment--asking questions and weighing and examining the infant; and ending the visit. "Haunting and telling" was an additional phase for certain visits. The nurse conducted child-focused home visiting in three patterns. The single pattern is described in this article. Potential maternal, child, interactive, and environmental consequences were identified, as were factors influencing the process of maternal-child home visiting. Social exchange theory emerged as useful in describing how the nurse initiated, maintained, and ended the home visiting process, and in describing attendant client consequences.
Client characteristics associated with not keeping appointments for public health nursing home visits.
Home visits have been identified as an intervention strategy for high-risk pregnant women. A necessary component of this intervention strategy is for the women to be home for the visit with the nurse. The purpose of this study was to identify factors associated with women not keeping their home visit appointments with a public health nurse. Subjects were 232 low-income high-risk pregnant women who received at least one home visit by a public health nurse. Younger age, more stressful life events, receipt of medical assistance, inadequacy of prenatal care, noncompliance with health recommendations, and longer gestational time were associated with not keeping public health nursing appointments. While this study provides some insight into the factors associated with women not keeping their appointments with the public health nurse, further investigation is warranted to identify strategies to reduce the incidence of not-kept appointments.
Effects of home visits by home nurses to elderly people with health problems: design of a randomised clinical trial in the Netherlands [ISRCTN92017183].
BACKGROUND: Preventive home visits to elderly people by public health nurses aim to maintain or improve the functional status of elderly and reduce the use of institutional care services. A number of trials that investigated the effects of home visits show positive results, but others do not. The outcomes can depend on differences in characteristics of the intervention programme, but also on the selection of the target population. A risk group approach seems promising, but further evidence is needed. We decided to carry out a study to investigate the effects in a population of elderly with (perceived) poor health rather than the general population. Also, we test whether nurses who are qualified at a lower professional level (home nurses instead of public health nurses) are able to obtain convincing effects. The results of this study will contribute to the discussion on effective public health strategies for the aged. METHODS/DESIGN: The study is carried out as a parallel group randomised trial. To screen eligible participants, we sent a postal questionnaire to 4901 elderly people (70-84 years) living at home in a town in the south of the Netherlands. After applying inclusion criteria (e.g., self-reported poor health status) and exclusion criteria (e.g., those who already receive home nursing care), we selected 330 participants. They entered the randomisation procedure; 160 were allocated to the intervention group and 170 to the control group. The intervention consists of (at least) 8 systematic home visits over an 18 months period. Experienced home nurses from the local home care organisation carry out the visits. The control group receives usual care. Effects on health status are measured by means of postal questionnaires after 12 months, 18 months (the end of the intervention period) and after 24 months (the end of 6-months follow-up), and face-to-face interviews after 18 months. Data on mortality and service use are continuously registered during 24 months. A cost-benefit analysis is included. The design and setting of the study, the selection of eligible participants and the study interventions are described in this article. Other included items are: the primary and secondary outcome measures, the statistical analysis and the economic evaluation.
Does closing branch surgeries affect home visiting?
Home visiting rates in a rural general practice were compared for 12 months before and 12 months after five branch surgeries were closed. In villages whose surgeries were closed no statistically significant change occurred in the new or repeat visiting rates. The consulting rate at the main surgery remained constant over the two years. Although visiting rates to villages that had had a branch surgery did not change after the closures, the pattern of visiting to these villages became more rational.
Why home visits? Analysis of 142 planned home visits.
The functions of the traditional home visit in practice and teaching are controversial. A different kind of planned home visit was developed and implemented as part of orientation of first-year family practice residents. The objectives were to get acquainted and establish communications; to facilitate observational skills and awareness of the community; and to improve research parameters of the family record. This kind of home visit is feasible: all residents participated; 92.2 percent of families participated of whom 90.8 percent responded to a follow-up questionaire. Communication patterns between doctor and patient/family were analyzed for skills at listening and speaking clearly. Poor communication was infrequent, occuring in only 8 to 12 percent of the encounters. Ethnic differences between family and resident were important in such visits.
Psychosocial home visits in cancer treatment: a qualitative study on the content of home visits.
As an initial part of a large randomized psychosocial intervention study on the effect of home visits to Danish patients with colorectal cancer, a qualitative interview study was performed to investigate how these home visits should be carried out. The study included 21 informants, consisting of a of patients with colorectal cancer, an of patients with breast cancer who had previously received home visits in another project, a of volunteers performing home visits, and a of researchers in the field of home visiting. The results of qualitative semistructured interviews were compared and analyzed. Common themes were identified and placed in a paradigm model. Respect for the patient as a fellow human being was a prerequisite for ensuring confidence and was chosen as the core category in the analysis. The analysis suggested that visits to patients' homes resulted in better balanced contacts than did visits at hospitals. Most patients requested personal involvement and continuity from their visitors, preferably a healthcare professional capable of providing health information and practical help. In conclusion, we expect that coping with the consequences of a diagnosis of cancer will be improved when patients are regarded as individuals rather than as objects. Home visits may facilitate this process.
Is home visiting an effective strategy? A meta-analytic review of home visiting programs for families with young children.
Home visiting programs for families with young children have been in effect for many years; however, this is the first comprehensive meta-analytic effort to quantify the usefulness of home visits as a strategy for helping families across a range of outcomes. Sixty home visiting programs contributed data to analysis within 5 child and 5 parent outcome groups. Standardized effect sizes were computed for each end-of-treatment outcome measure, for each treatment versus control contrast. Weighted mean standardized effect sizes ranged from -.043 to.318; 6 of the 10 significantly differed from 0. No one program characteristic consistently affected effect sizes across outcome groups. The extent to which these findings have practical use for the field is discussed.
Home visits to prevent nursing home admission and functional decline in elderly people: systematic review and meta-regression analysis.
CONTEXT: The effects of home visitation programs to prevent functional decline in elderly persons have been inconsistent, and the value of these programs is controversial. OBJECTIVE: To evaluate the effect of preventive home visits on functional status, nursing home admission, and mortality. DATA SOURCES: Studies published in English, French, German, Italian, or Spanish reporting randomized trials of the effects of preventive in-home visits in older people (mean age >70 years) living in the community were identified through searches of MEDLINE, PSYCHINFO, and EMBASE (January 1985--November 2001). We also searched the Cochrane Controlled Trials Register, checked reference lists of earlier reviews and book chapters, searched conference proceedings and specialty journals, and contacted experts. STUDY SELECTION: We screened 1349 abstracts and excluded those that did not test in-home interventions or in which the mean age of the study population was younger than 70 years. After further exclusions, 17 articles describing 18 trials were analyzed. DATA EXTRACTION: Two reviewers independently screened abstracts. Discrepancies were resolved by consensus with a third reviewer. For each included trial, we extracted data on the study population and the characteristics of the intervention. Two of us extracted information on 3 end points: nursing home admissions, mortality, and functional status. One of us assessed trial quality, including an examination of the method of randomization, blinding of caregivers and research staff ascertaining outcomes, and proportion of patients included in analyses of the 3 end points. DATA SYNTHESIS: The 18 trials included 13 447 individuals aged 65 years and older. The effect on nursing home admissions depended on the number of visits performed during follow-up. The pooled relative risk (RR) was 0.66 (95% confidence interval [CI], 0.48-0.92) for trials in the upper tertile (>9 visits) but was 1.05 (95% CI, 0.85-1.30) in the lower tertile (0-4 visits). Functional decline was reduced in trials that used multidimensional assessment with follow-up (RR, 0.76; 95% CI, 0.64-0.91) but not in other trials (RR, 1.01; 95% CI, 0.92-1.11). Functional decline was reduced (RR, 0.78; 95% CI, 0.64-0.95) in trials with a control group mortality rate in the lower tertile (3.4%-5.8%) but not (RR, 0.98; 95% CI, 0.84-1.13) in those with a control-group mortality rate in the upper tertile (8.3%-10.7%). A beneficial effect on mortality was evident in younger study populations (RR, 0.76; 95% CI, 0.65-0.88 for ages 72.7-77.5 years) but not in older study populations (RR, 1.09; 95% CI, 0.92-1.28 for ages 80.2-81.6 years). CONCLUSION: Preventive home visitation programs appear to be effective, provided the interventions are based on multidimensional geriatric assessment and include multiple follow-up home visits and target persons at lower risk for death. Benefits on survival were seen in young-old rather than old-old populations.
Benefits of dietitian home visits.
The home health-care client's nutrition needs have increased because of the acuity of his or her medical problems and nutrition-related diagnoses upon release from the hospital. In the home health-care industry, nutrition services have been addressed most often by the nursing profession and to a lesser degree by the dietetics profession. To promote dietitians' skills to a home health-care agency, benefits of nutrition services must be identified. A survey of home health-care nurses showed that 11 of 16 respondents were not confident teaching complex diets (eg, diet for diabetes). Furthermore, 5 of the 16 respondents stated that they were not qualified to teach complex diets. Home health-care nurses might require assistance by a dietitian in addressing complex nutrition issues. The client would benefit as a result of receiving comprehensive nutrition services by a trained professional. A second benefit is that reimbursement of nutrition home visits can be a source of agency revenue. The home health-care agency could also use dietitians as a marketing tool to potentially increase physician referrals. The Home Health Visiting Nurse Association generated $32,483 in agency revenue over 1 year because a dietitian was employed to provide home visits. Alliances should be formed among home health-care administrators and nursing and dietetics professionals to promote high-quality, cost-effective nutrition care for the homebound client.
A home visitation program welcomes home first-time moms and their infants.
This article describes a creative maternal and infant home visiting program for first-time parents. Two-year outcomes indicate the program improved parents' infant safety knowledge, positively affected the mother's decision to breastfeed, and promoted infant primary care visits in a cost-effective way.
[A study of the satisfaction of public health nurses on home visiting service].
"Home visit" expands its service from previous health maintenance to current continuous health care. It is always one of the popular methods of public health nurses in approaching their community population. Currently, home visit is still an important task for public health nurses in health stations. The purpose of this study was to explore the satisfaction among public health nurses in home health services. In addition, related factors that influence the satisfaction were to be explored. A structured questionnaire was used for data collection. In this study, the interviewees were 67 public health nurses in 11 health stations in Kaohsiung. Factor analysis was used to study the components of the satisfaction. There were five components of satisfaction: (1) administrative policy of the agencies, (2) sense of frustration and accomplishment when encountering clients' health problems, (3) clients' responses, (4) support system and availability of equipment, and (5) self assertiveness and cultivation of professional capacity. We found in this study that the percentage satisfaction among public health nurses was around 60%. The working years of nursing was significantly correlated with satisfaction of public health nurses.
[Age and development related changes in counseling priorities for pediatric home visits].
More home visits should be made in the context of prophylactic care for children up to three years of age, in order to come to grips with problems of child development likely to results from the inadequate knowledge and experience of parents and to promote age-adjusted motivation for the undisturbed development of their children. In this sense home visits can be an effective approach to primary prevention and a contribution to harmonious development in childhood. The priorities of counselling and their content are subject to change, depending on the age and development of the children involved. Examples are given of age-adjusted stimulation of development for one-year-old children. They are based on results of empirical investigations conducted between 1984 and 1987.
Implementing nurse home visitation programs.
Nurse home visitation has been an important component of public health for over 100 years. Recent reports of large clinical trials have provided a convincing body of evidence of the cost-effectiveness of home visitation. The findings from these studies have helped to renew policy interest in nurse home visitation as a means of improving health and quality of life for low-income families. Reimplementing home visitation on a large scale, however, will require using nurses with little or no home-visiting experience. Sponsoring organizations must delegate, and nurses from hospitals or clinics must accept, responsibility for both increased autonomy and discretion of home visitors. Case study analysis of observational and interview data from the implementation of a large demonstration home visitation program carried out in a health department in a mid-South city from 1989 to 1994 provides evidence that the bottom-up perspective of Hanf and Toonen (1983) best describes how such programs can be put in place. Nurses with little community experience were able to create appropriate strategies to help families achieve the broad program goals in the context of resource constraints associated with a poverty-level lifestyle and the existing health and human service system. Furthermore, nurses were able to establish an organizational culture and job structure in a city/county health department to support their work.
Telephone advisory service, visits to district nurses and home visits made by district nurses at a Swedish primary health care district.
All contacts with the district nurses were registered during a three-week period, daytime Monday to Friday, in a defined primary health care district (Vänersborg, Sweden): 855 incoming telephone calls, 1,016 visits to the district nurses (visits to child welfare unit excluded), and 380 home visits made by the district nurses. The telephone consultations comprised 38% of the total number of contacts and 14% of the time was devoted to this activity, visits to the district nurses at their reception units 45% of all contacts and 39% of the time, and home visits 17% and 47%, respectively. Symptoms from the upper respiratory tract and from the skin were the most common reasons for telephone consultations, while wounds and leg ulcers were the most common reasons for visits to the reception unit and for home visits. A great deal of the district nurse's work was requested by health centres and hospitals.
Home assessments in geriatrics revisited: an audit of a routine home visiting service.
Routine home visiting is a luxury not afforded to other medical specialties. The practice of routine home assessment visiting in geriatric medicine was evaluated in a prospective study of 110 consecutive referrals to determine whether; the response to general practitioners referrals could be predicted from the information given at the time of referral and; to identify where home visiting identified additional information of value in directing services more appropriately. Requests for admission were accurately predicted in 86-96% of cases by the visiting and a control doctor respectively. Additional information of value in directing services and patient management was gained from the home visit in 30% of admissions, 58% of day hospital cases and 80% of outpatients. It is possible to predict the outcome of home visits although implementation of such predictions without direct communication with general practitioners would result in a small number of unnecessary admissions and referrals to day hospital services.
Home visiting by general practitioners in England and Wales. Home visits are a feature of primary care in many western European countries.
Explore the source record for details and available documents.
The home visiting process in the contexts of the voluntary vs. required visit: examples from fieldwork.
Home visiting is a frequently used nursing intervention for families at risk. Yet, research on the nature of home visiting is lacking. Little empirical research has been conducted to corroborate or refine the definition of home visiting and phases of the home-visiting process. The "Hybrid Model of Concept Development" by Schwartz-Barcott and Kim (1986) was used to identify the nature of home visiting. The Hybrid Model combines theoretical analysis with empirical observation. The first phase includes theoretical analysis, continuing into the second phase, consisting of fieldwork. In the final analytical phase, theoretical findings are compared with the fieldwork findings. The completed review of historical and current literature and a definition of home visiting were presented earlier (Byrd, 1995). The findings of the fieldwork and final analytic phases are presented here. Two contexts of home visiting, "voluntary" and "required," emerged as distinctive. In the voluntary context, entry was relatively easily accomplished, interaction was client-controlled, and the tone was informal and friendly. In contrast, in the required context, entry was difficult, interaction was nurse-controlled, and the tone was formal, polite, and investigatory. Themes of resistance and distorted nurse-client communication emerged in this type of visit. Client characteristics and properties of the referral were contextual factors, influencing the process. The concept's initial definition was corroborated, and the model was expanded based on this empirical observation of maternal-child preventive home visits.