Home-based Nursing Intervention Research Articles

Impact of Self-Efficacy Intervention Program on Caregivers Adherence toward Home-based Care Children with Type I Diabetes Mellitus

Background and aims: Diabetes is a metabolic disorder associated with many complications; caregivers’ self-efficacy is essential for sustained home management. The study aimed to find out the effects of nursing intervention programs on caregivers’ self-efficacy regarding adhering to home-based management of child to type1 diabetes mellitus. Methods: A quasi‐experimental study design on home-based nursing intervention was conducted and recruited 60 caregivers who took homecare for their diabetes type 1. The systematic sampling method was used to select the participants Who were divided into two groups (30 in an intervention group and 30 in a control group) and who were registered at the Gulan General Hospital in Akre / Duhok city of Iraqi Kurdistan region. Verbal consent was obtained. starting from 3rd of January to the end of 5th September 2022.The home-based lesions were adopted for 5 months, Mann-Whitney U test, and T-Test ware used to identify the comparison between the variables. A p-value of ≤ 0.05, considered statistically significant. Results: There is no significant association between the control and study groups at the pretest before conducting the intervention program, while after conducting a home-based program for the intervention group, the results show that there was a highly significant difference between the pre and post test, the result reflects and successful program to change the self-efficacy of the caregivers from intervention, and it means a provided compared with the control group ( non-intervention group), at a p-value of ≤ 0.05. Conclusion: The results show that the caregivers who participated in the program (Intervention group), were successfully adapted to the self-efficacy program. Applying the program to a wider range of caregivers, to adhere to the caregivers and improve their self -efficacy toward home-based management of type 1 diabetes mellitus.

Effectiveness of a home-based nursing support and cognitive restructuring intervention on the quality of life of family caregivers in primary care: A pragmatic cluster-randomized controlled trial

BackgroundCaregivers of patients with chronic conditions or disability experience fatigue, burden and poor health-related quality of life. There is evidence of the effectiveness of support interventions for decreasing this impact. However, little is known about the benefits of home-based nursing intervention in primary health care. ObjectivesTo evaluate the effectiveness of a home-based, nurse-led-intervention (CuidaCare) on the quality of life of caregivers of individuals with disabilities or chronic conditions living in the community, measured at 12-month follow-up. MethodsA pragmatic, two-arm, cluster-randomized controlled trial with a 1-year follow-up period was performed between June 2013 and December 2015. Consecutive caregivers aged 65 years or older, all of whom assumed the primary responsibility of caring for people with disabling conditions for at least 6 months a year, were recruited from 22 primary health care centers. Subsequently, 11 centers were randomly assigned to usual care group, and 11 were assigned to the intervention group. The caregivers in the intervention group received the usual care and additional support (cognitive restructuring, health education and emotional support). The primary outcome was quality of life, assessed with the EQ-5D instrument (visual analog scale and utility index score); the secondary outcome variables were perception of burden, anxiety, and depression. Data were collected at baseline, at the end of the intervention, and at the 6- and 12-month follow-up visits. We analyzed the primary outcome as intention-to-treat, and missing data were added using the conditional mean single imputation method. ResultsA total of 224 caregivers were included in the study (102 in the intervention group and 122 in the usual care group). Generalized Estimating Equation models showed that the CuidaCare intervention was associated with a 5.46 point (95% CI: 2.57; 8.35) change in the quality of life, as measured with the visual analog scale adjusted for the rest of the variables at 12 months. It also produced an increase of 0.04 point (95% CI: 0.01; 0.07) in the utilities. No statistically significant differences were found between the two groups at 12 months with respect to the secondary outcomes. ConclusionsThe findings suggest that incorporating a home-based, nurse-led-intervention for caregivers into primary care can improve the health-related quality of life of caregivers of patients with chronic or disabling conditions.

The effectiveness of home-based nursing intervention in the elderly with recurrent diabetic foot ulcers: A case report.

Background: Inadequate glycemic control usually leads to peripheral neuropathy, vasculopathy, and foot deformities that leads to diabetic foot ulcer (DFU), and a 10-years history of diabetes and inadequate self-management increases the risk of reoccurring DFU. A home-based intervention program, which includes Diabetes Self-Management Education (DSME) and wound care is the most likely approach, to engage families and overcoming the barriers in self-care management. The aim of this study is to provide an overview on the effectiveness of home-based nursing intervention in the elderly patients with reoccurring diabetic foot ulcers.Design and method: In this study, a case study approach was used that presented a case related to self-management and wound care in elderly patients with reoccurring DFU. The intervention was carried out by the community health nurses for eight weeks with home visit.Results: Significant changes were reported in diabetes selfmanagement practices, blood glucose level, and wound healing. The Diabetes Self-Management Questionnaire (DSMQ) score increased from 5.62 to 8.,54 and the Summary of Diabetes Self- Care Activities (SDSCA) score increased from 3.2 to 6. The Bates Jansen Examination score decreased from 24 and 26 to 17 and 14 in six weeks.Conclusions: The results confirm that family-based interventions program are effective in improving glycemic control and wound healing. Community nursing is believed to prevent an increase in self-management behavior to prevent recurring DFU and maintain a healthy life-style about diabetes self-management education.Significance for public healthDiabetes mellitus (DM) with diabetic foot ulcer significantly contributes to the deterioration in health and financial burden on the patient. The increased risk of diabetic foot ulcers, especially in elderly patients with inadequate glycemic control tends to increase diabetes complications and mortality. Furthermore, the functional impairment, cognitive dysfunction, and poverty caused by the aging process make it difficult for elderly people to access health services. Home-based interventions carried out by community health nurses using the patient-centered care approach have advantages in improving access to services. Focusing on the self-management with Diabetes Self-Management Education (DSME) and wound care management to improve glycemic control, optimize the healing process, and also improve health promotion to prevent recurrent diabetic foot ulcers. This article provides an overview on the effectiveness of home-based nursing intervention in the elderly patients with recurrent diabetic foot ulcers.

Effects of a home-based nursing intervention programme among adolescents with type 1 diabetes.

To investigate the effects of a home-based nursing intervention programme established based on the Health Promotion Model on the health outcomes of adolescents with type 1 diabetes mellitus. After diagnosed with diabetes, it is necessary to ensure that nursing care is not limited to the hospital setting but continues at home. A quasi-experimental design with a pre- and post-test control group was used. The researchers have complied with the guidelines of TREND Checklist in presenting this study. This study was conducted in İzmir, Turkey, with 71 adolescents (35 in an intervention group and 36 in a control group) diagnosed with type 1 diabetes mellitus who were registered at the paediatric endocrinology outpatient clinics of two hospitals and were selected using the convenience sampling method between June-December 2017. A home-based nursing intervention programme (5week) was provided to the intervention group while standard care was provided to the control group. Data were collected at the baseline, and 3 and 6months after a 5-week home-based nursing intervention. Multi-way and one-way analysis of variance, the Bonferroni correction, regression analysis, t test, chi-squared analysis and a structural equation model were used for data analysis of the iterative measurements. At the end of the home-based nursing intervention programme, the HbA1c mean scores significantly decreased, while self-efficacy perception, frequency of managing diabetes and taking responsibility in managing diabetes increased in the intervention group compared to those in the control group. Frequency of admission to the hospital and average costs were lower in the intervention group than in control group. The home-based nursing intervention programme using structural equation modelling increased the frequency of managing diabetes and taking responsibility in managing diabetes and decreased HbA1c levels. The home-based nursing intervention programme was effective in decreasing HbA1c levels, increasing the frequency of diabetes management and taking responsibility in managing diabetes, and improving the self-efficacy of the adolescents. The home-based nursing intervention programme can be applied by nurses to ease the transition of adolescents with type 1 diabetes mellitus and their parents to healthy daily life practices and ensure their glycemic controls after being discharged.

The content and effectiveness of home-based nursing interventions to promote health and well-being in families with small children: a systematic review.

Although the use of preventive family nursing interventions in the home is increased, the literature on the content and effectiveness of these interventions remains fragmented. The aim of this review was to identify and describe the content of preventive family nursing interventions in families' homes and the effectiveness they had on the families' health and well-being. A systematic review was conducted using searches on the databases CINAHL, PubMed, Scopus and Web of Science (2003-2014). Altogether, 2077 articles were identified, and 11 were selected based on the inclusion and exclusion criteria. The main types of interventions were discussions and practical exercises to help parents cope with parenthood and relationships and interactions in the family, together with health, well-being, social relations and socio-economic situations. The effectiveness of family interventions was reported in all the selected studies. Greater knowledge of interventions is needed in the future, to develop program content and to explore the validity and reliability of used measurements. In addition, more effort is needed to develop quality appraisal tools for preventive interventions in families' homes.

Home-based nursing interventions improve knowledge of disease and management in patients with heart failure.

OBJECTIVE: to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire. METHODS: in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered. RESULTS: overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001); and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001). The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01), but weak and non significant at visit 4. CONCLUSION: the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument.

A home-based nursing intervention for enhancingquality of life of stroke survivors

A home-based nursing intervention for enhancingquality of life of stroke survivors

Reducing Parenting Stress in Families With Irritable Infants

Caring for an infant with unexplained, persistent crying is one of the most stressful events for new parents. Infant irritability, also referred to as infantile colic, occurs in 10-25% of all infants and is the most common parental concern reported in the first year of life. The aim of this study was to evaluate the effectiveness of a home-based nursing intervention in reducing parenting stress in three groups of families with irritable infants, using data from a larger evaluation study. A two-site, randomized clinical trial was conducted with 121 infants and their parents. Infants were randomized to a treatment or a control group. A third group of infants (n = 43) was added as a posttest-only comparison. The level of parenting stress was measured by the Parenting Stress Index (PSI) at baseline, after the 4-week intervention, and at the 8-week follow-up visit. A repeated measures analysis of variance (ANOVA) was used to compare the two groups across the three time points (baseline, immediately after the 4-week intervention, and at the 8-week follow-up visit). The results revealed a reduction in total parenting stress over time for both the treatment and control groups. Mothers in the treatment group reported reduced parenting stress on the parent-child dysfunctional interaction subscale (p = .04). Total parenting stress scores were found to be significantly higher for mothers in the posttest-only group (p = .009). Initial parenting stress levels were high in all participants. Parent feedback at the exit interview indicated that the nurse visits for data collection were also viewed as helpful in reducing the stress level associated with parenting these irritable infants. This home-based program was perceived as helpful in improving the interactions between parents and their irritable infants.

An Intervention Program for Families With Irritable Infants

To describe and evaluate a home-based nursing intervention program, the REST routine, which incorporates the use of infant behavior assessment, pattern recognition, individualized infant schedules, specific management strategies, and parent education and support. A two-site clinical trial was conducted on 164 healthy full-term infants with excessive unexplained irritability or colic. Infants between the ages of 2 to 6 weeks were randomized to routine care or a home-based intervention program (n = 121). A third group (n = 43) of infants too old at entry for randomization (mean age = 10.4 weeks) were entered into a posttest-only group. Infants in the REST routine treatment group cried 1.3 hours per day on average following the intervention program as compared to the control group crying 3 hours per day (p = .02). Infant irritability was resolved (< 1 hour) in 62% of the treatment group while only in 29% of the control group at the time of the 8-week follow-up visit (p = .04). Families in both the treatment and control groups reported benefiting from a nurse visiting in their home to inquire about their infant and their well-being. Options for individualizing the program for those most in need of intensive home visiting and other delivery modes for the intervention are areas for further investigation.

State of the Science

Nursing's role as key healthcare providers who give emotional support and teach self-care to patients with congestive heart failure has evolved substantially in recent years. The purpose of this article is to provide a systematic evaluation of the impact of posthospital nursing interventions in the management of heart failure. Four models of nursing interventions emerged: home-based nursing interventions, multidisciplinary interventions, heart failure clinics, and telephone- or technology-based nursing interventions. On the basis of currently available data, posthospital nursing interventions in congestive heart failure can improve clinical outcomes and decrease healthcare costs and resource use.

Caring for a Spouse after Prostate Surgery: The Preparedness Needs of Wives

This study describes wives' self-reports of preparedness to care for their husbands' physical and emotional needs during the first 6 months after surgery for prostate cancer. The research questions addressed in this article are part of a larger study designed to test the effects of a standardized nursing intervention protocol (SNIP) on quality-of-life outcomes in men postprostatectomy. The Preparedness for Caregiving Scale (PCGS) was administered to wives, and an open-ended questionnaire solicited wives' descriptions of how they felt unprepared. The results suggest that nursing services are needed after hospital discharge to support patients and family caregivers to manage the physical and emotional effects related to the cancer diagnosis and treatment. The information gained can be used to refine a home-based nursing intervention to facilitate caregivers' preparedness to enhance patients' physical function and psychosocial adaptation, and ultimately the couple's quality of life.