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J Nurs Scholarsh. 2000;32(4):369-76.

Effects of home visits to vulnerable young families.

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1
School of Nursing, Boston College, Chestnut Hill, MA, USA. Kearnema@bc.edu

Abstract

PURPOSE:

Nurses' home visits to new parents have been replaced in many high-need communities by nonprofessional visits without clear evidence of effectiveness. Previous reviews of home visiting research have combined nurse and non-nurse interventions and have pooled studies from the US, where home visiting is mainly limited to low-income families, with those from nations where home visiting is a universal service. This integrative review was focused on nurse-delivered interventions in the US and Canada to identify the nursing-specific models with the greatest effect in this cultural context. Evaluation of support for social ecology theory was a secondary aim.

DESIGN:

The sample consisted of 20 experimental and quasi-experimental studies of home nursing interventions for families of newborn infants who were vulnerable because of poverty, social risks, or prematurity.

METHODS:

Each report was examined systematically using specific rules of inference and a scoring system for methodological quality. Intervention effects on five outcome domains were described.

FINDINGS:

Maternal outcomes, maternal-infant interaction, and parenting were more often influenced than was child development, except in preterm infants. Well-child health care did not improve. Effective programs generally began in pregnancy, included frequent visits for more than a year, had well-educated nurses, and were focused on building a trusting relationship and coaching maternal-infant interaction. Social ecology theory was partially supported.

CONCLUSIONS:

Future nurse home-visiting research should test a combination of these effective components. Nurses can use this information to seek funding of nurse-delivered interventions for vulnerable families.

PMID:
11140201
[Indexed for MEDLINE]
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