The effect of health visitors' postpartum home visit frequency on first-time mothers: cluster randomised trial.

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  • Author(s): Christie J;Christie J; Bunting B
  • Source:
    International journal of nursing studies [Int J Nurs Stud] 2011 Jun; Vol. 48 (6), pp. 689-702. Date of Electronic Publication: 2010 Dec 03.
  • Publication Type:
    Journal Article; Randomized Controlled Trial
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Pergamon Press Country of Publication: England NLM ID: 0400675 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-491X (Electronic) Linking ISSN: 00207489 NLM ISO Abbreviation: Int J Nurs Stud Subsets: MEDLINE
    • Publication Information:
      Publication: Oxford ; New York : Pergamon Press
      Original Publication: Oxford.
    • Subject Terms:
      Community Health Nursing* ; House Calls* ; Postpartum Period*; Female ; Humans ; Pregnancy
    • Abstract:
      Background: Postpartum home visiting by nurses can benefit higher-risk families. Yet, little is known about the effects of universal services which provide care for all families including those at lowest risk (e.g., provision by health visitors-United Kingdom specialist community public health nurses).
      Objective: It was to determine the effect of frequency of health visitors' home visits on 'low-risk' first-time families' outcomes to 8 weeks postpartum and 7 months follow-up.
      Design: A cluster randomised controlled trial.
      Setting: Within one health and social care managerial area in Northern Ireland.
      Participants: First-time 'low risk' mothers who had given birth during 2002-2004 and were visited by a health visitor who had agreed to take part in the study, were invited to participate. In total, n=39 health visitors were allocated to 'intervention' and n=41 to 'control'. Of n=295 'low-risk' first-time mothers who agreed to take part, n=136 with intervention health visitors were offered six home visits 2-8 weeks postpartum and n=159 within the control group were offered one planned visit.
      Methods: Self-completed measures of parenting, maternal wellbeing and service use were gathered pre-intervention, 8 weeks and 7 months postpartum. The main outcome was the Edinburgh Postnatal Depression Scale (EPDS). At 8 weeks and 7 months postpartum, n=129 and n=115 intervention mothers, also n=151 and n=141 control mothers completed outcome measures.
      Results: An intention to treat analysis was performed using multilevel modelling analysis which statistically controlled for pre-home visit outcomes, clinic attendance and antenatal contact. The intervention had no impact on most outcomes, however, it was associated with an increased EPDS score (after adjustment: 0.16, 2.36 95% CI) at 8 weeks (before accounting for outliers) but not at 7 months (-0.62, 1.65 95% CI). Intervention mothers had higher service satisfaction (7.7, 21.28, 95% CI 8 weeks; 4.69, 22.71, 7 months) and were less likely to have used emergency medical services for their infants to 8 weeks (OR: 0.15, 0.85, 95% CI).
      Conclusion: Weekly postpartum visits to 'low-risk' mothers had variable effects, therefore, practitioners and researchers should consider further development and application of effective, evidence based home visiting content.
      (Copyright © 2010 Elsevier Ltd. All rights reserved.)
    • Publication Date:
      Date Created: 20101207 Date Completed: 20110921 Latest Revision: 20220318
    • Publication Date:
      20240829
    • Accession Number:
      10.1016/j.ijnurstu.2010.10.011
    • Accession Number:
      21129744