2.50
Hdl Handle:
http://hdl.handle.net/10755/150493
Type:
Presentation
Title:
Process Evaluation of a Nurse Home Visiting Intervention
Abstract:
Process Evaluation of a Nurse Home Visiting Intervention
Conference Sponsor:Sigma Theta Tau International
Conference Year:2010
Author:Liebel, Dianne Veronica, RN, PhD, MSEd
P.I. Institution Name:University of Rochester
Title:Post-Doctoral Fellow
21st INRC [Research Presentation] Background: Internationally older adults experiencing and recovering from disability prefer to remain living at home. Nurse home visiting thereby offers an effective method to deliver geriatric strategies to improve/maintain disability and promote health. The nurse intervention of the Medicare Primary and Consumer-Directed Care Demonstration is one of only six home visiting studies reporting positive disability outcomes for community dwelling elders with existing disability. Purpose: The purpose of the study was to use the classic Donabedian conceptual model to perform process evaluation on a nurse intervention that reported statistically significant differences in disability outcomes (ADL) compared to controls and illuminate these results further using case studies to examine the barriers and facilitators of disability maintenance/improvement. Methods: Performed process evaluation using quantitative methods and case studies to determine which intervention components were most associated with disability using data from nurse notes, case studies, and Demonstration databases. Results: Results showed high levels of participation, dose, and fidelity for intervention components. Home visits were effective in maintaining/improving disability among 60% of patients. These individuals were more limited in ADLs, younger, and had less cognitive impairment, higher SF-36 scores, and perceived their health as being unchanged. After adjusting for baseline characteristics, medication self-management and the number of intervention materials patients used were significantly associated with disability maintenance/improvement. Patients with more disability received significantly more home visits, disease self-management activities, goals, and family conferences. Sub-group analyses further revealed that patients receiving recommended doses of intervention components were more likely to maintain/improve disability. Case study analyses of patients with disability maintenance/improvement vs. worsening will be presented to elucidate how the nurse model impacted disability status and other health outcomes. Conclusion: These analyses provide evidence to potentially reform eligibility criteria and expand nursing services to patients who need chronic homecare management not eligible under current health system guidelines.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleProcess Evaluation of a Nurse Home Visiting Interventionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/150493-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Process Evaluation of a Nurse Home Visiting Intervention</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Liebel, Dianne Veronica, RN, PhD, MSEd</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Rochester</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Post-Doctoral Fellow</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dianne_liebel@urmc.rochester.edu</td></tr><tr><td colspan="2" class="item-abstract">21st INRC [Research Presentation] Background: Internationally older adults experiencing and recovering from disability prefer to remain living at home. Nurse home visiting thereby offers an effective method to deliver geriatric strategies to improve/maintain disability and promote health. The nurse intervention of the Medicare Primary and Consumer-Directed Care Demonstration is one of only six home visiting studies reporting positive disability outcomes for community dwelling elders with existing disability. Purpose: The purpose of the study was to use the classic Donabedian conceptual model to perform process evaluation on a nurse intervention that reported statistically significant differences in disability outcomes (ADL) compared to controls and illuminate these results further using case studies to examine the barriers and facilitators of disability maintenance/improvement. Methods: Performed process evaluation using quantitative methods and case studies to determine which intervention components were most associated with disability using data from nurse notes, case studies, and Demonstration databases. Results: Results&nbsp;showed high levels of participation, dose, and fidelity for intervention components. Home visits were effective in maintaining/improving disability among 60% of patients. These individuals were more limited in ADLs, younger, and had less cognitive impairment, higher SF-36 scores, and perceived their health as being unchanged. After adjusting for baseline characteristics, medication self-management and the number of intervention materials patients used were significantly associated with disability maintenance/improvement. Patients with more disability received significantly more home visits, disease self-management activities, goals, and family conferences. Sub-group analyses further revealed that patients receiving recommended doses of intervention components were more likely to maintain/improve disability. Case study analyses of patients with disability maintenance/improvement vs. worsening will be presented to elucidate how the nurse model impacted disability status and other health outcomes. Conclusion: These analyses provide evidence to potentially reform eligibility criteria and expand nursing services to patients who need chronic homecare management not eligible under current health system guidelines.</td></tr></table>en_GB
dc.date.available2011-10-26T10:34:33Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T10:34:33Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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