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Specialist home-based nursing services for children with acute and chronic illnesses

Overview of attention for article published in Cochrane database of systematic reviews, June 2013
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Title
Specialist home-based nursing services for children with acute and chronic illnesses
Published in
Cochrane database of systematic reviews, June 2013
DOI 10.1002/14651858.cd004383.pub3
Pubmed ID
Authors

Chitra S Parab, Carolyn Cooper, Susan Woolfenden, Susan M Piper

Abstract

Specialist paediatric home-based nursing services have been proposed as a cost-effective means of reducing distress resulting from hospital admissions, while enhancing primary care and reducing length of hospital stay. This review is an update of our original review, which was published in 2006. To evaluate specialist home-based nursing services for children with acute and chronic illnesses. We searched the following databases in February 2012: the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library 2012 Issue 2, Ovid MEDLINE, EMBASE, PsycINFO, CINAHL and Sociological Abstracts. We also searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. No language restrictions were applied. Randomised controlled trials (RCTs) of children from birth to age 18 years with acute or chronic illnesses allocated to specialist home-based nursing services compared with conventional health care. Outcomes included utilisation of health care, physical and mental health, satisfaction, adverse health outcomes and costs. Two review authors extracted data from the studies independently and resolved any discrepancies by recourse to a third author. Meta-analysis was not appropriate because of the clinical diversity of the studies and the lack of common outcome measures. We screened 4226 titles to yield seven RCTs with a total of 840 participants. Participants, interventions and outcomes were diverse. No significant differences were reported in health outcomes; two studies reported a reduction in the hospital stay with no difference in the hospital readmission rates. Three studies reported a reduction in parental anxiety and improvement in child behaviours was reported in three studies. Overall increased parental satisfaction was reported in three studies. Also, better parental coping and family functioning was reported in one study. By contrast, one study each reported no impact on parental burden of care or on functional status of children. Home care was reported as more costly for service providers with substantial cost savings for the family in two studies, while one study revealed no significant cost benefits for the family. Current research does not provide supporting evidence for a reduction in access to hospital services or a reduction in hospital readmission rate for children with acute and chronic illnesses using specialist home-based nursing services; however, the only summary finding across a few studies was that there is a significant decrease in length of hospitalisation. The preliminary results show no adverse impact on physical health outcomes and a number of papers reported improved satisfaction with home-based care. Further trials are required, measuring health, satisfaction, service utilisation and long-term costs.

Mendeley readers

The data shown below were compiled from readership statistics for 177 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Germany 2 1%
United States 2 1%
South Africa 1 <1%
Spain 1 <1%
Japan 1 <1%
New Zealand 1 <1%
Unknown 169 95%

Demographic breakdown

Readers by professional status Count As %
Student > Master 36 20%
Researcher 29 16%
Student > Ph. D. Student 27 15%
Student > Bachelor 17 10%
Student > Postgraduate 8 5%
Other 33 19%
Unknown 27 15%
Readers by discipline Count As %
Medicine and Dentistry 59 33%
Nursing and Health Professions 28 16%
Psychology 19 11%
Social Sciences 13 7%
Unspecified 7 4%
Other 21 12%
Unknown 30 17%