Caregivers of frail rural older adults. Effects of an advanced practice nursing intervention

Citation Dellasega, C., & Zerbe, T. (2002). Caregivers of frail rural older adults. Effects of an advanced practice nursing intervention. Journal of Gerontological Nursing, 28 (10), 40-49.

Design Experiment

Purpose The purpose of this experiment was to examine the effects of an Advanced Practice Nursing (APN) intervention on rural caregivers, after the care recipient was discharged from hospital.

Participants Participants (N=32) were caregivers, randomly assigned to treatment and control groups (n=16)

Outcome / Dependent Variables Caregiver stress symptoms, depressive symptoms, disability days requested and taken from work by caregivers.

Procedure The treatment group received standard care plus the Advanced Practice Nurse (APN) intervention. The APN intervention consisted of one in-hospital visit and two home visits, at 48 hours and 1 to 2 weeks post discharge. A phone call was made during the week between the two APN home visits. The intervention consisted of developing a comprehensive discharge plan, direct home care by the APN, continuous care during the transition from hospital to home, telephone availability, and evaluation of health status and cost outcomes.

Outcomes The intervention had a positive impact on caregiver outcomes. Participants in the treatment group had fewer physical health symptoms of a psychosomatic nature (although not statistically significant). Caregivers in the treatment group had fewer disability days taken from work post intervention. They also missed fewer days of work and showed significantly less depressive symptoms. The cost of the program was approximately $ 150 per client. When balanced against the decreased days of missed work and disability this is another important outcome.

Note: An Advanced Practice Nurse (APN) is an RN who has an advanced education (certification or graduate degree) beyond the typical 2 to 4 years of nursing education, and has clinical proficiency in a specific area of nursing care.

Author Dellasega, C., & Zerbe, T.