Abstract
Background and aims: Programs of preventive home visits for ambulatory housebound elders have not yet become established in Japan. The aim of this randomized pilot study was to investigate effects of such visits by public health nurses in Japan. Methods: A randomized controlled study with 18-month follow-up was conducted in a small Japanese agricultural town. Participants (n=119) were ambulatory housebound elders aged 65 and over, who were able to walk but who went outdoors less than three times a week at baseline survey. They were randomly assigned to intervention (n=59) or control group (n=60). Intervention group subjects received preventive home visits by public health nurses over 18 months (mean home visits=4.3). Control group subjects received usual primary and community care. Activities of daily living (ADLs), functional capacity, self-efficacy for daily activities, self-efficacy for health promotion, depression, and social support were collected via questionnaire at baseline and at the 18-month follow-up point. Results: At follow-up, 81.4% of intervention group subjects were still living at home vs 73.3% of control group subjects (NS). Simple group comparisons following repeated measures (ANCOVA) showed that the intervention group had higher ADL scores than the control group at follow-up (p=0.044). Conclusions: These pilot results suggest that home visits by public health nurses may be effective in helping to reduce ADL decline among ambulatory housebound elders.
Similar content being viewed by others
References
Rubenstein LZ, Aronow HU, Schloe M, et al. A home-based geriatric assessment, follow-up and health promotion program: Design, methods, and baseline findings from a 3-year randomized clinical trial. Aging Clin Exp Res 1994; 6: 105–20.
Pathy MSJ, Bayer A, Harding K, Dibbile A. Randomised trial of case finding and surveillance of elderly people at home. Lancet 1992; 340: 890–3.
Vass M, Avlund K, Hendriksen C, Anderson CK, Keiding N. Preventive home visits to older people in Denmark: methodology of a randomized controlled study. Aging Clin Exp Res 2002; 14: 509–15.
Stuck AE, Zuzahlen G, Neuenschhwander BE, Meyer Schweizer RA, Bauen G, Beck JC. Methodologic challenges of randomized controlled studies on in-home comprehensive geriatric assessment: the EIGER project. Aging Clin Exp Res 1995; 7: 218–23.
Dalby DM, Sellors JW, Fraser FD, Fraser C, van Ineveld C, Howard M. Effect of preventive home visits by a nurse on the outcomes of frail elderly people in the community: a randomized controlled trial. CMAJ 2000; 162: 497–500.
van Rossum E, Frederiks CMA, Philipsen H, Portengen K, Wiskerke J, Knipschild P. Effects of preventive home visits to elderly people. BMJ 1993; 307: 27–32.
Bernabei R, Landi F, Gambassi G, et al. Randomised trial of impact of model of integrated care and case management for older people living in the community. BMJ 1998; 316: 1348–51.
Newbury JW, Marley JE, Beilby JJ. A randomized controlled trial of the outcome of health assessment of people aged 75 years and over. Med J Aust 2001; 175: 104–7.
Stuck AE, Egger M, Hammer A, Minder CE, Beck JC. Home visits to prevent nursing home admission and functional decline in elderly people: systematic review and meta-regression analysis. JAMA 2002; 287: 1022–8.
Elkan R, Kendrick D, Dewey M, et al. Effectiveness of home based support for older people: systematic review and meta-analysis. BMJ 2001; 323: 1–9.
Stuck AE, Siu AL, Wieland GD, Adams J, Rubenstein LZ. Comprehensive geriatric assessment: a meta-analysis of controlled trials. Lancet 1993; 342: 1032–6.
Ganguli M, Fox A, Gilby J, Belle S. Characteristics of rural homebound older adults: a community-based study. J Am Geriatr Soc 1996; 44: 363–70.
Kono A, Kanagawa K. Characteristics of housebound elderly by mobility level in Japan. Nurs Health Sci 2001; 3: 105–11.
Kono A, Kai I, Sakato C, Rubenstein LZ. Frequency of going outdoors: a predictor of functional and psychosocial change among ambulatory frail elders living at home. J Gerontol 2004; 59A: 275–80.
Rubenstein LZ, Wieland D, Bernabei R. Geriatric assessment technology: international research perspective. Aging Clin Exp Res 1995; 7: 157–8.
Landi F, Lattanzio F, Gambassi G, et al. A model for integrated home care of frail older patients: the Silver Network project. Aging Clin Exp Res 1999; 11: 262–72.
Department of Health Care, Matsudo City. Hokenhu niyoru hokenshido no netakiri yobokoka nikansuru kennkyu (Efficacy in functional decline of home visits by public health nurses). 1999 (in Japanese).
Shakai Hoken Jitsumu Kenkyujyo. Shukanhoken-eiSci news (Weekly news of public health) 2000; 1081: 14–35 (in Japanese).
Koyano W, Shibata H, Katsuji N, Nakazato K, Haga H, Suyama Y. Measurement of competence: reliability and validity of the TMIG index of competence. Arch Gerontol Geriatr 1991; 13: 103–16.
Hill KD. Schwarz JA. Kalogeropoulous JA. Gilbson JS. Fear of falling revised. Arch Phys Med Rehabil 1996; 77: 1025–9.
Yokokawa Y, Kai I, Nakajima T. Development of a ‘self-efficacy for health promotion scale’ in community-dwelling elderly. Japan Journal of Public Health 1999; 46: 103–12 (in Japanese).
Sheikh JI, Yesavage JA. Geriatric depression scale (GDS) recent evidence and development: a shorter version. Clin Gerontol 1986; 5: 165–73.
Niino N, Imaizumi T, Kawakami N. A Japanese translation of the Geriatric Depression Scale. Clin Gerontol 1991; 10: 85–7.
Noguchi Y. Koreisha no sosharu sapoto (Social support for elders). Japanese Journal of Gerontology 1989; 34: 37–48 (in Japanese).
Hebert R, Robichaud L, Roy PM, Bravo G, Voyer L. Efficacy of a nurse-led multidimensional preventive programme for older people at risk of functional decline: a randomized controlled trial. Age Ageing 2001; 30: 147–53.
van Haastregt JCM, Diederiks JPM, van Rossum E, de Witte LP, Crebolder HFJM. Effects of preventive home visits to elderly people living in the community: systematic review. BMJ 2000; 320: 754–58.
Fabacher D, Josephson K, Pietruszca F, Linderborn K, Morley JE, Rubenstein LZ. An in-home preventive assessment program for independent older adults: a randomized controlled trial. J Am Geriatr Soc 1994; 42: 630–8.
Stuck AE, Aronow HU, Steiner A, et al. A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community. N Engl J Med 1995; 1184–9.
Stuck AE, Minder CE, Peter-Wuest I, et al. A randomized trial of in-home visits for disability prevention in community-dwelling older people at low and high risk for nursing home admission. Arch Intern Med 2000; 160: 977–86.
Rubenstein LZ, Stuck AE. Preventive home visits for older people: defining criteria for success. Age Ageing 2001; 30: 107–9.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kono, A., Kai, I., Sakato, C. et al. Effect of preventive home visits for ambulatory housebound elders in Japan: a pilot study. Aging Clin Exp Res 16, 293–299 (2004). https://doi.org/10.1007/BF03324554
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03324554