An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group

Dasom Kim; Insook Lee

doi:10.4040/jkan.2017.47.5.577

Journal List > J Korean Acad Nurs > v.47(5) > 1003264

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kim and Lee: An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group

Review Article

J Korean Acad Nurs 2017;47(5):577-588.

Published online: 15 January 2017

DOI: https://doi.org/10.4040/jkan.2017.47.5.577

An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group

Dasom Kim, Insook Lee

College of Nursing, Seoul National University, Seoul, Korea

Address reprint requests to : Lee, Insook College of Nursing, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-740-8828 Fax: +82-2-740-8492 E-mail: lisook@snu.ac.kr

Received 21 February 2017 Revised 22 June 2017 Accepted 26 September 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review.

Methods

We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers.

Results

Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach.

Conclusion

As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements.

Keywords: Mothers, Infants, Preschool child, Vulnerable populations, Home care services

References

1. Macintyre S. The black report and beyond: What are the issues? Social Science & Medicine. 1997; 44(6):723–745. https://doi.org/10.1016/S0277-9536(96)00183-9.

2. Evans T, Whitehead M, Diderichsen F, Bhuiya A, Wirth M. Challenging inequities in health: From ethics to action [Internet]. New York: Oxford University Press;c2001. [cited 2017 Jan 30]. Available from. https://books.google.co.kr/books/about/Challeng-ing_Inequities_in_Health.html?id=VpUiV5k0EAUC&source=kp_cover&redir_esc=y.

3. Dobson SM. Conceptualizing for transcultural health visiting: The concept of transcultural reciprocity. Journal of Advanced Nursing. 1989; 14(2):97–102. https://doi.org/10.1111/j.1365-2648.1989.tb00906.x.

4. Health Resource & Services Administration, Maternal & Child Health (US). Home visiting [Internet]. U.S.: Health Resource & Services Administration (HRSA);c2016. [cited 2016 Dec 27]. Available from. https://mchb.hrsa.gov/maternal-child-health-initiatives/home-visiting-overview.

5. Kang YS, Kwon IS. Health status of vulnerable preschool children and their mothers’ health management. Child Health Nursing Research. 2013; 19(3):159–167.

6. Kim E, Lee J. Study on current policies and desirable policy directions of child raising support benefits for disadvantages families: Focusing on poor, single parent, and disabled families. Social Welfare Policy. 2006; 25:253–278.

7. Whittemore R, Knafl K. The integrative review: Updated methodology. Journal of Advanced Nursing. 2005; 52(5):546–553. https://doi.org/10.1111/j.1365-2648.2005.03621.x.

8. Flaskerud JH, Winslow BJ. Conceptualizing vulnerable populations health-related research. Nursing Research. 1998; 47(2):69–78.

9. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [Internet]. London: The Cochrane Collaboration;c2011. [cited 2016 Dec 27]. Available from. http://training.cochrane.org/handbook.

10. Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ, et al. NECA’s guidance for undertaking systematic reviews and meta-analyses for intervention. Seoul: National Evidence-based Healthcare Collaborating Agency;2011. p. 86–91.

11. Kirkevold M. Integrative nursing research: An important strategy to further the development of nursing science and nursing practice. Journal of Advanced Nursing. 1997; 25(5):977–984. https://doi.org/10.1046/j.1365-2648.1997.1997025977.x.

12. Seo HJ, Kim SY, Lee YJ, Jang BH, Park JE, Sheen SS, et al. A newly developed tool for classifying study designs in systematic reviews of interventions and exposures showed substantial reliability and validity. Journal of Clinical Epidemiology. 2016; 70:200–205. https://doi.org/10.1016/j.jclinepi.2015.09.013.

13. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006; 3(2):77–101. https://doi.org/10.1191/1478088706qp063oa.

14. Lumley J, Donohue L. Aiming to increase birth weight: A randomised trial of pre-pregnancy information, advice and counselling in inner-urban Melbourne. BMC Public Health. 2006; 6:299. https://doi.org/10.1186/1471-2458-6-299.

15. Hannan J. APN telephone follow up to low-income first time mothers. Journal of Clinical Nursing. 2013; 22(1-2):262–270. https://doi.org/10.1111/j.1365-2702.2011.04065.x.

16. Klinnert MD, Liu AH, Pearson MR, Tong S, Strand M, Luck-ow A, et al. Outcome of a randomized multifaceted intervention with low-income families of wheezing infants. Archives of Pediatrics & Adolescent Medicine. 2007; 161(8):783–790. https://doi.org/10.1001/archpedi.161.8.783.

17. MacMillan HL, Thomas BH, Jamieson E, Walsh CA, Boyle MH, Shannon HS, et al. Effectiveness of home visitation by public-health nurses in prevention of the recurrence of child physical abuse and neglect: A randomised controlled trial. Lancet. 2005; 365(9473):1786–1793. https://doi.org/10.1016/S0140-6736(05)66388-X.

18. Koniak-Griffin D, Mathenge C, Anderson NLR, Verzemnieks I. An early intervention program for adolescent mothers: A nursing demonstration project. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 1999; 28(1):51–59. https://doi.org/10.1111/j.1552-6909.1999.tb01964.x.

19. Koniak-Griffin D, Verzemnieks IL, Anderson NL, Brecht ML, Lesser J, Kim S, et al. Nurse visitation for adolescent mothers: two-year infant health and maternal outcomes. Nursing Research. 2003; 52(2):127–136.

20. DuMont K, Mitchell-Herzfeld S, Greene R, Lee E, Lowenfels A, Rodriguez M, et al. Healthy Families New York (HFNY) randomized trial: Effects on early child abuse and neglect. Child Abuse & Neglect. 2008; 32(3):295–315. https://doi.org/10.1016/j.chiabu.2007.07.007.

21. Armstrong KL, Fraser JA, Dadds MR, Morris J. Promoting secure attachment, maternal mood and child health in a vulnerable population: A randomized controlled trial. Journal of Paediatrics and Child Health. 2000; 36(6):555–562. https://doi.org/10.1046/j.1440-1754.2000.00591.x.

22. Doyle O, McGlanaghy E, Palamaro-Munsell E, McAuliffe FM. Home based educational intervention to improve perinatal outcomes for a disadvantaged community: A randomised control trial. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2014; 180:162–167. https://doi.org/10.1016/j.ejogrb.2014.06.006.

23. Fields ME, Abel R, Vesely SK, Drazen CH, King A. A pilot study of parent education intervention improves early childhood development among toddlers with sickle cell disease. Blood. 2015; 126(23):527.

24. Tiono AB, Kaboré Y, Traoré A, Convelbo N, Pagnoni F, Sirima SB. Implementation of Home based management of malaria in children reduces the work load for peripheral health facilities in a rural district of Burkina Faso. Malaria Journal. 2008; 7:201. https://doi.org/10.1186/1475-2875-7-201.

25. Wen LM, Baur LA, Simpson JM, Rissel C, Wardle K, Flood VM. Effectiveness of home based early intervention on children’s BMI at age 2: Randomised controlled trial. BMJ. 2012; 344:e3732. https://doi.org/10.1136/bmj.e3732.

26. Wen LM, Baur LA, Simpson JM, Xu H, Hayes AJ, Hardy LL, et al. Sustainability of effects of an early childhood obesity prevention trial over time: A further 3-year follow-up of the healthy beginnings trial. JAMA Pediatrics. 2015; 169(6):543–551. https://doi.org/10.1001/jamapediatrics.2015.0258.

27. Barnet B, Liu J, DeVoe M, Duggan AK, Gold MA, Pecukonis E. Motivational intervention to reduce rapid subsequent births to adolescent mothers: A community-based randomized trial. Annals of Family Medicine. 2009; 7(5):436–445. https://doi.org/10.1370/afm.1014.

28. Hambidge SJ, Phibbs SL, Chandramouli V, Fairclough D, Steiner JF. A stepped intervention increases well-child care and immunization rates in a disadvantaged population. Pediatrics. 2009; 124(2):455–464. https://doi.org/10.1542/peds.2008-0446.

29. Bang KS. Effects of an early nursing intervention program for infants’ development and mother’s child rearing in poverty. Journal of Korean Academy of Nursing. 2009; 39(6):796–804. https://doi.org/10.4040/jkan.2009.39.6.796.

30. Dunst CJ, Johanson C, Trivette CM, Hamby D. Family-oriented early intervention policies and practices: Family-centered or not? Exceptional Children. 1991; 58(2):115–126. https://doi.org/10.1177/001440299105800203.

31. National Research Council. A study of interactions: Emerging issues in the science of adolescence: Workshop summary. Washington, D.C: National Academies Press;2006. p. 8–9.

Figure 1.

Quality assessment of selected studies. (A) Risk of bias for randomized controlled trials (RoB). (B) Risk of bias for non-randomized studies (RoBANS)

Figure 2.

Flow diagram of study selection process.

Table 1.

Analysis of Home Care Services of Relevant Research

Theme	Population	Intervention	Study No.	Intervention effect
				Positive effect	Non-significant effect
Patient-specific/	Pregnant	Identifying of patients social,	[14-16]	N/A	N/A
Situation-specific	women,	health problem (Needs
care planning and	mother, infant	assessment) and reflects it to
intervention	and toddlers	planning
		Language/culture specific	[14]	N/A	N/A
		intervention (e.g. refugees,
		immigrants)
		Situation specific intervention	[17-19]	N/A	N/A
		(e.g. single parents,
		adolescent mother)
Emphasis on self	Pregnant	Decision making (school,	[18,19]	N/A	N/A
care competency	women,	employment)
	mother	Improve parent’s self-	[18-21]	Parenting knowledge [21]	N/A
		sufficiency		Parenting attitude [21]
				Responsibility [21]
				Parent’s sense of
				competence [21]
				Social competence [18,19]
		Providing pre-pregnancy	[14,18-20,	Casaerean section rate [22]	Apgar scores [22]
		information	22]	Rate of spontaneous onset of	Birth weight [22]
				labour [22]	Gestational age [22]
					Prematurity [22]
		Information about maternal	[18,19]	N/A	N/A
		self-care (e.g. Nutrition,
		physical activity)
		Modifying behaviors	[18,19]	Smoking behavior [18,19]	N/A
	Infant and	Supporting management of	[16,23,24]	Caregiver quality of life [23]	Symptom severity of
	toddlers	acute/chronic communicable		Caregiver self-sufficiency [23]	asthma [23]
		disease		Episodes of malaria treated	Emergency department
				at community level [24]	visit [23]
		Safety management	[16,18,19]	N/A	HOME score [16]
Intense home visit	Infant and	Providing information of child	[25,26]	Infant weight gain [25]	Frequency of eating [25]
by developmental	toddlers	nutrition and physical activity		Introduction of solids [25]	processed meat [25]
milestone		by developmental milestone		BMI [25]	No continuous effect on
				Eating habits (TV viewing	BMI, physical activity,
				time) [25]	eating habit (3 years after
				Intake of fruit and	intervention) [26]
				vegetables [25]
				Physical activity [25]
		Knowledge of fetal/infants/	[17,20,21,	Parenting knowledge [21]	Parenting stress [21]
		toddlers’physical and	23,27]	Parenting attitude [21]	Gross motor [23]
		cognitive development		Cognitive development [23]	Fine motor [23]
				Expressive language [23]	Receptive language [23]
		Providing information	[15,28]	Immunization rate [15,28]	ER, ICU admission rate [28]
		and notification of age-		Influenza vaccine rate [28]
		appropriate immunizations
		Scheduling regular health	[15]	ER visit [15]	N/A
		check-ups		Health care charge [15]
Reinforcing	Pregnant women,	Maternal stress, anxiety	[15,22]	Maternal perceived stress [15]	N/A
and modeling	mother	management
mother-child		Maternal depression	[18,19]	Maternal substance use [18,19]	Parenting stress [18,19]
attachment		management			Parental depression
					[18,19]
					Social isolation [18,19]
	Pregnant women,	Developing parent-infant	[20-22,	Acceptability of child [21]	Breast feeding [21]
	mother, infant	attachment	29]	Restriction of parental role [21]	Utilization of medical
	and toddlers			Home environment	care [21]
				(HOME) [29]	Parenting stress [29]
				Maternal depression [29]
	Infant and toddlers	Prevent child abuse and	[17,20]	Minor physical aggression [20]	Reported abuse and
		neglect		Serious physical abuse [20]	neglect [20]
				Self-reported physical
				aggression [20]
				Psychological aggression [20]
				Harsh parenting in
				the past week [20]
				Physical abuse and neglect [17]
Communication	Pregnant women,	Providing counseling	[15,21,29]	Perceived maternal stress [15]	N/A
and interaction	mother, infant	pertaining to health		Perceived maternal health and
across the	and toddlers	concerns		social support [15]
intervention				Infant weight gain [15]
				ER visit [15]
				Infant hospitalization [15]
				Health care charge [15]
				Premature birth [15]
		Revitalizing family	[17-19]	Social competence [18,19]	N/A
		communication
		Developing communication	[17-19]	Social competence [18,19]	N/A
		skills
	Pregnant women,	Counselling on family	[18,19,27]	Repeat pregnancies in	N/A
	mother	planning		adolescent mothers [27]
Linkage with	Pregnant women,	Refer for specific health	[17-21]	Satisfaction of community	N/A
community	mother, infant	problem identified to		child health service [21]
resource and	and toddlers	expert (e.g. dietician,
multidisciplinary		relaxation group,
approach		general practitioner,
		physiotherapist)
		Refer to social service (e.g.	[17-21,28]	N/A	N/A
		food stamps)
		Linkage with community	[17-21]	N/A	N/A
		networks (e.g. play-group,
		self-help group)

^*N/A=Not applicable; cannot be specified in particular outcome variables.

Table 2.

Characteristics of Relevant Studies and Interventions (N=16)

Variables	Categories	N (%)
Study
Publication year	~2000	1 (6.3)
	2000~2010	10 (62.5)
	2010~2017	5 (31.3)
Sample size	1~30	0 (0.0)
	31~100	2 (12.5)
	101~200	6 (37.5)
	Over 201	8 (50.0)
Study design	Randomized controlled study	13 (81.3)
	Non-randomized controlled study	2 (12.5)
	Prospective cohort study	1 (6.3)
Theoretical frame	Discribed	5 (31.3)
	Not discribed	11 (68.8)
Intervention
Intervenor	Community health worker	2 (12.5)
	Public health nurse	5 (31.3)
	Child health nurse	3 (18.8)
	Advanced nurse practitioner	1 (6.3)
	Trained para-professionals	4 (25.0)
	Occupational Therapist	1 (6.3)
Intervention scope	Infants/toddlers	2 (12.5)
	Pregnant women	3 (18.8)
	Infants/toddlers and mothers	5 (31.3)
	Family	6 (37.5)
Frequency	1~10 session	7 (43.8)
	11~20 session	1 (6.3)
	21~30 session	2 (12.5)
	Over 31 session	3 (18.8)
	Not discribed	3 (18.8)
Duration	0~6 months	3 (18.8)
	7~12 months	5 (31.3)
	13~24 months	4 (25.0)
	Over 25 months	2 (12.5)
	Not discribed	2 (12.5)
Time per session	0~60 min	3 (18.8)
	61~120 min	5 (31.3)
	Over 2 hours	1 (6.3)
	Not discribed	7 (43.8)

TOOLS

Similar articles