NURSE HOME CARE-HIGH RISK PREGNANT WOMEN

护士家庭护理——高危孕妇

• 批准号: 3392581
• 负责人: DOROTHY BROOTEN
• 金额: $ 55.51万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-09-15 至 1996-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3392581
• 关键词: clinical trials; diabetes mellitus; disease /disorder proneness /risk; health care cost /financing; health care quality; home health care; human pregnant subject; human subject; infant mortality; mother /infant health care; nursing intervention; pregnancy

The United States currently ranks 20th in infant mortality among industrialized countries due largely to its high low birthweight (LBW) rate. Recently, home visiting of pregnant women at risk for LBW has been advocated by several national groups to augment routine prenatal care and improve maternal and infant outcomes. Such additive care will increase health care costs unless there are clear improved patient outcomes. The purpose of this randomized clinical trial is to compare maternal and infant outcomes and cost of care between 2 groups of women at high risk for delivering LBW infants: a control group (89) that will receive routine care; and in intervention group (89) in which half of routine prenatal physician office/clinic care will be substituted with nurse specialist care delivered via home visits and telephone contact. Both high risk group (controls and intervention) will be comprised of pregnant women with diabetes, chronic hypertension diagnosed or at high risk of preterm labor. The study will examine: (1) maternal outcomes: adequacy of prenatal care; morbidity; weight gain and hemoglobin; postpartum physician visits; continued employment/school attendance; affect; satisfaction with care (2) infant outcomes: gestational age; mortality and morbidity; health status over 1 year; placement and child abuse (3) cost; nurse specialist services; (4) major interventions used by nurse specialists. Both groups will be followed 1 year post delivery. Data analysis will include MANOVA, chi- square and t-tests. Study outcomes will provide important data on: nurse specialist home visiting effects on high risk pregnant women and their infants; relative cost of this substitutive care versus routine or additive home visiting care; major interventions needed in home visiting care of this high risk group. Data will be important to researchers, providers, insurers and policy maker.

美国目前在婴儿死亡率方面排名第20位， 工业化国家主要是由于其高低出生体重（LBW） 率 最近，对有低出生体重风险的孕妇进行家访， 几个国家团体提倡增加常规产前护理， 改善母婴结果。 这种添加剂护理将会增加 医疗保健成本，除非有明显改善的病人的结果。 的 这项随机临床试验的目的是比较孕产妇和婴儿 两组高危妇女之间的结局和护理费用 分娩LBW婴儿：对照组（89例），接受常规 干预组（89例），其中一半的常规产前护理 医生办公室/诊所护理将由护士专家护理取代 通过家访和电话联系提供。 高危人群 （对照组和干预组）将由以下孕妇组成： 糖尿病、慢性高血压或早产高危人群。 这项研究将审查：（1）产妇的结果：产前护理是否充分; 发病率;体重增加和血红蛋白;产后医生访视; 继续就业/上学;影响;对护理的满意度（2） 婴儿结局：胎龄;死亡率和发病率;健康状况 1年以上;安置和虐待儿童（3）费用;护士专家服务; (4)护理专家使用的主要干预措施。 两组将在 产后1年。 数据分析将包括MANOVA，chi- 平方和t检验。 研究结果将提供以下重要数据：护士 专家家访对高危孕妇的影响及其 婴儿;这种替代护理与常规或附加护理的相对成本 家庭访问护理;家庭访问护理所需的主要干预措施 这个高危人群。 数据对研究人员、供应商、 保险公司和政策制定者。