A controlled clinical trial of home care management versus hospital care management for preterm labour.
Prenatal hospitalisation has not been shown to reduce perinatal morbidity and mortality, yet it is still the treatment of choice for women who experience preterm labour. Home care management may be an alternative means of delivering safe, efficacious and care for these women. The objectives of this controlled clinical trial were to examine differences in neonate's gestational age and birthweight, and antenatal stress, social support satisfaction, and family functioning among pregnant women receiving home care and those receiving hospital care management. Pregnant women experiencing preterm labour (N=250) were randomly assigned to home care management (the experimental group [EG]) or hospital care management (the control group [CG]). A Perinatal Information Form was used to collect data on sociodemographic and pregnancy variables. The High-Risk Pregnancy Stress Scale, Brown's Social Behaviors Inventory, and the Family Assessment Measure III Dyadic Relationships Scale were administered to the women at randomisation (T1) and at 1-week (T2) and 2-weeks (T3) after randomisation. Gestational age and birthweight were similar in the two groups of neonates. Women in the EG reported that antenatal stress was significantly lower at T3 than at T1 and T2, while for those in the CG, antenatal stress was significantly lower at T3 than at T1, and significantly lower at T2 than at T1. Women in the EG were more satisfied with support from the male partner at T3 than women in the CG. There was no significant difference between the two groups in family functioning at T1, T2 and T3. These findings indicate that home care management is a safe and efficacious mode of health care delivery for women experiencing preterm labour.
Faculté des sciences infirmières, Université de Montréal, Centre de recherche, Hôpital Sainte-Justine, 9175 Côte Ste-Catherine, Montréal, H3T 1C5, Québec, Canada. celine.goulet@umontreal.ca
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C
Goulet
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Gévry
R J
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Gauthier
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Lepage
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Fraser
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Aita
D000328:Adult; D001724:Birth Weight; D003152:Community Health Nursing / Q000458:organization & administration*; D003696:Delivery Rooms / Q000458:organization & administration*; D005190:Family / Q000523:psychology; D005260:Female; D005865:Gestational Age; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D015403:Nursing Evaluation Research; D007752:Obstetric Labor, Premature / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018566:Pregnancy, High-Risk / Q000523:psychology; D011295:Prenatal Care / Q000458:organization & administration*; D015397:Program Evaluation; D011792:Quebec; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000517:prevention & control / Q000523:psychology