A systematic review of the effectiveness of in-home community nurse led interventions for the mental health of older persons.
OBJECTIVE
The aim was to systematically review evidence about the effectiveness of in-home community nurse-led interventions for older persons with, or at risk of, mental health disorders, to inform best practice nursing care with this focus. The primary review question was 'How effective are in-home community nurse-led interventions for older persons with or at risk of mental health disorders for improving mental health?' The outcome indices of interest were nursing actions to determine incidence or prevalence of mental health disorders, any change in a patient's attitude towards their mental health condition, any change in objective measurement of mental health, or a change in diagnostic status.


BACKGROUND
The rising incidence of mental health disorders in older persons is a major concern for community nurses in developed countries. Effectively facilitating improved mental health for older persons is necessary in this era of ageing populations with increased demands on health funding. Disseminating systematically reviewed evidence for in-home community nursing that positively impacts on the mental health of older persons is crucial to ensure effective care is provided to this vulnerable patient group.


RESULTS
This review reveals that there is evidence to support the superiority of applying validated screening tools for mental health disorders over relying on community nurses' opinions and non-validated tools about this matter.


METHODS
Systematic review.


METHODS
Search of electronic databases.


CONCLUSIONS
A clear need for replication and multi-centre trials of reviewed pertinent studies is identified. Relevance to clinical practice. Community nurses should consider using validated screening tools for this focus. Until such time as higher quality evidence is available about other nursing interventions, the reviewers suggest that the prime nursing action should be the identification of whether older persons receiving community nursing care might have a mental health disorder and, if so, then collaborative referral is made to appropriate services.
Thompson
Penelope
P
School of Nursing and Midwifery, La Trobe University, Bundoora, Vict., Australia.
Lang
Lyn
L
Annells
Merilyn
M
D000368:Aged; D001294:Attitude to Health; D019985:Benchmarking; D003152:Community Health Nursing / Q000458:organization & administration*; D003156:Community Mental Health Services / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D015577:Geriatric Assessment; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000458:organization & administration*; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D008603:Mental Health; D024802:Nurse's Role; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012017:Referral and Consultation; D012107:Research Design