Evaluation of a VNA mental health project

Abstract

Using a quasi-experimental design, discharged psychiatric patients referred to the Visiting Nurse Association of Cleveland during a nine-month period were randomly assigned to treatment or control groups. Patients were interviewed twice--after hospital discharge and six months later. Of the 110 patients who completed both interviews, which included a socially expected activities form, 62 were female, 63 nonwhite, 108 from the lowest two levels of socioeconomic status, and 74 schizophrenic. Six months postdischarge a 14% increase in employment was noted in the treatment group, who received nursing services, but no change was noted in the control group. Control group members (57%) were more likely to miss taking their prescribed medicines than were treatment group members (36%). Readmission occurred more frequently in the control (34%) than in the treatment group (28%). No difference was noted between the two groups on socially expected activities scores, possibly because: 1) the categories of the instrument may be too broad to discriminate between groups that are similar in their adjustment, 2) six months may not be a long enough time interval, 3) many patients had characteristics identified as "unfavorable" in reported studies, 4) an average of 2.3 visits a month by the nurses may not be adequate for the patients referred to this agency.