Public and community health nursing interventions with vulnerable primary care clients: a pilot study

The primary aim of this pilot study was to test the effects of public/community health nursing (P/CHN) home visitation and a mutual goal-setting intervention on the intensity of need for nursing care levels and health behavior of vulnerable primary care clients. A secondary aim was to describe the content of client health behavior improvement goals. Eighty clients, aged 19-93 years, judged by their primary care providers to have unmet health needs were referred for P/CHN services. A quasi-experimental design was used, with the intervention group receiving the mutual goal-setting intervention. Senior baccalaureate nursing students, guided by faculty case managers, provided home visitation nursing care and the mutual goal-setting intervention. No significant effects of mutual goal-setting were found, however the 10-week P/CHN home visitation intervention was found to have significant positive effects on intensity of need for nursing care levels and health behaviors. Also, preferred client health improvement goals for this population are described. Several implications for P/CHN practice and research are discussed.