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Women's experience with early labour management at home vs. in hospital: a randomised controlled trial
Patricia A Janssen1, Sarah L Desmarais
1UBC School of Population and Public Health, MPH Program, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3. patti.janssen@ubc.ca
Objective:
to compare experiences with early labour assessment and support at home vs. by telephone.
Design:
a randomised controlled trial of nurse home visits vs. telephone support for assessment and support of women in early labour.
Setting:
hospitals serving obstetrical populations in metropolitan and suburban Vancouver, British Columbia, Canada.
Participants:
healthy nulliparous women in labour at term with uncomplicated pregnancies participating in the third and fourth year of the trial.
Intervention:
women were randomised to receive early labour assessment and support at home (n=241) and or to receive assessment and support by telephone (n=182).
Measurement:
the Early Labour Experience Questionnaire (ELEQ), a 26-item self-administered questionnaire that measures women's experience with early labour care across three domains: emotional well-being, emotional distress and perceptions of nursing care.
Findings:
women who received home visits rated their early labour experience more positively overall compared to women who received telephone support (103.14 ± 12.45 vs. 99.67 ± 13.11, p<.01)including perceptions of nursing care that they received (38.64 ± 2.90 vs. 36.82 ± 4.09, p<.001). However, women's affective experiences did not differ.
Key Conclusions:
early labour nursing care provided at home is associated with a more positive experience of early labour compared to telephone support.