A study to evaluate the intervention of a nurse visiting patients with disabling chest disease in the community

This paper describes the work of two nurses visiting patients with chronic respiratory disease at home. The outcome measures suggested that there were fewer deaths in the nurses' group but failed to show any changes in quality of life. The nurses chose the nursing model devised by Roper et al. as a framework for their intervention. Initial assessment by the nurses showed the patients had a number of problems which could be grouped into physical health, knowledge, psychosocial and social. The nurses' monthly visits were used to assist the patients to plan strategies for resolving their problems. Advice was directed at helping patients promote and control their own health and measurable goals were set. Most of the patients achieved the goals set, valued the visits and said they wished them to continue. Psychosocial problems proved most difficult to solve. Patients' knowledge was demonstrated to have increased. A nursing audit found the patients had received 'excellent' quality of care. The nursing method used in this study would be appropriate for such work as it focuses attention on the individual patient and his problems. Application of this approach will require education and support for nurses.