Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .
Health promotion for frail older home care clients.
AIM This paper reports a study evaluating the comparative effects and costs of a proactive nursing health promotion intervention in addition to usual home care for older people compared with usual home care services alone . BACKGROUND An ageing population , budget constraints and technological advances in many countries have increased the pressure on home care re sources . The result is a shift in nursing services from health promotion to meet the more pressing need for postacute care . For frail older people with long-term needs , these changes combine to create a fragmented system of health service delivery , characterized by providing nursing on dem and rather than proactively . METHODS A two-armed , single-blind , r and omized controlled trial was carried out with older people > or = 75 years and eligible for personal support services through a home care programme in Ontario , Canada . Participants were r and omly allocated either to usual home care ( control ) or to a nursing ( experimental ) group . In addition to usual home care , the nursing group received a health assessment combined with regular home visits or telephone contacts , health education about management of illness , coordination of community services , and use of empowerment strategies to enhance independence . The data were collected in 2001 - 2002 . RESULTS Of the 288 older people who were r and omly allocated at baseline , 242 ( 84 % ) completed the study ( 120 nursing group ; 122  control group ) . Proactively providing older people with nursing health promotion , compared with providing nursing services on-dem and , result ed in better mental health functioning ( P = 0.009 ) , a reduction in depression ( P = 0.009 ) , and enhanced perceptions of social support ( P = 0.009 ) at no additional cost from a societal perspective . CONCLUSIONS Home based nursing health promotion , proactively provided to frail older people with chronic health needs , enhances quality of life while not increasing the overall costs of health care . The results underscore the need to re-invest in nursing services for health promotion for older clients receiving home care
Caution must therefore be exercised in interpreting results , but the case for investment in parenting and health visitor-related programmes appears most strong , especially when impacts beyond the health sector are taken into account .
In the workplace an economic return on investment in a number of comprehensive workplace health promotion programmes and stress management projects ( largely in the USA ) was reported , while group-based exercise and psychosocial interventions are of potential benefit to older people .