P39: The Effect of Home-Visit Nursing in Preventing Readmission of Patients with Mental Disorders to Psychiatric Hospitals: A Literature Review

Abstract

Background: The transition from hospital to community for psychiatric patients is often challenging due to difficulties in managing community life after discharge and receiving consistent mental health treatment (Marianne, 2019). Some systematic reviews reported on interventions to improve discharge from acute adult mental health inpatient care to the community (Tyler, 2019) and the effectiveness of crisis resolution/home treatment teams for older people with mental health problems (Toot, 2011). However, these reviews revealed inadequate evidence for nursing interventions in community. In Japan, home-visit nursing is considered to play an important role for people with mental disorders living in community.

This review aims to provide an overview of the effectiveness of home-visit nursing in supporting community life for individuals with mental disorders discharged from psychiatric hospitals.

Methods: We conducted a search in electronic databases including Medline (OVID) and CINAHL (EBSCOhost). The search was conducted using the following keywords: “mental disorders”, “hospitalization”, “patient readmission”, “home visit nursing”, “home nursing”, “home health care”, “home care services”, and “house calls”. The review included original articles and research reports. Conference reports and articles about other professions, and interventions conducted in hospitals or facilities were excluded.

Results: A total of 205 articles were extracted, with 109 from Medline and 96 from CINAHL. We retrieved 13 studies, including three randomized controlled trials, two interventional studies, and eight retrospective studies. Most participants were post-discharge individuals with mental disabilities, but some studies included individuals prior to hospital admission. Most studies reported that home-visit interventions reduced psychiatric rehospitalization, the duration of hospitalization, and medical costs. One study reported that community-based treatment for older persons with severe mental illness decreased depressive symptoms and psychiatric hospitalization at 6 months. Additionally, telephone follow-ups were reported to be more effective than regular interventions in some studies. However, the intervention and effectiveness measurement Methods varied among the studies.

Conclusions: Home-visit interventions appear to be effective in preventing hospitalization for individuals with mental disorders. However, it is difficult to make simple comparisons as the content of home-visit interventions varies according to the background system and the region. Further research and systematic reviews are necessary.