A Study Of The Work Of The Health Visitor And District Nurse With The Elderly

This study is concerned with a comparison of health care of the elderly by district nurse and health visitor. Interest has recently been expressed in the established health care workers particularly which type of professional nurse is the more appropriate to care for the elderly in the community. The literature suggests that health visitors make an important contribution to reducing general morbidity in the elderly. The work of the district nurse has not been looked at in such global terms, but in relation to specific task centred activities. Whilst both types of workers legitimately claim a role in health promotion, there has been little research which explores the impact of their health promotional work with the elderly. There is some evidence from the literature that health promotion may effect changes in individuals' health related activities. However, health promotion has not been studied in terms of the immediate changes in a person's perceived understanding of or control over their own health. Using a Health Belief Model as a framework for the study, a sample of elderly people was selected using a validated postal screening questionnaire. The clients were randomly distributed between health visitor intervention group and health visitor control group and a district nurse group. They were interviewed by independent researchers before and after intervention. A combined health record was devised to monitor the work of the nurses. A Health Belief Model incorporating locus of control was postulated. The experimental approach was justified and its limitations, when explored, indicated the study should be regarded as a pilot and has implications pointing to the value of a major project along these lines. The results showed that there were significant differences between the health visitor group and the district nurse group in terms of ‘activities of daily living', one of the measures of morbidity. ‘Subjectively perceived control over health care' significantly improved in the health visitor group, remained the same in those attended by the district nurse but deteriorated in those with no regular community nurse visiting. The findings support the hypothesis that the elderly retain or improve perceived control over their health care if regular health promotional visiting takes place; it is concluded that the current roles of the health visitor and district nurse with regard to health promotion are different from and complementary to each other. For comprehensive care, this pilot study indicates that both appear necessary.