The effects of home visits and telephone counseling by nurses on chronic disease management and emergency service use

This study was carried out as a retrospective, prospective and randomized controlled experimental study to evaluate the effect of home visits and telephone counseling on chronic disease management and emergency service use of individuals with chronic diseases who have repeated admissions to the emergency department. The research was conducted in the emergency service of Yağlıdere Public Hospital between January 2021 and July 2021. In the study, a total of 68 patients, 34 patients in the control group and 34 in the experimental group, were included in the sample. The data of the study were collected using the patient information form, patient follow-up form, self-care management processes-guarding (SCMP-G), medication adherence self-efficacy scale-short form (MASES-SF). The frequency of admission to the emergency department and complaints of the patients were compared six months retrospectively and six months forward from the beginning of the study. Home visits and telephone counseling were applied to the patients in the experimental group for three months. During these home visits, face-to-face individual trainings and briefings were provided in line with the needs of the individuals. No intervention was made in the control group. Oneway Anova, t-test, Kruskall Wallis, Mann-Withney U test, chi-square and Fisher's exact tests were used to evaluate the data. It was seen that the chronic patients' repeated admissions to the emergency service were mostly due to hypertension. Six months after the beginning of the study, the frequency of application to the emergency service by the experimental group was significantly lower than the control group (p<0.05). During the last observation, it was found that the mean scores of the MASES-SF scale, SCMP-G scale and the sub-dimensions of SCMP-G scale were significantly higher than the control group (p<0.05). The results showed that home visits and telephone counseling by the nurses reduced the frequency of emergency service use. Although this intervention did not change the reasons for using the emergency service, it was effective in reducing the rate of admissions for the same reasons. Also, it affected medication and self-care management in a positive way.