Nurse-initiated telephone follow-up of postpartum women

The purpose of this study was to determine whether or not a nurse-initiated telephone contact with postpartum women at home is an effective means by which well postpartum families can receive continued professional care, guidance and support. The 99 subjects v/ere selected at one U.S. Air Force Base hospital. Both groups consisted of multiparae and primiparae; women who had Cesarean sections were included. It was hypothesized that mothers who receive nursing follow-up by telephone two days after hospital discharge would identify fewer concerns and less intensity of concerns than' a group of mothers who received no nursing follow-up in the postpartum period. The research method used was an experimental design utilizing a treatment group and a control group. A pretest questionnaire was completed on all subjects in the hospital. The 62 subjects in the treatment group received a nurse-initiated telephone contact two days after hospital discharge. The phone call was made for the purpose of answering mothers' questions and offering information and anticipatory guidance about postpartum adjustment. The 37 control subjects received no phone contact. At six weeks, all subjects completed an interview and questionnaire developed by the investigators related to postpartum concerns and adjustment. Data analysis revealed one significant difference between the two groups of mothers in the hospital--control subjects tended to score higher on physical adjustment than did experimental subjects. This initial difference may have given control subjects an advantage in postpartum adjustment and may have suppressed the effect of the nursing intervention on the experimental subjects. Analysis of numbers and intensity of concerns at six weeks revealed only one significant difference between the groups. Multiparous women in the experimental group had significantly greater intensity of concern with family planning than did multiparae in the control group. Correlations found in the data analysis indicated that women who received the phone contact may have become more comfortable asking questions and expressing concerns. The data also suggested that the telephone contact had a cumulative effect with existing home support systems and with the miother's education in reducing the concern with depression at six weeks. The data indicated that new mothers, both multiparae and primiparae, identify a major focus on self care and infant care at two days after delivery with a dramatic shift to focus on psychosocial concerns at six weeks. Recommendations for further investigation and for postpartum care are included.