Intervention in physical rehabilitation programs for visiting nurses―validation of effectiveness using a manual: Randomized parallel-group comparison trial

Background: In developed countries, the demand for home healthcare is increasing as the population ages. Concurrently, the demand for visiting-nurse services is also on the rise. Visiting nurses are required to fulfill a wide range of roles, including active participation in rehabilitation programs. Learning rehabilitation skills can be challenging for nurses, as existing programs often require significant time commitments. However, the effectiveness of shorter, standardized approaches remains largely unexplored. Objectives: To evaluate the effectiveness of providing visiting nurses and their patients in community healthcare with simple physical rehabilitation programs utilizing videos, while assessing the patients’ activities of daily living and quality of life. Methods: Patients using visiting-nurse services participated in a 3-month randomized controlled trial, were divided into a manual intervention group and a control group. The primary evaluation criteria were the differences in the mean Functional Independence Measure and the mean EuroQol 5 dimensions 5 level scores before and after the intervention in both groups. This study was registered in the University hospital Medical Information Network database (UMIN000052101). Results: An analysis of 95 eligible patients showed that the mean difference in the patients' Functional Independence Measure was significantly higher in the intervention group (2.33 points) compared to the control group (−5.91 points). The difference in the patients’ EuroQol 5 dimensions 5 level was not significant between the intervention (0.01 points) and control groups (−0.01 points). Conclusion: This study is novel in its implementation for visiting nurses, regardless of the patients' conditions, and in its use of a relatively convenient educational manual with videos. The simplicity of the video-based education allows many visiting nurses, with limited exposure to rehabilitation, to learn about rehabilitation programs comfortably and effectively, thereby contributing to the improvement of the patients’ activities of daily living in community healthcare.