Objectives-To assess the effect of preventive home visits by public health nurses on the state of health of and use of services by elderly people living at home.Design-Randomised controlled trial.Setting-General population of elderly people in one ofthe southern regions ofthe Netherlands.Subjects-580 subjects aged between 75 and 84 years randomly allocated to intervention (292) or control (288) group.Interventions-Four visits a year over three years in intervention group. Control group received no home visits.Main outcome measures-Self rated health, functional state, well being, loneliness, aspects of the mental state (depressive complaints, memory disturbances), and mortality. Use of services and costs.

The aim of the present study is to acquire insight into the changes of quality of life, social networks, and social support of cancer patients during the first year after diagnosis, as well as into the relation between social support and the changes in quality of life. Newly diagnosed cancer patients (n = 51) were followed for 1 year. Semistructured personal interviews and questionnaires were used to gather data. On the average, patients' functioning improved and the amount of physical complaints decreased over the year. Psychological complaints and the global evaluation of life, however, did not change significantly over time. The patients were supported by small, dense networks, consisting mostly of family members. Size of the networks as well as the amount of emotional support showed some decrease over time. It appeared that emotional support was positively related to quality of life. Moreover, a tendency was found to indicate that patients with a deterioration in quality of life perceived a larger decrease in emotional support than patients with a positive course. The amount of perceived instrumental support did not change significantly. There is a tendency that patients who were functioning worse had a greater need for instrumental support. Although these findings indicate relations between types of support and quality of life, we cannot make statements on the causality of these relations.

Most studies of the problems and information needs of patients describe these only for the period of hospitalization. In this study, however, the authors focused on the first 6 months after discharge. Eighty-two cardiac patients, admitted to a university hospital with a myocardial infarction (MI) or for coronary artery bypass surgery (CABS), were interviewed 6 months after discharge. Questions required them to describe problems they experienced in early recovery and what information they needed. All but one of the 82 patients stated they had experienced problems during the first 6 months after discharge. Most problems described concerned: emotional reactions (59%), their change in physical condition (59%), deleterious effects of treatment (56%) and convalescence (54%). Topics on which most patients needed additional or different information were: deleterious effects of the treatment (26%), physical condition (24%), risk factors (24%), convalescence (24%) and knowledge of the disease (24%).

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