Study Shows Nurse Visits Help New Mothers, Babies

A leader in the field of research on postpartum depression and early mother-child interaction, professor emeritus of Boston College and former nursing research professor in the Connell School of Nursing June Andrews Horowitz has contributed two more significant studies on clinical depression following childbirth for women.

Having earned her Master of Science in Advanced Psychiatric Nursing from Rutgers University and later a Ph.D. from New York University, Horowitz’s works have been featured in more than 30 publications-the latest was published in the Journal of Obstetric Gynecologic and Neonatal Nursing.

As a senior scientist at the Brigham and Women’s Hospital (BWH) Center for Excellence in Nursing, Horowitz authored a comprehensive evaluation of new mothers selected from a 5,169-patient screening between BWH and Massachusetts General Hospital. The 134 mothers who screened positively were asked to participate in an interview conducted by an experienced psychiatric nurse. If the mother was then found to be experiencing postpartum depression, she was asked to partake in a study that consisted of having one-hour house visits from advanced nurses.

The objective of the study, the reports reads, was “to test the efficacy of the relationship-focused behavioral coaching intervention of Communicating and Relating Effectively (CARE) in increasing maternalinfant relational effectiveness between depressed mothers and their infants during the first 9 months postpartum.”

To assess whether home visits had an effect on the mothers, groups were divided into random clinical trials (RCT) with three phases and varying intervals ranging from six weeks to nine months. The groups were also randomized into treatment and control groups: the treatment group received coaching from the nurse on how to behave around their newborn children, while the control group received no coaching.

The first stage of the study consisted of recruiting from the two major Boston-area hospitals; the second stage commenced the RCT home visits; and the third stage focused on gathering information from focus groups and individual interviews with mothers after their home visits to understand their experiences while participating in the study.

The data showed that home visits from nurses-regardless of whether or not they coached the mothers on child interaction-resulted in a higher quality of mother-infant relationships, and it suggested that home visits from nurses led to a positive effect for all participants.

“Treatment and control groups had significant increases in quality of mother-infant interaction and decreases in depression severity,” the study reads. “Qualitative findings indicated presence of the nurse, empathic listening, focused attention and self-reflection during data collection, directions for video-recorded interaction, and assistance with referrals likely contributed to improvements for both groups.”

Horowitz’s latest research on postnatal depression and mothers’ behavior toward infants focuses on bringing CARE intervention-a system of relationship-focused behavioral nursing-to mothers, and it uses specific tools of measurement, including the Edinburgh Postnatal Depression Scale, to gauge depression among observations.

“Several participants from the treatment and control groups described how important the CARE study was to them as a source of support during the postpartum period,” the study reads. “Control group mothers indicated that they received support and benefit from the nurse home visits.”

Horowitz has since left the University for a position as associate dean at the Thomas Jefferson University School of Nursing in Philadelphia but continues to remain active in the field of nursing.


January 27, 2014