INVESTIGATING THE CHALLENGES OF NURSING CARE AT HOME: A NARRATIVE REVIEW

Metanat, Fateme; Hosseini, Asra; Farahmand fard, Behnaz; Motie, Mahdieh

doi:10.61186/unmf.22.7.536

Volume 22, Issue 7 (10-2024) Nursing and Midwifery Journal 2024, 22(7): 536-552 | Back to browse issues page

‎ 10.61186/unmf.22.7.536

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Metanat F, Hosseini A, Farahmand fard B, Motie M. INVESTIGATING THE CHALLENGES OF NURSING CARE AT HOME: A NARRATIVE REVIEW. Nursing and Midwifery Journal 2024; 22 (7) :536-552
URL: http://unmf.umsu.ac.ir/article-1-5211-en.html

INVESTIGATING THE CHALLENGES OF NURSING CARE AT HOME: A NARRATIVE REVIEW

Fateme Metanat¹

, Asra Hosseini¹

, Behnaz Farahmand fard¹

, Mahdieh Motie ^*²

1- Community Health Nursing Master's Student, Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
2- Nursing PhD student, Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran , mahdiehmotie71@gmail.com

Abstract: (1003 Views)

Background & Aim: As the elderly population and their needs increases, home nursing care has been proposed as an effective alternative to certain hospital services, which encounter various challenges. This study aimed to identify the challenges associated with home care nursing.
Materials & Methods: The current study is a narrative review. In the initial stage, we conducted a search for articles in both English and Farsi using Boolean operators and the keywords "Home Nursing," "Home Care," and "Nurse." And their Farsi equivalents. This search was performed across various international and national databases, including Science Direct, Web of Science, Scopus, PubMed, SID, and Google Scholar. We focused on articles published between 2003 and 2024. A total of 17 articles were examined based on the predefined inclusion and exclusion criteria, as well as their relevance to the study's objectives.
Results: The results show that the challenges of home care are divided into eight categories, which include in order of importance, organizational, occupational, socio-cultural, economic, individual, familial, and moral challenges.
Conclusion: Nursing care at home faces various challenges that necessitate fundamental reforms. These reforms should address systemic shortcomings and improve interpersonal dynamics by enhancing policies, infrastructure, and nurses' training to elevate the quality and effectiveness of home care services.

Keywords: Home Care, Home Nursing, Nurse

Full-Text [PDF 601 kb] (762 Downloads)

Type of Study: Review article | Subject: پرستاری

References

1. Krutter S, Schaffler‐Schaden D, Eßl‐Maurer R, Seymer A, Osterbrink J, Flamm M. Home care nursing for persons with dementia from a family caregivers' point of view: Predictors of utilisation in a rural setting in Austria. Health Soc Care Community 2022;30(1):389-99. https://doi.org/10.1111/hsc.13412 [PMID: 33963625] [DOI:10.1111/hsc.13412.] [PMCID: PMC9290922]

2. Johnson S, Bacsu J, Abeykoon H, McIntosh T, Jeffery B, Novik N. No place like home: a systematic review of home care for older adults in Canada. Can J Aging 2018;37(4):400-19. https://doi.org/10.1017/S0714980818000375 [PMID: 30176954] [DOI:10.1017/S0714980818000375.]

3. Irandoust K, Esmaiil Zali M, Parvari A, Na'emani F. Epidemiological Study of the Prevalence of Death in Older Adults Receiving Home Treatment Services in Tehran Using ICD-10, 2012-2016. J Mazandaran Univ Med Sci 2021;31(197):190-6. [URL:] [DOI:20.1001.1.17359260.1400.31.197.16.6. (Persian)]

4. Larsson R, Erlingsdóttir G, Persson J, Rydenfält C. Teamwork in home care nursing: A scoping literature review. Health Soc Care Community 2022;30(6):e3309-e27. https://doi.org/10.1111/hsc.13910 [PMID: 35862714] [DOI:10.1111/hsc.13910.] [PMCID: PMC10084131]

5. Sabetsarvestani P, Mohammadi F, Tehranineshat B, Bijani M, Fereidouni Z. Barriers to efficient management of in‐home care: A qualitative content analysis. Nurs Open 2022;9(2):1200-9. https://doi.org/10.1002/nop2.1161 [PMID: 34908248] [DOI:10.1002/nop2.1161.] [PMCID: PMC8859078]

6. Lee J, Kang M-J, Garcia JP, Dykes PC. Developing hierarchical standardized home care nursing statements using nursing standard terminologies. Int J Med Inform 2020;141:104227. 2020.104227 [PMID: 32763790] [DOI:10.1016/j.ijmedinf.]

7. Kuwayama T, Hamabata K, Kamesaki T, Koike S, Kotani K. Research on home care nursing in Japan using geographic information systems: a literature review. Jpn Clin Med 2018;9:1179670718814539. https://doi.org/10.1177/1179670718814539 [PMID: 30515029] [DOI:10.1177/1179670718814539.]

8. Schumacher C, Jones A, Costa AP. Home Care Nursing Visits and Same-Day Emergency Department Use: Which Patients Are Most at Risk? Can J Nurs Res 2021;53(4):376-83. https://doi.org/10.1177/0844562120949426 [PMID: 32819144] [DOI:10.1177/0844562120949426.]

9. Masoumi N, Hosseinzadeh M, VanSon C, Ghezeljeh TN. Home healthcare in Iran: A hybrid concept analysis. Iran J Nurs Midwifery Res 2021;26(3):196-203. https://doi.org/10.4103/ijnmr.IJNMR_198_20 [PMID: 34277369] [DOI:10.4103/ijnmr.IJNMR_198_20.] [PMCID: PMC8262539]

10. Arnold E, Finucane AM, Oxenham D. Preferred place of death for patients referred to a specialist palliative care service. BMJ Support Palliat Care 2015;5(3):294-6. https://doi.org/10.1136/bmjspcare-2012-000338 [PMID: 24644165] [DOI:10.1136/bmjspcare-2012-000338.] [PMCID: PMC4552913]

11. Hashemlu L, Esmaeili R, Bahramnezhad F, Rohani C. The experiences of home care team members regarding the needs of family caregivers of heart failure patients in home health care services in Iran: A qualitative study. ARYA Atheroscler 2022;18(4):1. [URL:] [DOI:10.48305/arya.2022.24350.]

12. Koohi Rostamkalaee Z, Nejatian A. Moral hazard in home health care in Iran: recommendations for policymakers. Int J Community Based Nurs Midwifery 2022;10(4):315-6. [URL:] [DOI:10.30476/IJCBNM.2022.94815.2021]

13. Heydari H. Home-based palliative care: A missing link to patients' care in Iran. Hayat. 2018;24(2):97-101. [URL:]

14. Hashemzadeh Z, Habibi F, Dargahi H, Arab M. Explanation of the Benefits and Challenges of Home Care Plan after Hospital Discharge: A Qualitative Study. Payavard Salamat 2023;17(1):34-44. (Persian) [URL:]

15. Despotova-Toleva L, Toleva-Nowak N. Narrative review of home care for palliative patients in general practice. Ann Palliat Med 2021;10(12):130093023-13023. https://doi.org/10.21037/apm-2021-01 [URL:] [DOI:10.21037/apm-2021-01.] [PMID: 34118861]

16. Giri S, Chenn LM, Romero-Ortuno R. Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses. Eur Geriatr Med 2021;12(6):1127-36. https://doi.org/10.1007/s41999-021-00531-2 [PMID: 34136990] [DOI:10.1007/s41999-021-00531-2.] [PMCID: PMC8208072]

17. Heggestad AKT, Magelssen M, Pedersen R, Gjerberg E. Ethical challenges in home-based care: A systematic literature review. Nurs Ethics 2021;28(5):628-44. https://doi.org/10.1177/0969733020968859 [PMID: 33334250] [DOI:10.1177/0969733020968859.]

18. García-Sánchez FJ, Martínez-Vizcaíno V, Rodríguez-Martín B. Barriers and facilitators for caregiver involvement in the home care of people with pressure injuries: A qualitative study. PLoS One 2019;14(12):e0226359. [PMID: 31869363] [DOI:10.1371/journal.pone.0226359] [PMCID: PMC6927621]

19. Wong GH, Yap P, Pang WS. Changing landscape of nursing homes in Singapore: challenges in the 21st century. Ann Acad Med Singapore 2014;43(1):44-50. [PMID: 24557465] [DOI:10.47102/annals-acadmedsg.V43N1p44]

20. Ellenbecker CH, Samia L, Cushman MJ, Alster K. Patient safety and quality in home health care. Patient safety and quality: An evidence-based handbook for nurses. 2008. [URL:]

21. Quadagno J, Stahl SM. Challenges in Nursing Home Care: A Research Agenda. Gerontologist 2003;43(suppl_2):4-6. doi: 10.1093/geront/43.suppl_2.4. [PMID: 12711719] [DOI:10.1093/geront/43.suppl_2.4]

22. Shahriari M, Nia DH, Cleage F, Hashemi MS. Challenges of Home Care: A Qualitative Study. 2023;23(1):215.. https://doi.org/10.1186/s12912-024-01878-0 [PMID: 38549100] [DOI:10.1186/s12912-024-01878-0.] [PMCID: PMC10976792]

23. Gol MJ, Navipour H, Asl AS. Family care capacity management in home health care: a content analysis qualitative. Q J Nurs Manag 2021;10(3):58-68. (Persian) [URL:]

24. Abedini Z, Khoramirad A, Eskandari N. Challenges of Tele-Nursing in the Follow-Up of Covid-19 Patients. Qom Univ Med Sci J 2022;15(12):808-15. http://dx.doi.org/10.32598/qums.15.12.2530.1. (Persian) [URL:] [DOI: 10.32598/qums.15.12.2530.1]

25. Barasteh S, Rassouli M, Karimirad MR, Ebadi A. Future challenges of nursing in health system of Iran. Front Pub Health 2021;9:676160. https://doi.org/10.3389/fpubh.2021.676160 [PMID: 34368051] [DOI:10.3389/fpubh.2021.676160.] [PMCID: PMC8345111]

26. Navipour H. Care comprehensive assessment in home health care: qualitative content analysis. 2022;16(6):23-32. (Persian) [URL:]

27. Fatemi NL, Moonaghi HK, Heydari A. Exploration of nurses' perception about professionalism in home care nursing in Iran: a qualitative study. Electron Physician 2018;10(5):6803. https://doi.org/10.19082/6803 [PMID: 29997765] [DOI:10.19082/6803.] [PMCID: PMC6033138]

28. Valizadeh L, Zamanzadeh V, Saber S, Kianian T. Challenges and Barriers Faced by Home Care Centers: An Integrative Review. Med Surg Nurs J 2018;7(3):e83486. [URL:] [DOI:10.5812/msnj.83486]

29. Hemati Z, Namnabati M, Taleghani F. Challenges for infants' home care: A qualitative study. Int J Pediatr 2016;4(6):1885-94. [URL:] [DOI:10.22038/ijp.2016.6897]

30. Heydari H, Shahsavari H, Hazini A, Nasrabadi AN. Exploring the barriers of home care services in Iran: A qualitative study. Scientifica 2016;2016(1):2056470. https://doi.org/10.1155/2016/2056470 [PMID: 27127677] [DOI:10.1155/2016/2056470.] [PMCID: PMC4835654]

31. Eskandari M, Abbaszadeh A, Borhani F. Changing care: New challenge in health care process in rural society according to health care providers' experience. J Health Prom Manag 2012;1(2):66-74. (Persian) [URL:]

32. Dehghannezhad J, Hassankhani H, Taleghani F, Rahmani A, SattarPour S, Sanaat Z. Home care nurses' attitude towards and knowledge of home palliative care in Iran: A cross-sectional study. Iran J Nurs Midwifery Res 2021;26(3):272-8. https://doi.org/10.4103/ijnmr.IJNMR_249_19 [PMID: 34277380] [DOI:10.4103/ijnmr.IJNMR_249_19.] [PMCID: PMC8262541]

33. Rajabi M. Challenges of Home Care in Iran: A Focus on the Functions of the Health System. Int J Community Based Nurs Midwifery 2023;11(3):222. [URL:] [DOI:10.30476/IJCBNM.2023.98683.2252]

34. Keyvanloo Shahrestanaki S. "Letter to Editor"Challenges of Home Care during the COVID-19 Outbreak. Iran J Nurs 2020;33(127):1-6. (Persian) [URL:]

35. Safdari R, Alizadeh M, Mohamadiazar M, Sharifi F, Fakhrzadeh H. Comparative Study of Home Care Program in Iran With Other Developed Countries. Iran J Diabetes Lipid Dis 2014;13(6):439-46. (Persian) [URL:]

36. Shahriari M, Nia DH, kalij F, Hashemi MS. Challenges of home care: a qualitative study. BMC Nurs 2024;23(1):215. https://doi.org/10.1186/s12912-024-01878-0 [PMID: 38549100] [DOI:10.1186/s12912-024-01878-0.] [PMCID: PMC10976792]

37. Attree M. Factors influencing nurses' decisions to raise concerns about care quality. J Nurs Manag. 2007;15:392-402. https://doi.org/10.1111/j.1365-2834.2007.00679.x [PMID: 17456168] [DOI:10.1111/j.1365-2834.2007.00679.x.]

38. Manchana V. Job demands and job resources for job satisfaction and quality health outcomes among nurses during COVID-19: A cross-sectional study in Indian health settings. J Educ Health Promot 2022;11:347. [PMID: 36568018] [DOI:10.4103/jehp.jehp_151_22] [PMCID: PMC9768740]

39. Wang JY, Zhuang HL, Chiou JY, Wang CW, Wang CY, Liu LF. Exploring factors influencing the work-related morale for certified nursing assistants in hospice care: A structural equation modeling study. PLoS One 2018;13(10):e0206281. https://doi.org/10.1371/journal.pone.0206281 [PMID: 30365527] [DOI:10.1371/journal.pone.0206281.] [PMCID: PMC6203351]

40. Johnson RW, Wang CX. The Financial Burden Of Paid Home Care On Older Adults: Oldest And Sickest Are Least Likely To Have Enough Income. Health Aff 2019;38(6):994-1002. https://doi.org/10.1377/hlthaff.2019.00025 [PMID: 31158022] [DOI:10.1377/hlthaff.2019.00025.]

41. Beauvais B, Kruse CS, Ramamonjiarivelo Z, Pradhan R, Sen K, Fulton L. An Exploratory Analysis of the Association Between Hospital Labor Costs and the Quality of Care. Risk Manag Healthc Policy 2023;16:1075-91. https://doi.org/10.2147/RMHP.S410296 [PMID: 37342727] [DOI:10.2147/RMHP.S410296.]

42. Riley WJ. Health disparities: gaps in access, quality and affordability of medical care. Trans Am Clin Climatol Assoc 2012;123:167-72; discussion 72-4. [URL:]

43. McMaughan DJ, Oloruntoba O, Smith ML. Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging. Front Pub Health 2020;8:231. https://doi.org/10.3389/fpubh.2020.00231 [PMID: 32626678] [DOI:10.3389/fpubh.2020.00231.] [PMCID: PMC7314918]

44. Kangovi S, Barg FK, Carter T, Long JA, Shannon R, Grande D. Understanding Why Patients Of Low Socioeconomic Status Prefer Hospitals Over Ambulatory Care. Health Aff 2013;32(7):1196-203. https://doi.org/10.1377/hlthaff.2012.0825 [PMID: 23836734] [DOI:10.1377/hlthaff.2012.0825.]

45. Rong X, Zhou Z, Su Y. Factors Affecting the Job Satisfaction of Caregivers in a Home-Based Elderly Care Program. Int J Environ Res Public Health 2022; 19(15). https://doi.org/10.3390/ijerph19159332 [PMID: 35954687] [DOI:10.3390/ijerph19159332.] [PMCID: PMC9368037]

46. Hsu W, Chao Y-C, Yang C-H. Factors influencing home care workers' loyalty in long-term nursing services. Humanit Soc Sci Commun 2023;10(1):308. [URL:] [DOI:10.1057/s41599-023-01819-3]

47. Regulation IoMCoNH. Improving the quality of care in nursing homes: National Academies Press; 1986. DOI: 10.17226/646 [DOI:10.17226/646]

48. Zakeri MA, Rahiminezhad E, Salehi F, Ganjeh H, Dehghan M. Burnout, Anxiety, Stress, and Depression Among Iranian Nurses: Before and During the First Wave of the COVID-19 Pandemic. Front Psychol 2021;12:789737. [PMID: 34899542] [DOI:10.3389/fpsyg.2021.789737] [PMCID: PMC8654725]

49. Babapour A-R, Gahassab-Mozaffari N, Fathnezhad-Kazemi A. Nurses' job stress and its impact on quality of life and caring behaviors: a cross-sectional study. BMC Nurs 2022;21(1):75. https://doi.org/10.1186/s12912-022-00852-y [PMID: 35361204] [DOI:10.1186/s12912-022-00852-y.] [PMCID: PMC8968092]

50. Reinhard SC, Given B, Petlick NH, Bemis AJPs, nurses qAe-bhf. Chapter 14: Supporting family caregivers in providing care. 2008;1:341-404. [URL:]

51. Arab M, Shahriari M, Keshavarzian A, Abbaszadeh A, Keshvari M. Nurses' experiences of the ethical values of home care nursing: A qualitative study. Int J Nurs Sci 2022;9(3):364-72. https://doi.org/10.1016/j.ijnss.2022.06.008 [PMID: 35891901] [DOI:10.1016/j.ijnss.2022.06.008.] [PMCID: PMC9305015]