Medical - Surgical Nursing Journal

Published by: Kowsar

Challenges and Barriers Faced by Home Care Centers: An Integrative Review

Leila Valizadeh 1 , Vahid Zamanzadeh 2 , Saman Saber 3 and Toktam Kianian 4 , *
Authors Information
1 Department of Pediatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
3 Department of Psychiatric Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
4 Department of Community Health Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
Article information
  • Medical - Surgical Nursing Journal: August 31, 2018, 7 (3); e83486
  • Published Online: January 6, 2019
  • Article Type: Review Article
  • Received: August 20, 2018
  • Accepted: December 9, 2018
  • DOI: 10.5812/msnj.83486

To Cite: 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. doi: 10.5812/msnj.83486.

Copyright © 2019, Medical - Surgical Nursing Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Context
2. Evidence Acquisition
3. Results
4. Discussion
5. Conclusion
  • 1. Cimino NM, Lockman K, Grant M, McPherson ML. Knowledge, skills, and attitudes in caring for older adults with advanced illness among staff members of long-term care and assisted living facilities: An educational needs assessment. Am J Hosp Palliat Care. 2016;33(4):327-34. doi: 10.1177/1049909114561996. [PubMed: 25473091].
  • 2. Hemati Z, Namnabati M, Taleghani F. Challenges for infants’ home care: A qualitative study. Int J Pediatr. 2016;4(6):1885-94.
  • 3. Kok L, Berden C, Sadiraj K. Costs and benefits of home care for the elderly versus residential care: A comparison using propensity scores. Eur J Health Econ. 2015;16(2):119-31. doi: 10.1007/s10198-013-0557-1. [PubMed: 24390144].
  • 4. Nikbakht-Nasrabadi A, Shabany-Hamedan M. Providing healthcare services at home-a necessity in Iran: A narrative review article. Iran J Public Health. 2016;45(7):867-74. [PubMed: 27516992]. [PubMed Central: PMC4980340].
  • 5. Miller EA, Intrator O, Gadbois E, Gidmark S, Rudolph JL. VA staff perceptions of barriers and facilitators to home-and community-based placement post-hospital discharge. J Aging Soc Policy. 2018:1-29. doi: 10.1080/08959420.2018.1444889. [PubMed: 29469672].
  • 6. Castor C, Hallstrom I, Hansson H, Landgren K. Home care services for sick children: Healthcare professionals' conceptions of challenges and facilitators. J Clin Nurs. 2017;26(17-18):2784-93. doi: 10.1111/jocn.13821. [PubMed: 28334466].
  • 7. Febles C, Nies MA, Fanning K, Tavernier SS. Challenges and strategies in providing home based primary care for refugees in the US. J Immigr Minor Health. 2017;19(6):1498-505. doi: 10.1007/s10903-016-0481-4. [PubMed: 27538414].
  • 8. Broome ME. Integrative literature reviews for the development of concepts. In: Rodgers BL, Astin Knafl K, editors. Concept development in nursing: foundations, techniques and applications. Philadelphia: WB Saunders Company; 2000. p. 231-50.
  • 9. Dumas LG, Blanks C, Palmer-Erbs V, Portnoy FL. Leadership in nursing homes-2009: Challenges for change in difficult times. Nurs Clin North Am. 2009;44(2):169-78. doi: 10.1016/j.cnur.2009.03.005. [PubMed: 19463673].
  • 10. Carretero S, Stewart J, Centeno C, Barbabella F, Schmidt A, Lamontagne-Godwin F, et al. Can technology-based services support long-term care challenges in home care? Analysis of evidence from social innovation good practices across the EU CARICT project summary report. European Commission; 2012.
  • 11. 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 Metab. 2014;13(6):439-46. Persian.
  • 12. Ajlouni MT, Dawani H, Diab SM. Home health care (HHC) managers perceptions about challenges and obstacles that hinder HHC services in Jordan. Glob J Health Sci. 2015;7(4):121-9. doi: 10.5539/gjhs.v7n4p121. [PubMed: 25946949]. [PubMed Central: PMC4802083].
  • 13. Hoge CW, Rye CB. Efficacy and challenges of in-home telepsychotherapy. Lancet Psychiatry. 2015;2(8):668-9. doi: 10.1016/S2215-0366(15)00226-6. [PubMed: 26249278].
  • 14. Heydari H, Shahsavari H, Hazini A, Nasrabadi AN. Exploring the barriers of home care services in Iran: A qualitative study. Scientifica (Cairo). 2016;2016:2056470. doi: 10.1155/2016/2056470. [PubMed: 27127677]. [PubMed Central: PMC4835654].
  • 15. Callahan C. Dissemination science: Addressing challenges to the widespread use of evidence-based home dementia care. Alzheimers Dement. 2016;12(7):P217. doi: 10.1016/j.jalz.2016.06.387.
  • 16. Saari M, Patterson E, Killackey T, Raffaghello J, Rowe A, Tourangeau AE. Home-based care: Barriers and facilitators to expanded personal support worker roles in Ontario, Canada. Home Health Care Serv Q. 2017;36(3-4):127-44. doi: 10.1080/01621424.2017.1393482. [PubMed: 29048246].
  • 17. Shahsavari H, Nasrabadi AN, Almasian M, Heydari H, Hazini A. Exploration of the administrative aspects of the delivery of home health care services: A qualitative study. Asia Pac Fam Med. 2018;17:1. doi: 10.1186/s12930-018-0038-x. [PubMed: 29410602]. [PubMed Central: PMC5781270].
  • 18. Wringe A, Cataldo F, Stevenson N, Fakoya A. Delivering comprehensive home-based care programmes for HIV: A review of lessons learned and challenges ahead in the era of antiretroviral therapy. Health Policy Plan. 2010;25(5):352-62. doi: 10.1093/heapol/czq005. [PubMed: 20144935].
  • 19. Shaibu S. Community home-based care in a rural village: Challenges and strategies. J Transcult Nurs. 2006;17(1):89-94. doi: 10.1177/1043659605281974. [PubMed: 16410441].
  • 20. Hokenstad A. More care at home: The challenge of creating viable community alternatives to nursing home care. Care Manag J. 2005;6(1):9-14. doi: 10.1891/cmaj.2005.6.1.9. [PubMed: 16447852].
  • 21. Mohammad N, Gikonyo J. Operational challenges community home based care (CHBC) for PLWHA in multi-country HIV/AIDS programs (MAP) for Sub-Saharan Africa. Washington, DC: World Bank; 2005.
  • 22. Baron S, McPhaul K, Phillips S, Gershon R, Lipscomb J. Protecting home health care workers: A challenge to pandemic influenza preparedness planning. Am J Public Health. 2009;99 Suppl 2:S301-7. doi: 10.2105/AJPH.2008.157339. [PubMed: 19461108]. [PubMed Central: PMC4504355].
  • 23. Higuchi KA, Christensen A, Terpstra J. Challenges in home care practice: A decision-making perspective. J Community Health Nurs. 2002;19(4):225-36. doi: 10.1207/S15327655JCHN1904_03. [PubMed: 12494743].
  • 24. Lee JS, Rock BD. Challenges in the new prospective payment system: Action steps for social work in home health care. Health Soc Work. 2005;30(1):48-55. doi: 10.1093/hsw/30.1.48. [PubMed: 15847237].
  • 25. Neergaard MA, Olesen F, Jensen AB, Sondergaard J. Shared care in basic level palliative home care: Organizational and interpersonal challenges. J Palliat Med. 2010;13(9):1071-7. doi: 10.1089/jpm.2010.0036. [PubMed: 20799902].
  • 26. McBride SE, Beer JM, Mitzner TL, Rogers WA. Challenges for home health care providers: A needs assessment. Phys Occup Therap Geriatr. 2011;29:5-22. doi: 10.3109/02703181.2011.552170.
  • 27. Rantz MJ, Zwygart-Stauffacher M, Flesner M, Hicks L, Mehr D, Russell T, et al. Challenges of using quality improvement methods in nursing homes that "need improvement". J Am Med Dir Assoc. 2012;13(8):732-8. doi: 10.1016/j.jamda.2012.07.008. [PubMed: 22926322]. [PubMed Central: PMC3461118].
  • 28. Koru G, Alhuwail D, Topaz M, Norcio AF, Mills ME. Investigating the challenges and opportunities in home care to facilitate effective information technology adoption. J Am Med Dir Assoc. 2016;17(1):53-8. doi: 10.1016/j.jamda.2015.10.008. [PubMed: 26612483].
  • 29. Fitzpatrick JM, Roberts JD. Challenges for care homes: Education and training of healthcare assistants. Br J Nurs. 2004;13(21):1258-61. doi: 10.12968/bjon.2004.13.21.17124. [PubMed: 15580072].
  • 30. Barak A, Spielberger J, Gitlow E. The challenge of relationships and fidelity: Home visitors' perspectives. Child Youth Serv Rev. 2014;42:50-8. doi: 10.1016/j.childyouth.2014.03.023.
  • 31. Warren-Stomberg M, Jacobsson J, Brattwall M, Jildenstal P. At-home monitoring after surgery/anaesthesia - A challenge. J Eval Clin Pract. 2016;22(6):882-6. doi: 10.1111/jep.12551. [PubMed: 27134050].
  • 32. Taylor C. Home care devices: A new challenge for the profession. Biomed Instrum Technol. 2008;42(5):351-6. doi: 10.2345/0899-8205(2008)42[351:HCDANC]2.0.CO;2. [PubMed: 18925807].
  • 33. Cruise C. Manufacturers face 'adjustment' challenge in home market. Biomed Instrum Technol. 2010;44(5):421-2. doi: 10.2345/0899-8205-44.5.421. [PubMed: 20946047].
  • 34. Floriani CA. Home-based palliative care: Challenges in the care of technology-dependent children. J Pediatr (Rio J). 2010;86(1):15-20. doi: 10.2223/JPED.1972. [PubMed: 20151088].
  • 35. Mohamadi F, Dabaghi F, Nikravesh MY. [Facilitating and hindering factors in family care giving process on iranian frail elderly: Female caregivers experiences]. Salmand. 2008;2(4):445-53. Persian.
  • 36. Goudarzi F, Abedi HA, Zarea K, Ahmadinejad F. [Caring experiences and challenges of families with patients in vegetative state]. J Clin Nurs Midwifery. 2015;3(4):65-79. Persian.
  • 37. Ewers M, Schaeffer D. How home care agencies in Germany view the AIDS challenge: Results of an exploratory study. J Assoc Nurses AIDS Care. 2000;11(4):65-72. doi: 10.1016/S1055-3290(06)60398-1. [PubMed: 10911596].
  • 38. Penz K, Duggleby W. “It’s different in the home …” the contextual challenges and rewards of providing palliative nursing care in community settings. J Hospice Palliat Nurs. 2012;14(5):365-73. doi: 10.1097/NJH.0b013e3182553acb.
  • 39. Pouladi S, Anoosheh M, Kazemnejad A, Zareiyan A. [Factors limiting families in elderly care: A thematic analysis]. J Qualitat Res Health Sci. 2013;2(2):146-57. Persian.
  • 40. Kitzman HJ, Cole R, Yoos HL, Olds D. Challenges experienced by home visitors: A qualitative study of program implementation. J Commun Psychol. 1997;25(1):95-109. doi: 10.1002/(sici)1520-6629(199701)25:1<95::aid-jcop7>;2-1.
  • 41. Geiger-Brown J, Muntaner C, McPhaul K, Lipscomb J, Trinkoff A. Abuse and violence during home care work as predictor of worker depression. Home Health Care Serv Q. 2007;26(1):59-77. doi: 10.1300/J027v26n01_05. [PubMed: 17387052].
  • 42. Suurmond J, Rosenmoller DL, El Mesbahi H, Lamkaddem M, Essink-Bot ML. Barriers in access to home care services among ethnic minority and Dutch elderly--A qualitative study. Int J Nurs Stud. 2016;54:23-35. doi: 10.1016/j.ijnurstu.2015.02.014. [PubMed: 25776734].
  • 43. Deng M, Petkovic M, Nalin M, Baroni I. A home healthcare system in the cloud--Addressing security and privacy challenges. Cloud Computing (CLOUD), 2011 IEEE International Conference on. IEEE; 2011. p. 549-56.
  • 44. Kale MS, Bishop TF, Federman AD, Keyhani S. Trends in the overuse of ambulatory health care services in the United States. JAMA Intern Med. 2013;173(2):142-8. doi: 10.1001/2013.jamainternmed.1022. [PubMed: 23266529]. [PubMed Central: PMC3776407].
  • 45. Michigan Office of Services to the Aging. Operating standards for service programs. 2017.
  • 46. Home Care Ontario. A guide to programs and services for seniors in Ontario. Ontario, Canada: Seniors; 2015.
  • 47. Ministry of Health Labour and Welfare. Service guide 2018: For people, for life, for the future. Tokyo: Ministry of Health Labour and Welfare; 2018.
  • 48. Centers for Medicare & Medicaid Services. Home health care CAHPS survey: Protocols and guidelines manual. 10th ed. CMS; 2018.
  • 49. Palesy D, Jakimowicz S, Saunders C, Lewis J. Home care in Australia: An integrative review. Home Health Care Serv Q. 2018;37(2):113-39. doi: 10.1080/01621424.2018.1438952. [PubMed: 29424658].
  • 50. Genet N, Boerma WG, Kringos DS, Bouman A, Francke AL, Fagerstrom C, et al. Home care in Europe: A systematic literature review. BMC Health Serv Res. 2011;11:207. doi: 10.1186/1472-6963-11-207. [PubMed: 21878111]. [PubMed Central: PMC3170599].
  • 51. Romagnoli KM, Handler SM, Hochheiser H. Home care: More than just a visiting nurse. BMJ Qual Saf. 2013;22(12):972-4. doi: 10.1136/bmjqs-2013-002339. [PubMed: 23940375]. [PubMed Central: PMC4120108].
  • 52. Stajduhar KI, Funk L, Roberts D, McLeod B, Cloutier-Fisher D, Wilkinson C, et al. Home care nurses' decisions about the need for and amount of service at the end of life. J Adv Nurs. 2011;67(2):276-86. doi: 10.1111/j.1365-2648.2010.05491.x. [PubMed: 20973810].
  • 53. Johansen E, Fagerstrom L. An investigation of the role nurses play in Norwegian home care. Br J Community Nurs. 2010;15(10):497-502. doi: 10.12968/bjcn.2010.15.10.78742. [PubMed: 20966846].
  • 54. Andrade AM, Silva KL, Seixas CT, Braga PP. Nursing practice in home care: An integrative literature review. Rev Bras Enferm. 2017;70(1):210-9. doi: 10.1590/0034-7167-2016-0214. [PubMed: 28226061].
  • 55. Silva KL, Sena RR, Silva PM, Braga PP, Souza CG. Serviços de atenção domiciliar na saúde suplementar e a inserção da enfermagem em Belo Horizonte/MG. Acta Paulista Enfermagem. 2012;25(3):408-14. Portuguese. doi: 10.1590/s0103-21002012000300014.
  • 56. Tosi F, Rinaldi A. Design and usability of the next medical devices for the home care. Design J. 2017;20(sup1):S2033-43.
  • 57. Australian Goverment . Your guide to home care package services. Australia: Australian Goverment; 2018.
  • 58. Letvak S. Nurses as working women. AORN J. 2001;73(3):675-8. 680-2. doi: 10.1016/S0001-2092(06)61961-3. [PubMed: 11253621].
  • 59. Koch S. Ubiquitous care in aging societies-A social challenge. In: Blobel B, Pharow P, Nerlich M, editors. EHealth: Combining health telematics, telemedicine, biomedical engineering, and bioinformatics to the ege: Global experts summit textbook. 134. 2008. p. 89-95.
  • 60. Klein R. The new politics of the National Health Service [dissertation]. Texas Tech University; 1972.
  • 61. Toth-Cohen S, Gitlin LN, Corcoran M, Eckhardt S, Kearney P, Lipsitt R. Providing services to family caregivers at home: Challenges and recommendations for health and human service professions. Alzheimers Care Quart. 2001;2(1):23-32.
  • 62. Tesfaye HT, Dip M. Health visitors' perceptions of barriers to health and wellbeing. Commun Practitioner. 2015;880:22-5.
  • 63. Burchill J, Pevalin DJ. Demonstrating cultural competence within health-visiting practice: Working with refugee and asylum-seeking families. Divers Equal Health Care. 2014;11(2). doi: 10.21767/2049-5471.100010.
  • 64. Talkington S. Ethical issues in home care. HEC forum. Springer; 1995.

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