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

Abstract

Context: Increasing life expectancy and the rise in the cost of long-term care at hospitals have led global healthcare systems towards offering home care services. Thus, identifying barriers to this valuable type of care can be an effective step in achieving health-related goals. This study was carried out to determine the challenges faced by home care centers. Evidence Acquisition: This research was conducted as an integrative review in 2018, whereby a wide range of keywords, such as home care, home care nursing, challenges, barriers, and their equivalents in Persian language were used to retrieve related articles. Certain valid Persian and international databases, including EBSCO, EMBACE, SienceDirect, Scopus, MEDLINE, Google Scholar, IranDoc, CINAHL, IranMedex, Magiran, and SID were utilized in order to search for relevant articles. Among papers written in Persian or English, which were useful for the purpose of this study with their full text being accessible, 39 articles were chosen and analyzed using the Broome (indirect cohort) method. Results: In the process of data analysis, the challenges faced by home care centers were revealed. They included non-application of standard and integrated methods for home care nursing services, deficiency in intra- and extra-organizational communications, absence of proper organizational infrastructure, lack of adequate and effective human resources, absence of legal and security supports, economic problems, information poverty, cultural constraints and ignoring ethical issues. Conclusions: There are many challenges and barriers to home care services; these are often intertwined and each is the cause or effect of others. This wide range of challenges and obstacles require coordination, as well as a comprehensive and accurate programming.