Keywords
Supporting factors, home care services, patient satisfaction
This article is included in the Health Services gateway.
Home care is an extension of hospital services that must be evaluated, coordinated, and educated to ensure proper care and accelerate recovery. The new concept of home care services can save costs and equipment. The purpose of this study was to determine the factors that influence patient satisfaction with home care services.
This study is a systematic review with PRISMA guidelines using three electronic databases ScienceDirect, Scopus, and Google Scholar. There were 228 articles with duplication reduction to 197 and narrowed down to 73 articles whose titles and abstracts were appropriate, but only 10 articles met the provisions in the full text. Literature search using the keywords Home Care Services AND Satisfaction, then the type of full-text article, in English and a publication period of 10 years. The data extraction process, irrelevant articles such as articles on patient satisfaction in nursing homes and out-of-home care were removed. PROSPERO approved the following research protocol number: CRD42023482315.
Found factors that influence patient satisfaction with home care services.
There are fifteen aspects that affect patient satisfaction and two aspects that affect patient satisfaction in general in long-term home care. It is hoped that the results of this literature review can be used as a reference for hospital home care managers to pay attention to aspects that can affect satisfaction. The author realizes that the methods in the articles vary greatly, which is a deficiency in this systematic review.
Supporting factors, home care services, patient satisfaction
The author and team have made improvements according to reviewer input, including several related matters, namely:
Recommendations
Streamline the Introduction and clearly define the gap this study addresses. (Response: Preliminary streamlining improvements and sharpening of the gaps discussed have been made)
Present the Results in a well-structured summary table. (Response: Improvements have been made to the presentation of the Results in a well-structured summary table, attached)
Expand the Discussion with clearer implications for practice and policy. (Response: The implications section relating to practice and policy has been corrected)
Address heterogeneity more robustly as a limitation. (Response: It has been corrected regarding the research limitations in terms of the heterogeneity of the article's research methods)
Seek professional language editing/proof reading for grammar, spelling and stylistic improvements. (Response: Professional language editing/re-checking has been done for grammar, spelling, and style corrections)
See the authors' detailed response to the review by Cheng Yin
See the authors' detailed response to the review by Kallol Kumar Bhattacharyya
See the authors' detailed response to the review by Jane EA Lewis
Home care services are continuous and comprehensive care provided to individuals or families in their homes. The nursing profession has undergone a paradigm shift, namely from a vocation that emphasizes skills to a professional that also emphasizes ethics, sense, professionalism, and responsibility. Nurses become equal partners with other health professions in managing patients. Nurses provide nursing care to patients, families, and communities to improve health, well-being, and maintain and recover from illness.1
Nurses explore information about the patient’s expectations for treatment and life, through ongoing care, and maintain good relationships with their families. Nurses complete assessments in an effort to obtain accurate and precise information about follow-up.2 Patients who are going home already have a follow-up care plan at home, and nurses are responsible for providing education so that patients can be independent, and reduce costs, including treatment time.3,4 Home care services aim to keep family members together and able to adapt to the needs required.5
Home care services generally require education and coordination between patients and home care workers to accelerate their recovery. This is also a new orientation for patients and their families because it can save costs and equipment.6–8 Currently, the provision of home care services does not reflect fair, safe, and cultural aspects. There are still obstacles such as communication, prejudice, ethnocentrism, education, lack of support from health services.9
One of the home care models that uses an innovative approach offers the potential to improve quality and overcome the challenges of home care. These challenges are resources, time and task rules, health and social care. This innovation model shows a shift from transactional to care that builds trust and relationships between service users, moving towards a proactive and preventive care model. Involving individual care teams and technology as part of the way of working, not just care solutions.10 Quality home care services in terms of reliability, assurance, direct evidence, empathy, and responsiveness are related to satisfaction.11
Health is synonymous with well-being, happiness, and life satisfaction which is the level of physical, emotional, intellectual, social, moral, and spiritual strength. Human health is a state of satisfaction or happiness and well-being that reflects the level of fulfillment of physical, psychological, spiritual, social, aesthetic, and material needs and desires that are felt.12 Home care has different rules and regulations for each home, so nurses must also be able to adjust to different conditions so that satisfaction can be achieved. Factors that influence patient satisfaction with home care services need to be identified, so that they can serve as a reference for home care providers and nurses who make home visits.
A systematic review was conducted to examine the factors influencing patient satisfaction using home care services by following the PRISMA guidelines. Eligibility criteria included human subjects of all ages, genders, and with or without disease, interventions with actions that can increase satisfaction, results of qualitative and quantitative research that state the influence on happiness, and literature review of home care patient satisfaction.
The characteristics of the report are all studies written in English and published from 2012 to 2022. A time span of 10 years is considered a source of literature that is still relevant to be used as a reference in evaluating satisfaction with home care services. Researchers searched for articles through three databases, namely ScienceDirect, Scopus, and Google Scholar. Researchers chose three databases that are open access providers, including Scopus and ScienceDirect are article search databases that can be accessed directly in the electronic resources of the University of Indonesia Library widely, making it easier for researchers. Researchers used Boolean operators to search for the following terms: (Home Care Services) AND (Satisfaction) and derivatives of these terms, full-text article type, English—nursing and health profession subjects, with open access.
In the data extraction process, the identification stage of the articles collected amounted to 228 articles, then the selection stage was carried out by screening duplicate articles from three databases, there were 31 similar articles, leaving 197 articles. The next screening stage was carried out, the eligibility stage was based on the English title and abstract and irrelevant ones such as articles on patient satisfaction variables in nursing homes and out-of-home care were removed, resulting in 73 articles. Furthermore, variables that met the inclusion criteria were selected, namely variables that affect patient satisfaction with home care, so that it was done by re-reading the suitability of the variables, leaving ten complete articles.
Critical appraisal was conducted to identify the quality of the included studies. The author conducted the process. Four research articles used a qualitative study checklist, five studies used a quantitative research checklist, and one used a mixed methods study. The data showed high heterogeneity in terms of research methods. The researcher conducted a quality assessment with one research member, and if there was disagreement on the review results, the researcher asked the other research members for the review results. The results are presented in a table showing a summary of the variables that affect satisfaction.
The nine steps of synthesis without meta-analysis (SWiM) in systematic reviews guide the analysis of data in articles using quantitative methods to complement and extend PRISMA. In the first step, synthesize the studies, grouping populations, interventions, outcomes, and study designs. Next, in steps 2–7, answer the review question. Similarities and differences that are primarily related to assessment methods, assessment tools, assessors involved, and competencies acquired are identified. In steps 8–10, results are formulated based on keywords for categorization. Results are synthesized and the certainty of findings is made in consistent language. Results are then presented in tables, indicating study groups and objectives, presenting and discussing results, and identifying limitations.
After selecting and using the Prisma chart ( Figure 1), ten articles were obtained that were the aim of this research, namely identifying factors that influence satisfaction with home care services. The first journal’s influencing factor is respecting patients and maintaining their dignity.13 Furthermore, the second journal states that nurses must understand the patient’s illness and establish a relationship of mutual trust.14 The third journal shows that the client’s economic factors and the staff’s working hours generally have an impact on satisfaction. This is related to home care services by professionals who will be assisted by caregivers where someone also needs routine assistance and more intensive care hours by caregivers outside of the services provided by professionals. Someone who is constrained by costs or who has costs are both satisfied with professional services because they are both covered by insurance. The time needed by professionals remains the same even though there is a caregiver. This means that insurance and assistance from caregivers in long-term care can provide positive things to clients.15 Furthermore, the four can coordinate in a comprehensive, continuous assessment of service and collaborate with multidisciplinary science.16 Fifth, sixth, and seven, well-prepared routines, language and communication, and empathy.17–19 Eighth, nine, and ten, namely quality nursing services, a combination of competence and professional skills in wound management, continuity of care, and training and experience of nurses.20–22
Nurses can start home care services with a humble attitude and have an attitude of respecting their clients and listening to them. This attitude is very important because it is related to making decisions for clients to suit their needs.23 The attitude and responsibility of nurses show that nursing actions are not just technical actions, but require a process of change and dynamic organization.24 Nurses maintain a person’s dignity, which is one of the fundamental actions and rights of every human being since birth to have the same dignity. Respectful attitudes to anyone must be carried out by nurses because it is the core concept that is guaranteed for every human being.25
A nurse when caring for a home care patient must be flexible, be able to trust each other and be able to approach the patient. Nurses must be able to explain the importance of mutual trust, and the need to create a sense of trust.26 Nurses must be able to understand their clients’ conditions, because they will seek a deep understanding of their illness, the causes of their illness, and prevention of complications.27
Nurses contribute to coordinating with the health team, to support the interventions provided. Good coordination also has an impact on meeting the complex needs of clients.28 Collaboration with other nurses needs to be improved, and made systematic by nurse managers, because it can improve patient safety culture.29 Nurses can undertake lifelong learning to improve their standards of care. Nurses can also improve their knowledge, skills and stay up to date with the latest scientific developments.30
Nurses can provide empathy, namely being able to understand the client’s personal experience without being tied down, and being able to communicate well including emotional, cognitive and behavioral aspects. Clients will feel safe to convey their problems in order to be able to provide services according to their needs.31 Understanding empathy towards patients can improve nursing communication skills.32
Home care nurses can provide continuous professional nursing services by involving their families. Nurses need home care guidelines as a reference to provide the best quality of care to patients.33 Professional skills are also needed such as wound care. Registered nurses are required to have diverse competencies and perform good quality evidence-based actions.34 Optimal home care depends on collaborative action and dialogue between the client, family, home care nurse, and general practitioner. A good starting point is when the interdisciplinary collaboration meeting is held for good results in home care services.35
The implications of the results of this study are that nurses can carry out home care by paying attention to aspects of respect and maintaining dignity that affect patient satisfaction. Home care nurses can also learn to understand client illnesses, establish trusting relationships, assess services, collaborate, choose language, communicate, empathize, and maintain quality of service. The results of this study still have shortcomings, namely in the varying methods of scientific articles such as qualitative, quantitative, mixed methods studies.
Factors that influence patient satisfaction using home care services become input for the provider’s management. Nurses and teams can pay attention to factors that can affect patient satisfaction. This will be an evaluation for subsequent research.
Figshare: Factors Influencing Patient Satisfaction in Home Care Services: A Systematic Review. https://doi.org/10.6084/m9.figshare.26489203.v1.36
This project contains the following underlying data:
1. PRISMA flow diagram: the number of records identified, included and excluded and the reasons for exclusions in this review.
2. Summary review: The summary table contains sample size criteria, methods, and main results.
3. Collection of reviewed articles
4. Prisma 2020 checklist
Data are available under the terms of the Creative Commons Zero “Universal” data waiver (CC0 1.0 Public domain dedication).
Figshare: Factors Influencing Patient Satisfaction in Home Care Services: A Systematic Review. https://doi.org/10.6084/m9.figshare.26489203.v1.36
This project contains the following extended data:
1. PRISMA checklist: a critical tool in the field of systematic reviews
2. PRISMA flow diagram: the number of records identified, included and excluded and the reasons for exclusions in this review.
Data are available under the terms of the Creative Commons Zero “Universal” data waiver (CC0 1.0 Public domain dedication).
We thank The Center for Higher Education (BPPT) and the Lembaga Pengelola Dana Pendidikan (LPDP) for the significant support in the development of this article.
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Are the rationale for, and objectives of, the Systematic Review clearly stated?
Yes
Are sufficient details of the methods and analysis provided to allow replication by others?
Partly
Is the statistical analysis and its interpretation appropriate?
Partly
Are the conclusions drawn adequately supported by the results presented in the review?
Partly
If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.)
Yes
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Public Health, health outcomes, disease prevention, I am an active clinician as well as an academic.
Are the rationale for, and objectives of, the Systematic Review clearly stated?
Partly
Are sufficient details of the methods and analysis provided to allow replication by others?
Partly
Is the statistical analysis and its interpretation appropriate?
Yes
Are the conclusions drawn adequately supported by the results presented in the review?
Partly
If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.)
Partly
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: N/A
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Long-term care, Dementia, Late life cognitive impairment, Quality of life and quality of care in long-term care.
Are the rationale for, and objectives of, the Systematic Review clearly stated?
Partly
Are sufficient details of the methods and analysis provided to allow replication by others?
Partly
Is the statistical analysis and its interpretation appropriate?
Partly
Are the conclusions drawn adequately supported by the results presented in the review?
Partly
If this is a Living Systematic Review, is the ‘living’ method appropriate and is the search schedule clearly defined and justified? (‘Living Systematic Review’ or a variation of this term should be included in the title.)
Not applicable
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Long-term care, Dementia, Late life cognitive impairment, Quality of life and quality of care in long-term care.
Alongside their report, reviewers assign a status to the article:
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Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list:
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