Factors influencing patient satisfaction in home care services: A systematic review

Deby Zulkarnain Rahadian Syah; Krisna Yetti; Enie Novieastari; Dewi Gayatri; Sri Nining

doi:10.12688/f1000research.154937.1

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Systematic Review

Factors influencing patient satisfaction in home care services: A systematic review

[version 1; peer review: 1 approved with reservations]

Deby Zulkarnain Rahadian Syah ^1,2, Krisna Yetti¹, Enie Novieastari¹, Dewi Gayatri¹, Sri Nining^3,4

Deby Zulkarnain Rahadian Syah ^1,2, Krisna Yetti¹, [...] Enie Novieastari¹, Dewi Gayatri¹, Sri Nining^3,4

PUBLISHED 27 Aug 2024

Author details Author details

¹ Faculty of Nursing, Universitas Indonesia, Depok, West Java, 16424, Indonesia
² Faculty of Health Science, Universitas Jenderal Achmad Yani Yogyakarta, Sleman, Special Region of Yogyakarta, 55293, Indonesia
³ Faculty of Nursing, Universitas Kristen Krida Wacana, Jakarta, West Jakarta, Indonesia
⁴ Nursing Committee, Woman and Child Bunda Jakarta, Menteng, Central Jakarta, Indonesia

Deby Zulkarnain Rahadian Syah
Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Writing – Original Draft Preparation

Krisna Yetti
Roles: Methodology, Supervision, Validation

Enie Novieastari
Roles: Supervision, Validation

Dewi Gayatri
Roles: Supervision, Validation

Sri Nining
Roles: Supervision, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

This article is included in the Health Services gateway.

Abstract

Background

Home care services are an extension of hospital services provided by hospital staff. The hospital must conduct evaluation, coordination, and education for home care patients to ensure proper care and expedite their recovery. This service also introduces a new concept to the community, as it can help save on costs and equipment

Methods

A systematic review examined the factors influencing patient satisfaction using home care services by following the PRISMA guidelines. PROSPERO submitted and approved the study protocol with the following numbers: CRD42023482315.

Result

Researchers have searched articles through the ScienceDirect, Scopus, and Google Scholar databases. Two hundred eighty-eight articles were selected, but 10 met the inclusion criteria. It was found that factors influenced patient satisfaction with home care services and two things that did not affect them: financial aspects and working time.

Conclusion

Fifteen aspects influence patient satisfaction and two aspects that do not influence patient satisfaction.

Keywords

Supporting factors, home care services, patient satisfaction

Corresponding author: Deby Zulkarnain Rahadian Syah

Competing interests: No competing interests were disclosed.

Grant information: This study was supported by The Center for Higher Education (BPPT) and the Lembaga Pengelola Dana Pendidikan (LPDP). We affirm that the funders had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright: © 2024 Rahadian Syah DZ et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Rahadian Syah DZ, Yetti K, Novieastari E et al. Factors influencing patient satisfaction in home care services: A systematic review [version 1; peer review: 1 approved with reservations]. F1000Research 2024, 13:969 (https://doi.org/10.12688/f1000research.154937.1) First published: 27 Aug 2024, 13:969 (https://doi.org/10.12688/f1000research.154937.1) Latest published: 29 May 2025, 13:969 (https://doi.org/10.12688/f1000research.154937.4)

Introduction

The nursing profession is experiencing a paradigm shift, jobs initially classified as vocational have been transformed into professional. Previously seen as an extension or assistant to doctors, nurses are now seen as equal partners with doctors in developed countries. The nursing service is a method of implementing nursing practice for individual patients, families, and communities to promote health, well-being, and maintaining and recovering from disease. Nurses must be able to take the opportunity to be at the policy-making table with a unified voice to support each other from the scope of nursing practice for health equity.¹^,²

Patients admitted to the hospital already have follow-up care plans at home. Nurses are responsible for educating patients and their families to make patients independent so that they can reduce hospitalization, which reduces costs and time.³^,⁴ In general, home care services are a continuation of hospital services and are carried out by hospital staff, but in evaluation, education and coordination between patients and home care staff are needed to speed up their recovery. It is also a new orientation for the community because it can save costs and equipment.⁵^–⁷ Home care services require a formal method to measure quality and allocate health services that impact individual patients’ health, so further research is needed on home care and the progress of health services that continue to develop.⁸^,⁹

Providing nursing services in home care services does not reflect fair, safe and cultural aspects. Barriers are still found such as communication, prejudice, ethnocentrism, lack of education, lack of support from health services.¹⁰ The research results show that implementing culturally sensitive nursing care training can increase motivation to interact with patients, even a nurse who was previously reluctant to interact because it was difficult to communicate can finally interact well.¹¹

One home care model that uses an innovative approach offers the potential to improve quality and address home care challenges. These challenges are resources, time and task rules, health and social care. The form of innovation shows a move from transactional to care that builds trust and relationships between service users, moving towards a proactive and preventive care model. Involve individual care teams and technology as part of the way of working rather than just a care solution.¹²

Quality home care services in the aspects of reliability, guarantee, direct evidence, empathy and responsiveness are related to patient family satisfaction.¹³ 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.¹⁴

Methods

Research design

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.

Search methods

Report characteristics are all studies written in English and published from 2012 to 2022. Researchers searched articles through the ScienceDirect, Scopus, and Google Scholar databases. Researchers have checked out article references from database searches to find additional relevant articles. We used Boolean operators to search for the following terms: (Home Care Services) AND Satisfaction and derivatives of these terms, full-text article type, English—subject nursing and health professions, with open access.

Data extraction

In the data extraction process, irrelevant articles, such as articles about patient satisfaction in nursing homes and outside home care, were removed, resulting in 228 relevant articles based on title and abstract. These articles were screened, and 31 were removed due to duplication, leaving 197 relevant articles based on title and abstract. Next, variables that met the inclusion criteria were selected, namely variables that influenced home care patient satisfaction, leaving 73 pieces. Next, the selection was carried out by rereading the suitability of the variables, leaving ten complete articles that met the inclusion criteria.

Quality appraisal

Critical appraisal is carried out to identify the quality of the research included in it. The author carries out the process. Four research articles used a list of qualitative studies, five studies used quantitative research checklists, and one used a mixed methods study.

Data analysis

The nine synthesis steps without meta-analysis (SWiM) in systematic reviews guided data analysis.¹⁵ In the first group, the studies are to be synthesized. Grouping populations, interventions, outcomes, and research design. Next, in stages 2–6, answer review questions. Similarities and differences mainly related to assessment methods, assessment tools, assessors involved, and acquired competencies were identified. Findings are formulated based on keywords for categorized. The findings are categorised into two major themes: the assessment process and the competencies obtained. The findings are then entered into tables, indicating study groups and themes, presenting and discussing results, and identifying limitations.

Results

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.¹⁶ Furthermore, the second journal states that nurses must understand the patient’s illness and establish a relationship of mutual trust.¹⁷ The third journal shows the opposite: economic factors and working hours do not affect home care patient satisfaction.¹⁸ Furthermore, the four can coordinate in a comprehensive, continuous assessment of service and collaborate with multidisciplinary science.¹⁹ Fifth, sixth, and seven, well-prepared routines, language and communication, and empathy.²⁰^–²² 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.²³^–²⁵

Figure 1. Prisma flowchart.

Table 1. PICO exploration.

Population	All people/clients or patients who utilize home care services
Intervention	Home care services by a nurse or home care team
Context	What factors support home care patient satisfaction
Outcome	Satisfaction of patients who use home care services

Discussion

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.²⁶ The attitude and responsibility of nurses show that nursing actions are not just technical actions, but require a process of change and dynamic organization.²⁷ 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.²⁸

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. Meeting after meeting will describe the positive aspects that are assessed by the client. Nurses must be able to explain the importance of mutual trust, and the need to create a sense of trust.²⁹ 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.³⁰

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.³¹ Collaboration with other nurses needs to be improved, and made systematic by nurse managers, because it can improve patient safety culture.³² Nurses strive for continuous professional development and undertake lifelong learning to improve standards of care. Nurses are also motivated to improve their knowledge, skills and follow the latest scientific developments.³³

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. A health professional can provide empathy well which can influence therapeutic changes in their clients. Clients will feel safe to convey their problems in order to be able to provide services according to their needs.³⁴ Understanding empathy towards patients can improve nursing communication skills.³⁵

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.³⁶ Professional skills are also needed such as wound care. Registered nurses are required to have diverse competencies and perform good quality evidence-based actions. Consistent and structured areas of competency such as wound care can be improved and developed to produce services according to client expectations.³⁷ 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.³⁸

Implication and limitations

Respect and maintaining dignity are supporting factors that influence patient satisfaction found in nurses or home care teams. Meanwhile, what can be learned and trained is understanding the client’s illness, establishing a relationship of trust, assessing services, collaboration, language, communication, empathy, and quality of service. Aspects that must be possessed include experience and training. The limitation of this research is that home care services are not specific to specific cases or are general. The articles reviewed also vary between qualitative, quantitative and mixed research.

Conclusion

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. There are two factors that do not influence patient satisfaction, namely finances and working time. This will be an evaluation for subsequent research.

Ethics and consent

Ethical approval and consent were not required.

Data availability

Underlying data

No data are associated with this article.

Extended data

Figshare: Factors Influencing Patient Satisfaction in Home Care Services: A Systematic Review. https://doi.org/10.6084/M9.FIGSHARE.26489203.V1.³⁹

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 review contains an analysis of the selected articles in this review.

Data are available under the terms of the Creative Commons Zero “Universal” data waiver (CC0 1.0 Public domain dedication).

Reporting guidelines

Figshare: Factors Influencing Patient Satisfaction in Home Care Services: A Systematic Review. https://doi.org/10.6084/M9.FIGSHARE.26489203.V1 ³⁹

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).

Acknowledgments

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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Comments on this article Comments (0)

Version 4

VERSION 4 PUBLISHED 27 Aug 2024

Author details Author details

Deby Zulkarnain Rahadian Syah
Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Writing – Original Draft Preparation

Krisna Yetti
Roles: Methodology, Supervision, Validation

Enie Novieastari
Roles: Supervision, Validation

Dewi Gayatri
Roles: Supervision, Validation

Sri Nining
Roles: Supervision, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

This study was supported by The Center for Higher Education (BPPT) and the Lembaga Pengelola Dana Pendidikan (LPDP). We affirm that the funders had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Article Versions (4)

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Published: 29 May 2025, 13:969

https://doi.org/10.12688/f1000research.154937.4

version 3

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Published: 20 Jan 2025, 13:969

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version 2

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Published: 25 Nov 2024, 13:969

https://doi.org/10.12688/f1000research.154937.2

version 1

Published: 27 Aug 2024, 13:969

https://doi.org/10.12688/f1000research.154937.1

© 2024 Rahadian Syah DZ et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Rahadian Syah DZ, Yetti K, Novieastari E et al. Factors influencing patient satisfaction in home care services: A systematic review [version 1; peer review: 1 approved with reservations]. F1000Research 2024, 13:969 (https://doi.org/10.12688/f1000research.154937.1)

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Open Peer Review

Version 1

VERSION 1

PUBLISHED 27 Aug 2024

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Reviewer Report 09 Nov 2024

Kallol Kumar Bhattacharyya, Utah State University, Logan, Utah, USA

Approved with Reservations

https://doi.org/10.5256/f1000research.170032.r334099

Comments to the Author

I am pleased to review the manuscript “Factors influencing patient satisfaction in home care services: A systematic review.” The study is important in evaluating the factors influencing the satisfaction of home care patients to ensure proper care and expedite their recovery. Although the article is well-written, and the findings likely benefit future researchers, some fundamental issues dampen my enthusiasm.

Major Issues.

Abstract: The first sentence of the Result section, “Researchers have searched …databases,” should go to the Methods section. Also, a purpose statement for this study should be added in the Background section.
The Introduction section needs more work highlighting the purpose of the current study. The ideas jumped from one to another; there should be more transition sentences, and more importantly, it needs to be more focused to highlight the novelty or strengths of the current research, i.e., what this paper adds to the literature. Further, the authors need to build a robust theoretical base in the Introduction.
Search Methods: “…published from 2012 to 2022. Researchers searched articles through the ScienceDirect, Scopus, and Google Scholar databases.” Why were these specific electronic databases chosen? Was there any rationale behind choosing a specific timeframe?
In Figure 1, the PRISMA flowchart should include reasons for excluding studies in both steps of the screening section (full reasons for n=197 to n=73).
Quality appraisal needs more details.
Data Analysis: Regarding the reliability checks, the authors should provide more clarity to ensure accuracy. I am curious to see what methodology they followed (including citation): having fuller information about how these categorization decisions were made and agreed upon would convince me that these categories fully and reliably reflect the appropriate methodology.
The authors provide a systematic review of 10 studies. The included studies have a heterogeneity of design, sample, and variables. I recommend pointing out the heterogeneity of the included studies as one of the main limitations of this study.

The Implication and Conclusion sections need more work from a policy perspective.

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.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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Author Response 15 Nov 2024

Deby Zulkarnain Rahadian Syah, Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia

15 Nov 2024

Author Response

Thank you to Mr. Kallol Kumar Bhattacharyya for reviewing our article in detail. You are an expert in Gerontology, Dementia, Long-term that I admire. We are happy for the inputs ... Continue reading Thank you to Mr. Kallol Kumar Bhattacharyya for reviewing our article in detail. You are an expert in Gerontology, Dementia, Long-term that I admire. We are happy for the inputs that are very constructive in order to achieve good quality of the article. We will immediately improve it according to the inputs and suggestions. May Mr. Kallol Kumar Bhattacharyya always be in good health and happy. Warm regards Deby Zulkarnain Rahadian Syah
Thank you to Mr. Kallol Kumar Bhattacharyya for reviewing our article in detail. You are an expert in Gerontology, Dementia, Long-term that I admire. We are happy for the inputs that are very constructive in order to achieve good quality of the article. We will immediately improve it according to the inputs and suggestions. May Mr. Kallol Kumar Bhattacharyya always be in good health and happy. Warm regards Deby Zulkarnain Rahadian Syah
Competing Interests: No competing interests were disclosed. Close
Report a concern
Author Response 25 Nov 2024

Deby Zulkarnain Rahadian Syah, Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia

25 Nov 2024

Author Response
1. Abstract: The first sentence of the Result section, “Researchers have searched …databases,” should go to the Methods section. Also, a purpose statement for this study should be added in the Background section.
  Response:
... Continue reading
Abstract: The first sentence of the Result section, “Researchers have searched …databases,” should go to the Methods section. Also, a purpose statement for this study should be added in the Background section.
Response: The literature search database has been included in the Method section. The purpose of this study has been added to the background, namely to determine what factors can influence patient satisfaction with home care services from previously published literature.

The Introduction section needs more work highlighting the purpose of the current study. The ideas jumped from one to another; there should be more transition sentences, and more importantly, it needs to be more focused to highlight the novelty or strengths of the current research, i.e., what this paper adds to the literature. Further, the authors need to build a robust theoretical base in the Introduction.
Response: The paragraphs in the Introduction have been arranged according to the research objectives starting from paragraph one describing the issue of the professional nurse paradigm. Paragraph two describing the need for post-hospitalization care in hospitals. Paragraph three several obstacles to home care services. Paragraph four the importance of innovation in home care services that can increase patient satisfaction. The objectives of this literature review have been added.

Search Methods: “…published from 2012 to 2022. Researchers searched articles through the ScienceDirect, Scopus, and Google Scholar databases.” Why were these specific electronic databases chosen? Was there any rationale behind choosing a specific timeframe?
Response: The researcher chose the 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. The 10-year time span is considered as a source of literature that is still relevant to be used as a reference in evaluating home care service satisfaction.

In Figure 1, the PRISMA flowchart should include reasons for excluding studies in both steps of the screening section (full reasons for n=197 to n=73).
Response: In the data extraction process, irrelevant articles such as articles on patient satisfaction in nursing homes and out-of-home care were removed resulting in 228 relevant articles based on the title and abstract in English. The articles were filtered and 31 articles were removed due to duplication in the Google Scholar database search leaving 197 relevant articles based on the title and abstract. Furthermore, variables that met the inclusion criteria were selected, namely variables that affect patient satisfaction with home care leaving 73 articles. Furthermore, the selection was carried out by re-reading the suitability of the variables leaving ten complete articles that met the inclusion criteria.

Quality appraisal needs more details.
Response: 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.

Data Analysis: Regarding the reliability checks, the authors should provide more clarity to ensure accuracy. I am curious to see what methodology they followed (including citation): having fuller information about how these categorization decisions were made and agreed upon would convince me that these categories fully and reliably reflect the appropriate methodology.
Response: 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, studies should be synthesized, 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.

The authors provide a systematic review of 10 studies. The included studies have a heterogeneity of design, sample, and variables. I recommend pointing out the heterogeneity of the included studies as one of the main limitations of this study.
Response: The author admits that in conducting the analysis of the 10 literatures, there are limitations, namely three different research designs obtained. However, the variables that influence home care patient satisfaction from the 10 literatures can be used as an evaluation for the development of home care services that prioritize patient satisfaction aspects.
Abstract: The first sentence of the Result section, “Researchers have searched …databases,” should go to the Methods section. Also, a purpose statement for this study should be added in the Background section.
Response: The literature search database has been included in the Method section. The purpose of this study has been added to the background, namely to determine what factors can influence patient satisfaction with home care services from previously published literature.

The Introduction section needs more work highlighting the purpose of the current study. The ideas jumped from one to another; there should be more transition sentences, and more importantly, it needs to be more focused to highlight the novelty or strengths of the current research, i.e., what this paper adds to the literature. Further, the authors need to build a robust theoretical base in the Introduction.
Response: The paragraphs in the Introduction have been arranged according to the research objectives starting from paragraph one describing the issue of the professional nurse paradigm. Paragraph two describing the need for post-hospitalization care in hospitals. Paragraph three several obstacles to home care services. Paragraph four the importance of innovation in home care services that can increase patient satisfaction. The objectives of this literature review have been added.

Search Methods: “…published from 2012 to 2022. Researchers searched articles through the ScienceDirect, Scopus, and Google Scholar databases.” Why were these specific electronic databases chosen? Was there any rationale behind choosing a specific timeframe?
Response: The researcher chose the 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. The 10-year time span is considered as a source of literature that is still relevant to be used as a reference in evaluating home care service satisfaction.

In Figure 1, the PRISMA flowchart should include reasons for excluding studies in both steps of the screening section (full reasons for n=197 to n=73).
Response: In the data extraction process, irrelevant articles such as articles on patient satisfaction in nursing homes and out-of-home care were removed resulting in 228 relevant articles based on the title and abstract in English. The articles were filtered and 31 articles were removed due to duplication in the Google Scholar database search leaving 197 relevant articles based on the title and abstract. Furthermore, variables that met the inclusion criteria were selected, namely variables that affect patient satisfaction with home care leaving 73 articles. Furthermore, the selection was carried out by re-reading the suitability of the variables leaving ten complete articles that met the inclusion criteria.

Quality appraisal needs more details.
Response: 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.

Data Analysis: Regarding the reliability checks, the authors should provide more clarity to ensure accuracy. I am curious to see what methodology they followed (including citation): having fuller information about how these categorization decisions were made and agreed upon would convince me that these categories fully and reliably reflect the appropriate methodology.
Response: 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, studies should be synthesized, 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.

The authors provide a systematic review of 10 studies. The included studies have a heterogeneity of design, sample, and variables. I recommend pointing out the heterogeneity of the included studies as one of the main limitations of this study.
Response: The author admits that in conducting the analysis of the 10 literatures, there are limitations, namely three different research designs obtained. However, the variables that influence home care patient satisfaction from the 10 literatures can be used as an evaluation for the development of home care services that prioritize patient satisfaction aspects.
Competing Interests: No competing interests were disclosed. Close
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Author Response 15 Nov 2024

Deby Zulkarnain Rahadian Syah, Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia

15 Nov 2024

Author Response

Thank you to Mr. Kallol Kumar Bhattacharyya for reviewing our article in detail. You are an expert in Gerontology, Dementia, Long-term that I admire. We are happy for the inputs ... Continue reading Thank you to Mr. Kallol Kumar Bhattacharyya for reviewing our article in detail. You are an expert in Gerontology, Dementia, Long-term that I admire. We are happy for the inputs that are very constructive in order to achieve good quality of the article. We will immediately improve it according to the inputs and suggestions. May Mr. Kallol Kumar Bhattacharyya always be in good health and happy. Warm regards Deby Zulkarnain Rahadian Syah
Thank you to Mr. Kallol Kumar Bhattacharyya for reviewing our article in detail. You are an expert in Gerontology, Dementia, Long-term that I admire. We are happy for the inputs that are very constructive in order to achieve good quality of the article. We will immediately improve it according to the inputs and suggestions. May Mr. Kallol Kumar Bhattacharyya always be in good health and happy. Warm regards Deby Zulkarnain Rahadian Syah
Competing Interests: No competing interests were disclosed. Close
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Author Response 25 Nov 2024

Deby Zulkarnain Rahadian Syah, Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia

25 Nov 2024

Author Response
1. Abstract: The first sentence of the Result section, “Researchers have searched …databases,” should go to the Methods section. Also, a purpose statement for this study should be added in the Background section.
  Response:
... Continue reading
Abstract: The first sentence of the Result section, “Researchers have searched …databases,” should go to the Methods section. Also, a purpose statement for this study should be added in the Background section.
Response: The literature search database has been included in the Method section. The purpose of this study has been added to the background, namely to determine what factors can influence patient satisfaction with home care services from previously published literature.

The Introduction section needs more work highlighting the purpose of the current study. The ideas jumped from one to another; there should be more transition sentences, and more importantly, it needs to be more focused to highlight the novelty or strengths of the current research, i.e., what this paper adds to the literature. Further, the authors need to build a robust theoretical base in the Introduction.
Response: The paragraphs in the Introduction have been arranged according to the research objectives starting from paragraph one describing the issue of the professional nurse paradigm. Paragraph two describing the need for post-hospitalization care in hospitals. Paragraph three several obstacles to home care services. Paragraph four the importance of innovation in home care services that can increase patient satisfaction. The objectives of this literature review have been added.

Search Methods: “…published from 2012 to 2022. Researchers searched articles through the ScienceDirect, Scopus, and Google Scholar databases.” Why were these specific electronic databases chosen? Was there any rationale behind choosing a specific timeframe?
Response: The researcher chose the 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. The 10-year time span is considered as a source of literature that is still relevant to be used as a reference in evaluating home care service satisfaction.

In Figure 1, the PRISMA flowchart should include reasons for excluding studies in both steps of the screening section (full reasons for n=197 to n=73).
Response: In the data extraction process, irrelevant articles such as articles on patient satisfaction in nursing homes and out-of-home care were removed resulting in 228 relevant articles based on the title and abstract in English. The articles were filtered and 31 articles were removed due to duplication in the Google Scholar database search leaving 197 relevant articles based on the title and abstract. Furthermore, variables that met the inclusion criteria were selected, namely variables that affect patient satisfaction with home care leaving 73 articles. Furthermore, the selection was carried out by re-reading the suitability of the variables leaving ten complete articles that met the inclusion criteria.

Quality appraisal needs more details.
Response: 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.

Data Analysis: Regarding the reliability checks, the authors should provide more clarity to ensure accuracy. I am curious to see what methodology they followed (including citation): having fuller information about how these categorization decisions were made and agreed upon would convince me that these categories fully and reliably reflect the appropriate methodology.
Response: 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, studies should be synthesized, 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.

The authors provide a systematic review of 10 studies. The included studies have a heterogeneity of design, sample, and variables. I recommend pointing out the heterogeneity of the included studies as one of the main limitations of this study.
Response: The author admits that in conducting the analysis of the 10 literatures, there are limitations, namely three different research designs obtained. However, the variables that influence home care patient satisfaction from the 10 literatures can be used as an evaluation for the development of home care services that prioritize patient satisfaction aspects.
Abstract: The first sentence of the Result section, “Researchers have searched …databases,” should go to the Methods section. Also, a purpose statement for this study should be added in the Background section.
Response: The literature search database has been included in the Method section. The purpose of this study has been added to the background, namely to determine what factors can influence patient satisfaction with home care services from previously published literature.

The Introduction section needs more work highlighting the purpose of the current study. The ideas jumped from one to another; there should be more transition sentences, and more importantly, it needs to be more focused to highlight the novelty or strengths of the current research, i.e., what this paper adds to the literature. Further, the authors need to build a robust theoretical base in the Introduction.
Response: The paragraphs in the Introduction have been arranged according to the research objectives starting from paragraph one describing the issue of the professional nurse paradigm. Paragraph two describing the need for post-hospitalization care in hospitals. Paragraph three several obstacles to home care services. Paragraph four the importance of innovation in home care services that can increase patient satisfaction. The objectives of this literature review have been added.

Search Methods: “…published from 2012 to 2022. Researchers searched articles through the ScienceDirect, Scopus, and Google Scholar databases.” Why were these specific electronic databases chosen? Was there any rationale behind choosing a specific timeframe?
Response: The researcher chose the 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. The 10-year time span is considered as a source of literature that is still relevant to be used as a reference in evaluating home care service satisfaction.

In Figure 1, the PRISMA flowchart should include reasons for excluding studies in both steps of the screening section (full reasons for n=197 to n=73).
Response: In the data extraction process, irrelevant articles such as articles on patient satisfaction in nursing homes and out-of-home care were removed resulting in 228 relevant articles based on the title and abstract in English. The articles were filtered and 31 articles were removed due to duplication in the Google Scholar database search leaving 197 relevant articles based on the title and abstract. Furthermore, variables that met the inclusion criteria were selected, namely variables that affect patient satisfaction with home care leaving 73 articles. Furthermore, the selection was carried out by re-reading the suitability of the variables leaving ten complete articles that met the inclusion criteria.

Quality appraisal needs more details.
Response: 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.

Data Analysis: Regarding the reliability checks, the authors should provide more clarity to ensure accuracy. I am curious to see what methodology they followed (including citation): having fuller information about how these categorization decisions were made and agreed upon would convince me that these categories fully and reliably reflect the appropriate methodology.
Response: 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, studies should be synthesized, 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.

The authors provide a systematic review of 10 studies. The included studies have a heterogeneity of design, sample, and variables. I recommend pointing out the heterogeneity of the included studies as one of the main limitations of this study.
Response: The author admits that in conducting the analysis of the 10 literatures, there are limitations, namely three different research designs obtained. However, the variables that influence home care patient satisfaction from the 10 literatures can be used as an evaluation for the development of home care services that prioritize patient satisfaction aspects.
Competing Interests: No competing interests were disclosed. Close
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Version 4

VERSION 4 PUBLISHED 27 Aug 2024

Open Peer Review

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Reviewer Reports

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	1	2	3
Version 4 (revision) 29 May 25
Version 3 (revision) 20 Jan 25			read
Version 2 (revision) 25 Nov 24	read	read
Version 1 27 Aug 24	read

Kallol Kumar Bhattacharyya, Utah State University, Logan, USA
Cheng Yin, University of North Texas, Denton, USA
Jane EA Lewis, Cardiff Metropolitan University, Cardiff, UK

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Reviewer Report

7 Views

15 May 2025 | for Version 3

Jane EA Lewis, Cardiff Metropolitan University, Cardiff, UK

7 Views Cite this report Responses(2)

Approved With Reservations

Strengths

Patient (and family) satisfaction in home care is a crucial and under-explored area, especially as healthcare systems increasingly shift toward community-based care models. Therefore, this is a relevant and timely topic
The study demonstrates an effort to follow PRISMA standards and includes a registered PROSPERO protocol, which supports methodological transparency.
I can see that the authors actively engaged with previous peer reviewer comments across versions and addressed many concerns (e.g., abstract structure, inclusion/exclusion clarification, and PICO framework use).
The review identifies diverse, multidimensional factors such as dignity, communication, trust, empathy, insurance, and caregiver support that impact satisfaction, offering a broad and inclusive perspective.
Use of SWiM (Synthesis Without Meta-analysis) is appropriate given the heterogeneity of the studies and helps consolidate non-quantitative evidence.

Weaknesses and suggested areas for Improvement

The abstract still appears to lack conciseness and initially omits a clear methods summary (though added in revision).
The introduction is overly verbose, lacks focus, and needs smoother transitions between nursing paradigms and the relevance of patient satisfaction.
Methodological Gaps: The rationale for database selection and time frame, while eventually mentioned, was not initially justified. PRISMA flowchart, though updated, still lacks some granularity (e.g., reasons for exclusions at each stage).
Results Presentation: The findings are described narratively but would benefit from clear, tabular summaries showing study characteristics, sample sizes, methods, and key outcomes. This will widen the audience to include those that are interested but time poor. The key findings (e.g., financial and caregiver-related factors) are not deeply discussed.
Discussion and Implications: This section lacks critical reflection on how the study heterogeneity affects synthesis and implications. The actionable recommendations for policy makers or practitioners are limited. Some claims are repeated across sections, reducing analytical sharpness.
Writing Quality and Grammar: Some sections are overly wordy and grammatically awkward, reducing clarity and impact (e.g., “What are the factors that influence…” question style statements in conclusions or transitions). There are a number of spelling errors.

Recommendations

Streamline the Introduction and clearly define the gap this study addresses.
Present the Results in a well-structured summary table.
Expand the Discussion with clearer implications for practice and policy.
Address heterogeneity more robustly as a limitation.
Seek professional language editing/proof reading for grammar, spelling and stylistic improvements.

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.

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Responses (2)

Author Response

09 Aug 2025

Deby Zulkarnain Rahadian Syah, Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia

The following are responses and answers to several confirmations of improvements made by the author according to reviewer input.

1.The abstract still appears to lack conciseness and initially omits a clear methods summary (though added in revision).
Answer: The summary has been corrected and summarized as follows
Background: 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. Methods: 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. Results Found factors that influence patient satisfaction with home care services. Conclusion 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.

2.The introduction is overly verbose, lacks focus, and needs smoother transitions between nursing paradigms and the relevance of patient satisfaction.
Answer: The sentences in the introduction have been corrected, both in terms of sentence structure and choice of appropriate words so that they are not ambiguous.
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.
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. 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. Home care services aim to keep family members together and able to adapt to the needs required.
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. 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. 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. Quality home care services in terms of reliability, assurance, direct evidence, empathy, and responsiveness are related to satisfaction.
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. 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.

3.Methodological Gaps: The rationale for database selection and time frame, while eventually mentioned, was not initially justified. PRISMA flowchart, though updated, still lacks some granularity (e.g., reasons for exclusions at each stage).
Answer: The reasons for choosing a database have been stated as follows.
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.

4.Results Presentation: The findings are described narratively but would benefit from clear, tabular summaries showing study characteristics, sample sizes, methods, and key outcomes. This will widen the audience to include those that are interested but time poor. The key findings (e.g., financial and caregiver-related factors) are not deeply discussed.
Answer: The table has been adjusted to the criteria of sample size, method, and main results (attached in the figshare link)

5.Discussion and Implications: This section lacks critical reflection on how the study heterogeneity affects synthesis and implications. The actionable recommendations for policy makers or practitioners are limited. Some claims are repeated across sections, reducing analytical sharpness.
Answer: The implications and deficiencies have been corrected, as follows.
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.

6.Writing Quality and Grammar: Some sections are overly wordy and grammatically awkward, reducing clarity and impact (e.g., “What are the factors that influence…” question style statements in conclusions or transitions). There are a number of spelling errors.
Answer: The spelling error has been reviewed and corrected.

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)

Thank you, greetings of health and happiness always

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Competing Interests

No competing interests were disclosed.

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Reviewer Report

14 Views

11 Jan 2025 | for Version 2

Cheng Yin, University of North Texas, Denton, Texas, USA

14 Views Cite this report Responses(2)

Not Approved

Please revise your manuscript to improve the quality of your paper.
Abstract:

Please add a concise methods section outlining the PRISMA guidelines, data sources, and key steps in this section.
The statement “The purpose of this study has been added to the background” is redundant and unnecessary.

Introduction:

The transition between nursing paradigm and home care services is abrupt.
Please explain why the importance of evaluating patient satisfaction is particularly significant in the context of home care services.

Methods:

You need to use a clear framework like PCC (Population, Concept, Context) or justify the chosen inclusion criteria.
The flow diagram does not fully adhere to PRISMA 2020 guidelines and lacks reasons for exclusions at different stages.
The methodology does not mention whether grey literature or reference hand searches were included.
The study mentions using SWiM for narrative synthesis but is not provided.

Results:

This paper lacks depth in explaining the significance of findings such as financial and working time factors.
This paper does not include detailed tables summarizing findings, study characteristics, or variables.
Please ensure consistent formatting of study data, including variables, age ranges, and outcomes, if presented in tables.

Discussion:

There are limited actionable recommendations for healthcare providers or policymakers.
The paper acknowledges heterogeneity in study designs but does not critically evaluate how this affects the synthesis of findings.

Some sentences are unnecessarily verbose and have grammatical errors.
Given the extent of revisions required to address these fundamental issues, I recommend major revising the manuscript (not acceptance). I encourage the authors to rework the paper thoroughly, addressing the methodological and structural concerns raised once these issues have been resolved.

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

I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above.

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Responses (2)

Author Response

20 Jan 2025

Deby Zulkarnain Rahadian Syah, Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia

Here are the improvements based on reviewer input:
Abstract:
1.Please add a concise methods section outlining the PRISMA guidelines, data sources, and key steps in this section.
Answer: Methods: PRISMA guidelines were followed in this systematic review using three electronic databases namely ScienceDirect, Scopus, and Google Scholar. There were 228 articles with the keywords Home Care Services AND Satisfaction and derivatives of these terms, full text article type, English language. Subject nursing and health professions, with open access. The data extraction process, irrelevant articles such as articles on patient satisfaction in nursing homes and outside home care were removed. PROSPERO submitted and approved the research protocol with the following number: CRD42023482315.
2.The statement “The purpose of this study has been added to the background” is redundant and unnecessary.
Answer: Fixed according to reviewer's feedback

Introduction:
1.The transition between nursing paradigm and home care services is abrupt.
Answer: When someone is sick, they need competent care. Homecare services are ongoing and comprehensive care provided to individuals or families in their homes. The nursing profession has undergone a paradigm shift, namely from vocational to professional. Nurses were previously seen as extensions or assistants of one of the health professions, but are now equal partners with other health professions. Nurses provide nursing care to individual patients, families, and communities to improve health, well-being, and maintain and recover from an illness.
2.Please explain why the importance of evaluating patient satisfaction is particularly significant in the context of home care services.
Answer: Home care is a service in each patient's home with different rules and regulations for each home, so nurses must also be able to adjust to these different conditions so that satisfaction can be achieved. What are the factors that influence patient satisfaction in home care services, so that they can be a reference for home care service providers and nurses who make home visits.

Methods:
1.You need to use a clear framework like PCC (Population, Concept, Context) or justify the chosen inclusion criteria.
Answer: The framework adopted using PICO is described below:
Population: All people/clients or patients who utilize home care services: not limited to children or adults, male or female patients including certain diseases
Intervention: Home care services by a nurse or home care team: There is no specific intervention chosen, because the service is based on all actions carried out by nurses and the team for clients at home.
Context: What factors support home care patient satisfaction: identify what factors can impact home care patient satisfaction
Outcome: Satisfaction of patients who use home care services
The exclusion criteria are:
a. patient satisfaction in nursing homes
b. patient satisfaction in hospitals
c. patient satisfaction in clinics
2.The flow diagram does not fully adhere to PRISMA 2020. guidelines and lacks reasons for exclusions at different stages.
Answer: The PRISMA flowchart has been revised as per the feedback.
3.The methodology does not mention whether grey literature or reference hand searches were included.
Answer: A total of 10 literatures obtained were quite varied in terms of research methods, including qualitative and quantitative, client illness, and client age, so this is a limitation of this study.
4.The study mentions using SWiM for narrative synthesis but is not provided.
Answer: The narrative synthesis table has been included in the initial manuscript submission, but it is requested not to be attached.

Results:
1.This paper lacks depth in explaining the significance of findings such as financial and working time factors.
Answer: Two aspects that influence patient satisfaction in general in long-term home care are finances, namely health insurance and working hours assisted by care givers.
2.This paper does not include detailed tables summarizing findings, study characteristics, or variables.
Answer: In the initial manuscript submission, 10 article analyses were included, but we were asked to delete them.
3.Please ensure consistent formatting of study data, including variables, age ranges, and outcomes, if presented in tables.
Answer: for the age range, gender and intervention variables, there are no limitations, perhaps for further research this can be used as input for researchers to determine more specific variables.

Discussion: (Adjusted based on reviewer feedback)
1.There are limited actionable recommendations for healthcare providers or policymakers.
2.The paper acknowledges heterogeneity in study designs but does not critically evaluate how this affects the synthesis of findings. Beberapa kalimat terlalu bertele-tele dan memiliki kesalahan tata bahasa.
3.Some sentences are unnecessarily verbose and have grammatical errors.

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Competing Interests

No competing interests were disclosed.

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Reviewer Report

16 Views

14 Dec 2024 | for Version 2

Kallol Kumar Bhattacharyya, Utah State University, Logan, Utah, USA

16 Views Cite this report Responses(1)

Approved

Comments to the Author

It is my pleasure to re-review the manuscript “Factors influencing patient satisfaction in home care services: A systematic review.” It is now a much better manuscript. I suggest a couple of minor changes and do not need to see it again. All the best.

Minor Issues.

1. Abstract: While the authors responded my earlier comments properly, they missed to include a Methods section in the Abstract; consider adding it. This should start from “A systematic review…”

2. In the last sentence of the Introduction section, the authors do not need to add “The purpose of this study has been added to the background…;” instead, only mention the purpose of the study.

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.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

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Reviewer Report

19 Views

09 Nov 2024 | for Version 1

Kallol Kumar Bhattacharyya, Utah State University, Logan, Utah, USA

19 Views Cite this report Responses(2)

Approved With Reservations

Abstract: The first sentence of the Result section, “Researchers have searched …databases,” should go to the Methods section. Also, a purpose statement for this study should be added in the Background section.
The Introduction section needs more work highlighting the purpose of the current study. The ideas jumped from one to another; there should be more transition sentences, and more importantly, it needs to be more focused to highlight the novelty or strengths of the current research, i.e., what this paper adds to the literature. Further, the authors need to build a robust theoretical base in the Introduction.
Search Methods: “…published from 2012 to 2022. Researchers searched articles through the ScienceDirect, Scopus, and Google Scholar databases.” Why were these specific electronic databases chosen? Was there any rationale behind choosing a specific timeframe?
In Figure 1, the PRISMA flowchart should include reasons for excluding studies in both steps of the screening section (full reasons for n=197 to n=73).
Quality appraisal needs more details.
Data Analysis: Regarding the reliability checks, the authors should provide more clarity to ensure accuracy. I am curious to see what methodology they followed (including citation): having fuller information about how these categorization decisions were made and agreed upon would convince me that these categories fully and reliably reflect the appropriate methodology.
The authors provide a systematic review of 10 studies. The included studies have a heterogeneity of design, sample, and variables. I recommend pointing out the heterogeneity of the included studies as one of the main limitations of this study.

The Implication and Conclusion sections need more work from a policy perspective.

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.

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Responses (2)

Author Response

25 Nov 2024

Deby Zulkarnain Rahadian Syah, Faculty of Nursing, Universitas Indonesia, Depok, 16424, Indonesia

Abstract: The first sentence of the Result section, “Researchers have searched …databases,” should go to the Methods section. Also, a purpose statement for this study should be added in the Background section.
Response: The literature search database has been included in the Method section. The purpose of this study has been added to the background, namely to determine what factors can influence patient satisfaction with home care services from previously published literature.
The Introduction section needs more work highlighting the purpose of the current study. The ideas jumped from one to another; there should be more transition sentences, and more importantly, it needs to be more focused to highlight the novelty or strengths of the current research, i.e., what this paper adds to the literature. Further, the authors need to build a robust theoretical base in the Introduction.
Response: The paragraphs in the Introduction have been arranged according to the research objectives starting from paragraph one describing the issue of the professional nurse paradigm. Paragraph two describing the need for post-hospitalization care in hospitals. Paragraph three several obstacles to home care services. Paragraph four the importance of innovation in home care services that can increase patient satisfaction. The objectives of this literature review have been added.
Search Methods: “…published from 2012 to 2022. Researchers searched articles through the ScienceDirect, Scopus, and Google Scholar databases.” Why were these specific electronic databases chosen? Was there any rationale behind choosing a specific timeframe?
Response: The researcher chose the 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. The 10-year time span is considered as a source of literature that is still relevant to be used as a reference in evaluating home care service satisfaction.
In Figure 1, the PRISMA flowchart should include reasons for excluding studies in both steps of the screening section (full reasons for n=197 to n=73).
Response: In the data extraction process, irrelevant articles such as articles on patient satisfaction in nursing homes and out-of-home care were removed resulting in 228 relevant articles based on the title and abstract in English. The articles were filtered and 31 articles were removed due to duplication in the Google Scholar database search leaving 197 relevant articles based on the title and abstract. Furthermore, variables that met the inclusion criteria were selected, namely variables that affect patient satisfaction with home care leaving 73 articles. Furthermore, the selection was carried out by re-reading the suitability of the variables leaving ten complete articles that met the inclusion criteria.
Quality appraisal needs more details.
Response: 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.
Data Analysis: Regarding the reliability checks, the authors should provide more clarity to ensure accuracy. I am curious to see what methodology they followed (including citation): having fuller information about how these categorization decisions were made and agreed upon would convince me that these categories fully and reliably reflect the appropriate methodology.
Response: 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, studies should be synthesized, 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.
The authors provide a systematic review of 10 studies. The included studies have a heterogeneity of design, sample, and variables. I recommend pointing out the heterogeneity of the included studies as one of the main limitations of this study.
Response: The author admits that in conducting the analysis of the 10 literatures, there are limitations, namely three different research designs obtained. However, the variables that influence home care patient satisfaction from the 10 literatures can be used as an evaluation for the development of home care services that prioritize patient satisfaction aspects.

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Competing Interests

No competing interests were disclosed.

Alongside their report, reviewers assign a status to the article:

Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested

Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.

Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions

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Factors influencing patient satisfaction in home care services: A systematic review

Abstract

Background

Methods

Result

Conclusion

Keywords

Introduction

Methods

Research design

Search methods

Data extraction

Quality appraisal

Data analysis

Results

Figure 1. Prisma flowchart.

Table 1. PICO exploration.

Discussion

Implication and limitations

Conclusion

Ethics and consent

Data availability

Underlying data

Extended data

Reporting guidelines

Acknowledgments

References

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