[version 2; peer review: 1 approved, 1 not approved]
No competing interests were disclosed.
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. 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. 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. Researchers have searched articles through the ScienceDirect, Scopus, and Google Scholar databases. 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.
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.
Fifteen aspects influence patient satisfaction and two aspects that do not influence patient satisfaction. It is expected that the results of this literature review can be used as a reference for hospitals that provide home care services to pay attention to aspects that can affect satisfaction. The author realizes that the varying methods in the articles reviewed are deficiencies in the results of this study.
Some differences from the first version are: Literature search database has been included in the method section. The purpose of the study has been added to the background, which is to determine what factors can affect patient satisfaction with home care services from previously published literature. 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. 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. Critical assessment was conducted in four research articles using a qualitative study checklist, five studies use a quantitative research checklist, and one uses a mixed method study. Data shows high heterogeneity in terms of research methods. Researchers conduct quality assessment with one research member, and if there is an disagreement on the results of a review, the researcher asks the results of a review from other research members. 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.
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.
Nurses explore information related to patient expectations in their treatment and life, through ongoing care, and maintaining good relationships with the patient’s family. Nurses fill in data in an effort to complete accurate and precise information about the patient’s condition.
In general, home care services are a continuation of hospital services and are carried out by hospital staff, but in the evaluation, education and coordination between patients and home care staff are needed to accelerate their recovery. This is also a new orientation for the community because it can save costs and equipment.
One home care model that uses an innovative approach offers the potential to improve quality and address the challenges of home care. These challenges are resources, time and task rules, health and social care. This form of innovation shows a shift from transactional to care that builds trust and relationships between service users, moving towards a proactive and preventative care model. Involving individual care teams and technology as part of the way of working, not just a care solution.
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.
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. 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 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.
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, 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.
After selecting and using the Prisma chart (
| 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 |
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.
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.
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.
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.
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.
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 author realizes that the varying methods in the articles reviewed are deficiencies in the results of this study.
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.
Ethical approval and consent were not required.
No data are associated with this article.
Figshare: Factors Influencing Patient Satisfaction in Home Care Services: A Systematic Review.
This project contains the following underlying data:
PRISMA flow diagram: the number of records identified, included and excluded and the reasons for exclusions in this review. Summary review: The summary review contains an analysis of the selected articles in this review.
Data are available under the terms of the
Figshare: Factors Influencing Patient Satisfaction in Home Care Services: A Systematic Review.
This project contains the following extended data:
PRISMA checklist: a critical tool in the field of systematic reviews 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
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.
Please revise your manuscript to improve the quality of your paper.
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. 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. 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. 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. 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
Is the statistical analysis and its interpretation appropriate?
Yes
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
Are sufficient details of the methods and analysis provided to allow replication by others?
Partly
Are the conclusions drawn adequately supported by the results presented in the review?
Partly
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.
Thank you Mr. Cheng Yin for your input and corrections, I will immediately fix it according to the input that has been submitted. Warm greetings, may you always be healthy
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
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.
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.
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.
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.
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.
1. Abstract: While the authors responded my earlier comments properly, they missed to include a
2. In the last sentence of the
Are the rationale for, and objectives of, the Systematic Review clearly stated?
Partly
Is the statistical analysis and its interpretation appropriate?
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
Are sufficient details of the methods and analysis provided to allow replication by others?
Partly
Are the conclusions drawn adequately supported by the results presented in the review?
Partly
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.
Thank you Mr. Kallol Kumar Bhattacharyya for the review that has been done on my article, I will immediately fix it according to the input, namely
1. Adding Method to the abstract
2. Adjusting the sentence "The purpose of this study has been added to the background…;" instead, only mention the purpose of the study.
May Mr. Kallol Kumar Bhattacharyya always be healthy and happy
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.
Abstract: The first sentence of the
The
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
Are the rationale for, and objectives of, the Systematic Review clearly stated?
Partly
Is the statistical analysis and its interpretation appropriate?
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
Are sufficient details of the methods and analysis provided to allow replication by others?
Partly
Are the conclusions drawn adequately supported by the results presented in the review?
Partly
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.
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
Abstract: The first sentence of the
The
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.