Parent satisfaction with sustained home visiting care for mothers and children: an integrative review

Abstract Aim To synthesise and analyse the existing literature regarding parent satisfaction with sustained home visiting care for mothers and children. Background Sustained home visiting is a service delivery mechanism of both prevention and intervention, in which people receive structured support services within their home environment over an extended period of months or years. For the purposes of this paper, sustained home visiting refers to in-home nursing support to address health inequities for mothers and young children. Sustained home visiting programs have been found to support improved health, wellbeing, and developmental outcomes for children and families. However, there is limited knowledge with regards to the level of parent satisfaction with care provided at home, and the factors and elements of care parents perceive to be critical to their satisfaction. It is important for healthcare practitioners to understand what practices and process parents consider to be a priority in securing their ongoing engagement. Design Integrative review. Data sources PubMed/Medline, CINAHL, Embase, and PsycINFO. Methods A multi-step approach was used to search and retrieve peer-reviewed studies from the databases. Study selection, data extraction, data synthesis and critical appraisal were undertaken by two independent researchers. Results A total of 13 studies met the inclusion criteria, including nine quantitative and four qualitative studies. The review found that parents provided with home visiting interventions had higher levels of satisfaction with care than those who received routine or facility-based care. Service dose was a factor associated with parent satisfaction, however, the direction of impact on parent satisfaction was mixed. Other elements of care parents perceived as important to service satisfaction included the nurse-client relationship, being treated with respect, empowerment, and emotional support. Conclusion While it is critically important that home visiting practitioners provide evidence-based care and interventions, it is equally important that services are delivered in the context of positive and empowering relationships. Further research is recommended to understand the care process and mechanisms that enhance parent satisfaction and positive experiences, providing optimal quality of care.

【摘要】研究目的：综合并分析现有关于母婴持续居家照护服务家长满意度的相关文献。
研究背景：持续居家访视是兼具预防与干预属性的服务交付模式，服务对象可在家庭环境中获得为期数月乃至数年的结构化支持服务。本文所界定的持续居家访视，特指为解决母婴群体健康不平等问题而提供的居家护理支持。现有研究表明，持续居家访视项目可助力儿童与家庭的健康、福祉及发育结局得到改善。然而，目前学界对家长对居家照护服务的满意度水平，以及家长认为影响其满意度的关键照护因素与内容，尚缺乏充分认知。对于医疗保健从业者而言，明晰家长认为哪些实践与流程是维系其持续参与照护的核心优先级，具有重要意义。
研究设计：整合性综述（Integrative review）。
数据来源：PubMed/Medline、CINAHL、Embase及PsycINFO数据库。
研究方法：采用多步骤流程检索上述数据库中的同行评议研究，并由两名独立研究者分别完成研究筛选、数据提取、数据综合与质量评价工作。
研究结果：共计13项研究符合纳入标准，其中9项为定量研究，4项为定性研究。本综述发现，接受居家访视干预的家长，其对照护服务的满意度水平显著高于接受常规门诊或机构照护的家长。服务剂量（service dose）是与家长满意度相关的影响因素，但其对家长满意度的影响方向存在异质性。家长认为对服务满意度至关重要的其他照护要素包括：护患关系、获得尊重的对待、赋权支持以及情感关怀。
研究结论：尽管居家访视从业者提供循证照护与干预措施至关重要，但在积极且赋权型的关系框架下提供服务，同样具有同等重要的意义。未来仍需开展进一步研究，以阐明能够提升家长满意度与正向体验的照护流程与机制，从而实现最优的照护服务质量。