Background: Preeclampsia (PE) is one of the leading causes of mortality and complications during pregnancy. It seems that usual prenatal care is not enough for these patients. They require more assistance, support, and guidance from health professionals, and home care is an effective strategy in this regard. Also, Iran has no official or compiled program for home care in high-risk pregnancy. This study was designed to explore the potential achievements and barriers of home care for mothers with PE. Methods: In this qualitative study with conventional content analysis, twenty-eight participants (mothers with PE, maternal health policy-makers, and health care providers) were selected through purposeful sampling with maximum variation. Data were collected through semi-structured interviews until saturation was achieved. Simultaneously, data analysis was performed using MXQDA software. Finally, the main categories were extracted. Results: Seven main categories were extracted. Three main categories for the potential achievement included “family involvement in maternal care”, “holistic maternal health promotion”, and “improving utility of services”. The other four categories emerged for barriers included: “more willingness to provide in-hospital medical care”, “clients’ concerns about cultural issues”, “providers` unwillingness to delivery home care”, and “insufficiency of infrastructures for home care”. Conclusion: Paying attention to home care advantages, based on the socio-cultural context of the community, making effort to remove the barriers, and organizing home care infrastructures contribute to improvement in the quality of care in women with PE. |
- Akbarzadeh M, Khajehei M, Sharif F, Hadzic M. High-risk pregnancy: Effects on postpartum depression and anxiety. British Journal of Midwifery. 2012;20:104-113.
- Dutta DC, Konar H. DC Dutta’s Textbook of obstetrics: including perinatology and contraception. 8th ed. India: Jaypee Brothers Medical Publishers; 2016.
- Lee H, Crowne SS, Estarziau M, et al. The Effects of Home visiting on prenatal Health, Birth outcomes, and Health care use in the first year of life. Final implementation and impact finding from the mother and infant home visiting program evaluation-strong start. US: Office of Planning, Research and Evaluation; 2019.
- Goyal NK, Folger AT, Hall ES, et al. Effects of Home Visiting and Maternal Mental Health on Use of the Emergency Department among Late Preterm Infants. Journal of Obstetric, Gynecologic and Neonatal Nursing. 2015;44:135-44.
- Mokhtari F, Bahadoran P, Baghersad Z. Effectiveness of Postpartum Homecare Program as a New Method on Mothers’ Knowledge about the Health of the Mother and the Infant. Iranian Journal of Nursing and Midwifery Research. 2018;23:316-21.
- Rostgaard T. Quality reforms in Danish home care –balancing between standardisation and individualization. Health & Social Care in Community. 2012;20:247-54.
- Paulsell D, Avellar S, Martin ES, Grosso PD. Home Visiting Evidence of Effectiveness Review: Executive Summary. US: Office of Planning, Research and Evaluation; 2011.
- Petitgout JM, Pelzer DE, McConkey SA, Hanrahan K. Development of a hospital –based care coordination program for children with special health care needs. Journal of Pediatric Health Care. 2013;27:419-25.
- Issel LM, Forrestal SG, Slaughter J, et al. A Review of Prenatal Home-Visiting Effectiveness for Improving Birth Outcomes. Journal of Obstetric, Gynecologic & Neonatal Nursing. 2011;40:157-65.
- Ichikawa K, Fujiwara T, Nakayama T. Effectiveness of Home Visits in Pregnancy as a Public Health Measure to Improve Birth Outcomes. PLoS One. 2015;10:e0137307.
- Kirkwood BR, Manu A, ten Asbroek AHA, et al. Effect of the Newhints home-visits intervention on neonatal mortality rate and care practices in Ghana: a cluster randomized controlled trial. Lancet. 2013;381:2184-92.
- Waiswa P, Peterson S. Home visits: a strategy to improve newborn survival. Lancet. 2013;382:2184-92.
- Forde I, Nader C, Socha-Dietrich K, et al. Primary Care Review of Denmark. France: Organization for Economic Co-operation and Development; 2016.
- Peacock S, Konrad S, Watson E, et al. Effectiveness of home visiting programs on child outcomes: A systematic review. BMC Public Health. 2013;13:17.
- Roman L, Raffo JE, Zhu Q, Meghea CI. A Statewide Medicaid Enhanced Prenatal Care Program: Impact on Birth Outcomes. JAMA Pediatrics. 2014;168:220-7.
- Valizadeh L, Zamanzadeh V, Saber S, Kianian T. Challenges and Barriers Faced by Home Care Centers: An Integrative Review. Medical Surgical Nursing Journal. 2018;7:e83486.
- Abdelmoneium AO, Alharahsheh ST. Family Home Caregivers for Old Persons in the Arab Region: Perceived Challenges and Policy Implications. Open Journal of Social Sciences. 2016;4:151-64.
- Wong AK, Ong SF, Matchar DB, et al. Complexities and Challenges of Singapore Nurses Providing Postacute Home Care in Multicultural Communities: A Grounded Theory Study. Journal of Transcultural Nursing. 2018;29:402-9.
- Adib hajbagheri M, Parvizi S, Salsali M. Qualitative research methods. Tehran: Boshra Publisher; 2015. [In Persian]
- Seidman I. Interviewing as Qualitative Research: A Guide for Researchers in Education and the Social Sciences. 5th ed. New York (US): Teachers College Press; 2019.
- Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004;24:105-12.
- Lincoln YS, Guba E. Naturalistic Inquiry. California (US): Sage Publications; 1985.
- Harden BJ, Chazan‐Cohen R, Raikes H, Vogel Chi. Early head start home visitation: the role of implementation in bolstering program benefits. Journal of Community Psychology. 2012;40:438-55.
- Doi L, Jepson R, Hardie S. Realist evaluation of an enhanced health visiting programme. PLoS One. 2017;12:e180569.
- West A, Gagliardi L, Gatewood A, et al. Randomized Trial of a Training Program to Improve Home Visitor Communication around Sensitive Topics. Maternal and Child Health Journal. 2018;22:70-8.
- Roux IM, Tomlinson M, Harwood JM, et al. Outcomes of Home Visits for Pregnant Mothers and their Infants: a Cluster Randomised Controlled Trial. AIDS. 2013;27:1461-71.
- Stocker R, Bamford C, Brittain K, et al. Care home services at the vanguard: a qualitative study exploring stakeholder views on the development and evaluation of novel, integrated approaches to enhancing healthcare in care homes. BMJ Open. 2018;8:e017419.
- Barboza M, Kulane A, Burström B, et al. Building trust through a postnatal extended home visiting programme in Sweden: parents’ perceptions. European Journal of Public Health. 2018;28(S4).
- Christie L. The importance of the antenatal home visit by health visitor. Journal of Health Visiting. 2016;4:142-8.
- Simpser E, Hudak ML. Financing of Pediatric Home Health Care. Pediatrics. 2017;139:e20164202.
- Ranjbar F, Gharacheh M, Vedadhir A. Overmedicalization of Pregnancy and Childbirth. International Journal of Women’s Health and Reproduction Sciences. 2019;7:419-20.
- World Health Organization. Recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization; 2016.
- Simkhada B, Porter MA, van Teijlingen ER. The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study. BMC Pregnancy and Childbirth. 2010;10:34.
- Kohan S, Mohammadi F, Mostafavi F, Gholami A. Being Single as a Social Barrier to Access Reproductive Healthcare Services by Iranian Girls. International Journal of Health Policy and Management. 2017;6:147-53.
- Chen L, Qiong W, van Velthoven MH, et al. Coverage, quality of and barriers to postnatal care in rural Hebei, China: a mixed method study. BMC Pregnancy and Childbirth. 2014;14:31.
- D’Souza JC, James ML, Szafara KL, Fries BE. Hard Times: The Effects of Financial Strain on Home Care Services Use and Participant Outcomes in Michigan. The Gerontologist. 2009;49:154-65.
- Gudnadottir M, Bjornsdottir K, Jonsdottir S. Integrated Home Care Service: Qualitative Study on Collaboration between Home Care Nursing and Social Service. International Journal of Integrated Care. 2017;17:1-8.
- Berna Demiralp, Jessica S Speelman, Christine M Cook, et al. Incomplete Home Health Care Referral After Hospitalization Among Medicare Beneficiaries. Journal of the American Medical Directors Association. 2021;22:1022-8.
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