Designing a Process Model of Home Care Service Delivery in Iran: A Mixed Methods Study

Document Type: Original Article


1 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

2 Department of English Language, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran

3 Social Determinants of Health Research Center, Lorestan University of Medical Science, Khorramabad, Iran

4 Department of Community Health Nursing, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.

5 Department of Home-Based Palliative Care, ALA Cancer Prevention and Control of Charity Center (MACSA), Charity Foundation, Tehran, Iran


Background: Considering the position of home health care in the current world, the objective of this
study was to design an applied model of providing home care services in Iran.
Methods: The mixed methods approach was employed in three stages in Iran from Feb 2015 to Sep
2016. During the first phase, the qualitative method of content analysis was used. Data were collected by conducting 26 individual interviews and holding one focus group session involving 7 people. Data
analysis was based on Graneheim and Lundman’s approach to content analysis.
In the second phase of the study, a literature review was carried out and at the end of this stage, a
preliminary model was designed. The model was standardized in the third phase using the Delphi
method with 23 participants in two rounds.
Results: In the first and second stages of the study, various categories emerged including patient
referral, agreement, determination of the needed level of care, care plans designing, provision of
comprehensive services, documentation, service monitoring, inter-professional cooperation, issuance
of death certificates at home, ethical considerations, and the evaluation of services. Then, in the Delphi phase, 20 (95.2%) of the experts confirmed the structure and content of the model and its applicability.
Conclusion: The designed model can be helpful in organizing the provision of integrated and
comprehensive health services to clients at home, which can be effective in improving the clients’
health and enhancing their self-care and autonomy.



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