Rural Homecare Nurses' Challenges in Providing Seamless Patient Care in Rural Japan

Abstract

Homecare nurses manage patients with extreme homecare dependence through interprofessional collaboration. The quality of the collaboration depends on situations, and the difficulties of homecare nurses are complicated in rural settings because of a few healthcare resources. This study determined rural homecare nurses' difficulties during interprofessional collaboration in providing seamless patient care. Focus groups, followed by one-on-one interviews, were conducted with 13 rural homecare nurses working in rural Japan. Using thematic analysis, four themes were extracted: collaboration with physicians, the collaboration with the government, the collaboration with care workers, and the collaboration among hospital nurses. Rural homecare nurses have difficulties in their working relationships with other professionals, with vague definitions of each professional's roles and responsibilities, and with information-sharing. Interprofessional education and information-sharing should respect rural professional and cultural backgrounds. Respect can accomplish mutual understanding among professional care, leading to seamless patient care in rural home care.

Keywords: homecare nurses; interprofessional collaboration; multimorbidity; patient care; quality of care; rural medical care.