Multidimensional factors affecting homebound older adults: A systematic review

PURPOSE: To systematically identify the multidimensional factors affecting homebound older adults. DESIGN: Systematic review. METHODS: We searched PubMed, MEDLINE, Cochrane Library, CINAHL, EMBASE, and PsycINFO from inception to November 15, 2020. This systematic review followed the Preferred Reporting Items for Systematic Review and Meta‐analysis guidelines. The Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross‐Sectional Studies was used for quality assessment. FINDINGS: Nineteen studies met the review criteria; the studies were either cross‐sectional or longitudinal. Most studies have focused on personal factors affecting homebound older adults. The individual construct consisted of demographic, biological, psychological, functional, and health‐related factors. The structural construct included architectural, environmental, community, and social factors. Based on the different definitions of homebound used in the studies, the prevalence of homebound status ranged from 3.5% to 39.8%. CONCLUSIONS: The prevalence of homebound status among older adults varied depending on how homebound was defined. Homebound status is the interaction between the individual and structural constructs. Variations in cultural, political, and economic conditions could influence homebound status across countries over time. Comprehensive assessment and interventions for homebound older adults based on multidisciplinary approaches are recommended for nurses. CLINICAL RELEVANCE: This research will impact the development of nursing strategies to screen homebound older adults and provide targeted preventive interventions so that older adults with many risk factors do not become homebound.