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1- Department of Nursing, Student Research Committee, University of Social Welfare and Rehabilitation sciences, Tehran, Iran.
2- Department of Nursing, Student Research Committee, University of Social Welfare and Rehabilitation sciences, Tehran, Iran. ,mahdiehmotie711@gmail.com
3- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
2- Department of Nursing, Student Research Committee, University of Social Welfare and Rehabilitation sciences, Tehran, Iran. ,
3- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Abstract: (92 Views)
Background: The global rise in the older adult population has increased the need for effective rehabilitation care to maintain functional independence. Despite its proven benefits, rehabilitation services for older adults face numerous barriers, particularly in middle-income countries such as Iran. This study aimed to systematically identify and categorize rehabilitation care challenges for older adults at both national and international levels.
Methods: In this narrative review with a systematic search strategy, we searched MagIran, SID, IranDoc, PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2008 and 2024. Original quantitative or qualitative studies addressing barriers to geriatric rehabilitation were included. Data extraction and qualitative content analysis were performed independently by two reviewers. Findings were synthesized and categorized into thematic domains.
Results: Of 98 retrieved records, 23 studies met the inclusion criteria (15 Iranian, 8 international). Challenges were classified into seven main domains: structural (e.g., inadequate infrastructure, lack of specialized equipment), behavioral (e.g., poor communication, elder mistreatment), educational (e.g., insufficient staff training, low health literacy), socio-economic (e.g., inadequate insurance coverage, high out-of-pocket costs), functional (e.g., ineffective referral systems, poor primary care implementation), governance and leadership (e.g., fragmented policies, lack of coordination), and self-care limitations (e.g., physical disabilities, cognitive decline, reduced resilience). Financial barriers and rehabilitation process-related challenges were the most frequently reported obstacles.
Conclusion: Rehabilitation care for older adults faces multifaceted barriers across structural, educational, financial, and governance domains. Strengthening community-based integrated rehabilitation models, expanding insurance coverage, enhancing nurse and family caregiver training, and addressing governance fragmentation are priority actions. Future research should focus on understudied areas such as governance challenges and behavioral barriers.
Methods: In this narrative review with a systematic search strategy, we searched MagIran, SID, IranDoc, PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2008 and 2024. Original quantitative or qualitative studies addressing barriers to geriatric rehabilitation were included. Data extraction and qualitative content analysis were performed independently by two reviewers. Findings were synthesized and categorized into thematic domains.
Results: Of 98 retrieved records, 23 studies met the inclusion criteria (15 Iranian, 8 international). Challenges were classified into seven main domains: structural (e.g., inadequate infrastructure, lack of specialized equipment), behavioral (e.g., poor communication, elder mistreatment), educational (e.g., insufficient staff training, low health literacy), socio-economic (e.g., inadequate insurance coverage, high out-of-pocket costs), functional (e.g., ineffective referral systems, poor primary care implementation), governance and leadership (e.g., fragmented policies, lack of coordination), and self-care limitations (e.g., physical disabilities, cognitive decline, reduced resilience). Financial barriers and rehabilitation process-related challenges were the most frequently reported obstacles.
Conclusion: Rehabilitation care for older adults faces multifaceted barriers across structural, educational, financial, and governance domains. Strengthening community-based integrated rehabilitation models, expanding insurance coverage, enhancing nurse and family caregiver training, and addressing governance fragmentation are priority actions. Future research should focus on understudied areas such as governance challenges and behavioral barriers.
Keywords: Rehabilitation, Aged, Health Services for the Aged, Health Services Accessibility, Rehabilitation Nursing
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