Enablers and Barriers to Home Management for Children with Gastroenteritis: Systematic Review.

Objective: To identify enablers and barriers to home management for children with acute gastroenteritis perceived by health care professionals and caregivers. Study design: A systematic review was conducted using the following databases: PubMed, Embase, Web of Science, and Cumulative Index to Nursing & Allied Health. Studies from high-income countries published from 2003 to 2023 who included children with acute gastroenteritis younger than 6 years, treated via home management, and addressed enablers or barriers from the perspective of healthcare professionals or caregivers, were eligible for inclusion. Studies were independently reviewed for inclusion, data extraction, and quality assessment. Data synthesis was conducted using the Theoretical Domains Framework and Capability, Opportunity, Motivation-Behavior model. Results: In total, 4476 studies were screened, with 16 meeting the inclusion criteria. The commonest enablers for health care professionals concerned the "opportunity" component (ie, access to clinical decision tools, protocols, provision of free oral rehydration therapy), followed by their "capability" component (ie, knowledge about guidelines, oral rehydration therapy, and ondansetron) to initiate home management. Conversely, caregivers' factors relied more on internal factors within the "motivation" component (ie, emotions, insecurity, need for reassurance), whereas "opportunity" components (ie, information sheets, monitoring calls) could assist them in managing their child with gastroenteritis at home. Conclusions: Health care professionals could benefit from enhanced capabilities and clinical decision support systems, whereas caregivers may require access to information resources and support for positive emotions and beliefs in their capabilities. Addressing these aspects could optimize home management, potentially allowing more children with acute gastroenteritis to be treated at home.