Feasibility and impact of a nurse-led home-based care model for refugees with restricted mobility: A mixed-methods study in Beirut, Lebanon

BACKGROUND

People with restricted mobility in humanitarian settings face extreme barriers to healthcare access, leading to functional decline, social isolation, and significant mental health distress (World Report on Disability, 2011). In Lebanese refugee camps, hazardous infrastructure, and the rising burden of non-communicable diseases (NCDs) further exacerbate the vulnerability of home-bound individuals and their informal caregivers (Saleh et al., 2021). This study evaluates a nurse-led home-based care (HBC) model designed to address these physical and psychosocial needs.

METHODS

This mixed-methods descriptive study investigated a nurse-led HBC program in the Shatila and Bourj el Barajneh refugee camps in Beirut, Lebanon, between June 2021 and October 2023. We analysed routinely collected operational data for 105 patient-caregiver pairs (verbal retrospective consent) and conducted semi-structured in-depth interviews with a purposive subsample of 16 pairs (written prospective consent) to explore participant perceptions. Quantitative outcomes were analysed for the n = 79 dyads who completed the full intervention.

RESULTS

The program achieved a high retention rate of 82%. Quantitative findings demonstrated significant improvements in mental health, with a reduction in depression and anxiety scores for both patients and caregivers (both p < 0.001). Patient dependency also decreased significantly (Basic Activities of Daily Living, p = 0.003). While medication adherence was high at enrolment, the program successfully maintained these levels throughout. Qualitative data revealed that the program’s primary value was in alleviating profound social isolation and providing emotional support, which participants often prioritized over medical services.

CONCLUSION

HBC is a feasible and effective model for improving the well-being of highly vulnerable populations in complex humanitarian settings. The study underscores that in contexts of chronic distress, the psychosocial and relational components of care are as vital as clinical intervention for fostering resilience in both patients and caregivers.