Infection prevention and control knowledge, attitudes, and practices among patients and informal caregivers in home-based care: A systematic review

Background Infection prevention and control (IPC) remains a challenge in home-based care, a rapidly expanding care sector worldwide. Despite the central role of patients and informal caregivers, little is known about their knowledge, attitudes, and practices (KAP). Methods We conducted a systematic review, following PRISMA guidelines, to synthesize evidence on IPC-related KAP among adult patients and informal caregivers in home-based care. PubMed, CINAHL, and Embase were searched for peer-reviewed studies from 1990 to 2025. Eligible studies focused on IPC-related KAP in home health care or home-based care. Study quality was assessed using the 2018 Mixed Methods Appraisal Tool. Results Thirty-four studies met inclusion criteria. Knowledge gaps were common in condition- and device-specific areas such as nebulizer hygiene, catheter care, and wound management. Attitudes were influenced by perceived infection risk, stigma, and social responsibility. While hand hygiene was frequently practiced, adherence to more complex IPC behaviors, such as equipment disinfection and quarantine, was limited. Informal caregivers often assumed IPC responsibilities without adequate training or support. Conclusions IPC-related KAP remains inconsistent among patients and informal caregivers in home-based care, especially in complex or resource-limited settings. Targeted education, caregiver support, and validated KAP assessment tools are needed to improve IPC in this growing sector.