BACKGROUND: During the Covid-19 pandemic, family visitation to intensive care was severely restricted. In response, family communication moved to remote-only options. The effect on patients and families of this communication change is poorly understood.
OBJECTIVE: The aim of this review was to synthesise the available research on remote-only communication interventions and their effect on patient and family outcomes within the intensive care environment.
METHODS: A systematic review of relevant studies was undertaken.
METHODS: Databases included CINAHL, APA PsychINFO, MEDLINE, and Ovid Embase.
METHODS: Databases were searched with a date restriction of June 1st, 2011, to June 1st, 2023. Two independent reviewers assessed each study using the Mixed Methods Appraisal Tool, version 2 of the Cochrane risk-of-bias tool for randomised controlled trials, and the Risk Of Bias In Nonrandomised Studies of Interventions tool for methodological quality and risk of bias. Of the 2292 articles screened, 10 studies met the inclusion criteria.
RESULTS: Ten studies were included (n = 3861). Methodological quality was mostly poor, with one study evaluated as high on Mixed Methods Appraisal Tool quality criteria. Two themes were derived from the literature: (i) patient and family satisfaction; and (ii) patient and family psychological distress symptoms. Five studies reported patient and family satisfaction, with four studies finding statistically significant improvement following the communication intervention. However, only one of the five studies specifically evaluated the satisfaction with the communication intervention. Nine studies reported patient and family psychological distress symptoms, using 12 measurement tools. A variable effect of interventions was found within this theme.
CONCLUSIONS: This review identified important gaps in the research examining remote-only family communication interventions in intensive care. Inconsistent delivery of remote-only communication interventions, biased research methods, and variable outcome measurement tools impacted the reliability and validity of current evidence. Further research on remote-only communication interventions and the effect on families is recommended.

BACKGROUND: Pharmacist-led medication reviews are an established intervention to support patients prescribed multiple medicines or with complex medication regimes. For this systematic review, a medication review was defined as \'a consultation between a pharmacist and a patient to review the patient\'s total medicines use with a view to improve patient health outcomes and minimise medicines-related problems\'. It is not known how varying approaches to medication reviews lead to different outcomes.
OBJECTIVE: To explore the common themes associated with positive outcomes from pharmacist-led medication reviews.
METHODS: Randomised controlled trials of pharmacist-led medication reviews in adults aged 18 years and over were included. The search terms used in MEDLINE, EMBASE and Web of Science databases were \"medication review\", \"pharmacist\", \"randomised controlled trial\" and their synonyms, time filter 2015 to September 2023. Studies published before 2015 were identified from a previous systematic review. Risk of bias was assessed using the Cochrane risk of bias 2 tool. Descriptions of medication reviews\' components, implementation and outcomes were narratively synthesised to draw out common themes. Results are presented in tables.
RESULTS: Sixty-eight papers describing 50 studies met the inclusion criteria. Common themes that emerged from synthesis include collaborative working which may help reduce medicines-related problems and the number of medicines prescribed; patient involvement in goal setting and action planning which may improve patients\' ability to take medicines as prescribed and help them achieve their treatment goals; additional support and follow-up, which may lead to improved blood pressure, diabetes control, quality of life and a reduction of medicines-related problems.
CONCLUSIONS: This systematic review identified common themes and components, for example, goal setting, action planning, additional support and follow-up, that may influence outcomes of pharmacist-led medication reviews. Researchers, health professionals and commissioners could use these for a comprehensive evaluation of medication review implementation.
UNASSIGNED: CRD42020173907.

BACKGROUND: Mental health disorders, particularly depression and anxiety, are widespread globally and necessitate effective solutions. The patient-centred approach has been identified as a viable and effective method for addressing these challenges. This paper synthesised the principles of patient-centred mental health services and provides a comprehensive review of the existing literature.
METHODS: This is a qualitative content analysis study conducted in a systematic review framework in 2022. PubMed, Scopus, ProQuest and Cochrane databases were systematically searched, and by screening the titles, abstracts, and the texts of studies related to the purpose of the research, the data were extracted. Evaluation of the quality of the studies was done using the CASP checklist for qualitative studies. After selecting the final studies based on the entry and exit criteria, subsequently, a thematic analysis of findings was conducted on the data obtained from the systematic review.
RESULTS: The database search produced 6649 references. After screening, 11 studies met the inclusion criteria. The quality scores indicated the studies were of high level of quality with acceptable risk of bias. The thematic analysis identified six major principles of patient-centredness in mental health services: education, involvement and cooperation, access, effectiveness and safety, health and well-being, and ethics.
CONCLUSIONS: Patient-centredness is a complex approach in mental health services. The principles and elements of patient-centredness foster positive patient outcomes, enhance healthcare quality and ensure compassionate and effective care. Upholding these principles is crucial for delivering patient-centred, ethical and effective mental health services. Furthermore, the study found that patient education can boost adherence and satisfaction, and decrease unnecessary hospitalisations. Patient involvement in decision-making is influenced by their age and the relationship with their psychologists. And, effective leadership and resource management can enhance clinical processes and patient-centredness in mental health services.

BACKGROUND: Surgical site infections can significantly impact postoperative recovery. Patient participation, which involves patients actively engaging in wound care, has been linked to improved healing and reduced wound complications. However, there is limited synthesis of the literature that explores the patient\'s role and participation in the context of surgical wound care.
OBJECTIVE: To explore patients\' perceptions of how they participate in surgical wound care, within 30 days post-operation.
METHODS: An integrative review guided by Whittemore and Knafl\'s methodology. This review was registered with PROSPERO (CRD42022363669).
METHODS: Searches were conducted in Medline (Ovid), CINAHL (Complete), and EMBASE (Elsevier) databases in October 2023, supplemented by forward and backward citation searching.
METHODS: Based on a priori eligibility criteria, two authors independently screened articles to select relevant studies. The quality of the included research articles was critically appraised using the Mixed Methods Appraisal Tool. A descriptive and thematic synthesis was used to synthesise the findings.
RESULTS: Of the 4701 records screened for titles and abstracts, 25 studies using qualitative, quantitative, and mixed-methods designs were included. Three key themes were identified. In theme 1, \'I am healing: how my wound shapes me and my journey,\' physical symptoms, psychological factors and previous experiences significantly influenced patients\' engagement in wound care. Theme 2, \'Taking charge of my healing: my active engagement in wound care\' described how patient participation in surgical wound care goes beyond clinical procedures and can include the use of technology and holistic self-care. Finally, theme 3, \'Navigating the path to recovery: How others shape my experience\' showed that effective communication is crucial for promoting participation, yet issues like inadequate information can leave patients unprepared for wound management.
CONCLUSIONS: This review highlights opportunities to personalise and prioritise a patient-oriented approach to surgical wound care. Clinicians and educators should adopt an individualised approach by tailoring patient participation based on patient factors (i.e. physical symptoms) and adopt patient-centred communication approaches. Researchers should focus on exploring approaches to self-care and technology, as these approaches may enhance patient participation in wound care.

BACKGROUND: Emergency department (ED) triage is often patients\' first contact with a health service and a critical point for patient experience. This review aimed to understand patient experience of ED triage and the waiting room.
METHODS: A systematic six-stage approach guided the integrative review. Medline, CINAHL, EmCare, Scopus, ProQuest, Cochrane Library, and JBI database were systematically searched for primary research published between 2000-2022 that reported patient experience of ED triage and/or waiting room. Quality was assessed using established critical appraisal tools. Data were analysed for descriptive statistics and themes using the constant comparison method.
RESULTS: Twenty-nine articles were included. Studies were mostly observational (n = 17), conducted at a single site (n = 23), and involved low-moderate acuity patients (n = 13). Nine interventions were identified. Five themes emerged: \'the who, what and how of triage\', \'the patient as a person\', \'to know or not to know\', \'the waiting game\', and \'to leave or not to leave\'.
CONCLUSIONS: Wait times, initiation of assessment and treatment, information provision and interactions with triage staff appeared to have the most impact on patient experience, though patients\' desires for each varied. A person-centred approach to triage is recommended.

BACKGROUND: Patient safety is crucial in dentistry, yet it has received delayed recognition compared with other healthcare fields. This literature review assesses the current state of patient safety in dentistry, investigates the reasons for the delay, and offers recommendations for enhancing patient safety in dental practices, dental schools, and hospitals.
METHODS: The review incorporates a thorough analysis of existing literature on patient safety in dentistry. Various sources, including research articles, guidelines and reports, were reviewed to gather insights into patient safety definitions, challenges and best practices specific to dentistry.
RESULTS: The review underscores the importance of prioritising patient safety in dentistry at all levels of healthcare. It identifies key definitions and factors contributing to the delayed focus on patient safety in the field. Additionally, it emphasises the significance of establishing a patient safety culture and discusses approaches such as safety plans, incident management systems, blame-free cultures and ethical frameworks to enhance patient safety.
CONCLUSIONS: Patient safety is vital in dentistry to ensure high-quality care and patient well-being. The review emphasises the importance of prioritising patient safety in dental practices, dental schools and hospitals. Through the implementation of recommended strategies and best practices, dental organisations can cultivate a patient safety culture, enhance communication, mitigate risks and continually improve patient safety outcomes. The dissemination of knowledge and the active involvement of all stakeholders are crucial for promoting patient safety and establishing a safe dental healthcare system.

BACKGROUND: Empathy is fundamental to the provision of efficacious patient-centered health care. Currently, there is no comprehensive synthesis of peer-reviewed empirical research related to empathy in the nutrition and dietetics profession. Understanding empathy in the context of nutrition and dietetics care may lead to improved teaching practices that support nutrition and dietetics students and practitioners to provide high-quality, empathic, patient-centered care.
OBJECTIVE: This scoping review aimed to understand the approaches through which empathy is conceptualized, measured, and taught in the field of nutrition and dietetics.
METHODS: Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses-Scoping Reviews Statement and Checklist, a scoping review process was undertaken. Five databases were searched in February 2023: Cumulative Index to Nursing and Allied Health, Embase, Medline, PsycInfo, and Scopus, with no date limits. Eligible studies were English language-based, peer-reviewed, empirical research exploring or measuring empathy as an outcome in primary data stratified to nutrition and dietetics. Extracted qualitative data were synthesized and analyzed thematically with an inductive, interpretivist approach applied to conceptualize the interrelationship between empathy and dietetic practice. Quantitative data were extracted and summarized in a table.
RESULTS: Twenty-six studies were included in the scoping review. Analysis identified 2 overarching themes underpinning the current literature on empathy in nutrition and dietetics that described empathy as a key skill in the application of patient-centered care, which was supported by approaches to lifelong cultivation of empathy in the nutrition and dietetics profession. A range of tools has measured empathy in nutrition and dietetics students and practitioners with no clear consensus in findings across studies.
CONCLUSIONS: This review identified the extent and nature of empathy within nutrition and dietetics, from both practitioner and patient perspectives, and the vast array of approaches used to teach and quantify empathy in students and practitioners. Insights from this review inform the need for future studies. The results of this review suggest that future research include exploring implications of empathic dietetics care on patient outcomes and identification of best practice, evidence-based curricula and strategies to support sustainable cultivation and maintenance of empathic care across the career span of nutrition and dietetics practitioners.

OBJECTIVE: Studies conflict about whether language discordance increases rates of hospital readmissions or emergency department (ED) revisits for adult and paediatric patients. The literature was systematically reviewed to investigate the association between language discordance and hospital readmission and ED revisit rates.
METHODS: Searches were performed in PubMed, Embase and Google Scholar on 21 January 2021, and updated on 27 October 2022. No date or language limits were used.
METHODS: Articles that (1) were peer-reviewed publications; (2) contained data about patient or parental language skills and (3) included either unplanned hospital readmission or ED revisit as one of the outcomes, were screened for inclusion. Articles were excluded if: unavailable in English; contained no primary data or inaccessible in a full-text form (eg, abstract only).
METHODS: Two reviewers independently extracted data using Preferred Reporting Items for Systematic Reviews and Meta-Analyses-extension for scoping reviews guidelines. We used the Newcastle-Ottawa Scale to assess data quality. Data were pooled using DerSimonian and Laird random-effects models. We performed a meta-analysis of 18 adult studies for 28-day or 30-day hospital readmission; 7 adult studies of 30-day ED revisits and 5 paediatric studies of 72-hour or 7-day ED revisits. We also conducted a stratified analysis by whether access to interpretation services was verified/provided for the adult readmission analysis.
METHODS: Odds of hospital readmissions within a 28-day or 30-day period and ED revisits within a 7-day period.
RESULTS: We generated 4830 citations from all data sources, of which 49 (12 paediatric; 36 adult; 1 with both adult and paediatric) were included. In our meta-analysis, language discordant adult patients had increased odds of hospital readmissions (OR 1.11, 95% CI 1.04 to 1.18). Among the 4 studies that verified interpretation services for language discordant patient-clinician interactions, there was no difference in readmission (OR 0.90, 95% CI 0.77 to 1.05), while studies that did not specify interpretation service access/use found higher odds of readmission (OR 1.14, 95% CI 1.06 to 1.22). Adult patients with a non-dominant language preference had higher odds of ED revisits (OR 1.07, 95% CI 1.004 to 1.152) compared with adults with a dominant language preference. In 5 paediatric studies, children of parents language discordant with providers had higher odds of ED revisits at 72 hours (OR 1.12, 95% CI 1.05 to 1.19) and 7 days (OR 1.02, 95% CI 1.01 to 1.03) compared with patients whose parents had language concordant communications.
CONCLUSIONS: Adult patients with a non-dominant language preference have more hospital readmissions and ED revisits, and children with parents who have a non-dominant language preference have more ED revisits. Providing interpretation services may mitigate the impact of language discordance and reduce hospital readmissions among adult patients.
UNASSIGNED: CRD42022302871.

Digital assistive technologies (eg, applications, wearables and robots) have emerged as promising tools for managing various aspects of daily life, such as basic assistance, encompassing social interaction, memory support, leisure activities, location tracking and health monitoring. In order to understand how these technologies can be utilised for people living with dementia, their impacts must first be reviewed. Currently, there is limited literature available on the topic, usually only focusing on a particular kind of digital assistive technology. Therefore, this paper presents a protocol for a scoping review that aims to provide a general overview of the impact digital assistive technologies can have on the quality of life for people living with dementia.
We will follow the scoping review framework proposed by Arksey and O\'Malley. A comprehensive search will be performed to identify original research articles or clinical trials published between 2013 and 2023 across five online databases (Cochrane, Embase, PubMed, Scopus and Web of Science). The review will encompass both qualitative and quantitative themes derived from the literature. Relevant studies will be identified through a comprehensive search using specific search terms related to the population (people with dementia), intervention (digital assistive technologies) and outcome (quality of life). The screening of titles, abstracts and full texts will be performed to select eligible studies based on predetermined inclusion and exclusion criteria. Data will be extracted using a standardised form, and the findings will be synthesised and reported qualitatively and quantitatively.
Ethical approval is not required because this study is a scoping review based on published data. We intend to publish our findings in a peer-reviewed journal.

OBJECTIVE: To identify factors acting as barriers or enablers to the process of healthcare consent for people with intellectual disability and to understand how to make this process equitable and accessible.
METHODS: Databases: Embase, MEDLINE, PsychINFO, PubMed, SCOPUS, Web of Science and CINAHL. Additional articles were obtained from an ancestral search and hand-searching three journals.
METHODS: Peer-reviewed original research about the consent process for healthcare interventions, published after 1990, involving adult participants with intellectual disability.
RESULTS: Inductive thematic analysis was used to identify factors affecting informed consent. The findings were reviewed by co-researchers with intellectual disability to ensure they reflected lived experiences, and an easy read summary was created.
RESULTS: Twenty-three studies were included (1999 to 2020), with a mix of qualitative (n=14), quantitative (n=6) and mixed-methods (n=3) studies. Participant numbers ranged from 9 to 604 people (median 21) and included people with intellectual disability, health professionals, carers and support people, and others working with people with intellectual disability. Six themes were identified: (1) health professionals\' attitudes and lack of education, (2) inadequate accessible health information, (3) involvement of support people, (4) systemic constraints, (5) person-centred informed consent and (6) effective communication between health professionals and patients. Themes were barriers (themes 1, 2 and 4), enablers (themes 5 and 6) or both (theme 3).
CONCLUSIONS: Multiple reasons contribute to poor consent practices for people with intellectual disability in current health systems. Recommendations include addressing health professionals\' attitudes and lack of education in informed consent with clinician training, the co-production of accessible information resources and further inclusive research into informed consent for people with intellectual disability.
UNASSIGNED: CRD42021290548.