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Journal article

Integrating patient values and preferences in healthcare: a systematic review of qualitative evidence

Abstract:

Objectives: To identify and thematically analyse how healthcare professionals (HCPs) integrate patient values and preferences (‘values integration’) in primary care for adults with non-communicable diseases (NCDs).


Design: Systematic review and meta-aggregation methods were used for extraction, synthesis and analysis of qualitative evidence.


Data sources: Relevant records were sourced using keywords to search 12 databases (ASSIA, CINAHL, DARE, EMBASE, ERIC, Google Scholar, GreyLit, Ovid-MEDLINE, PsycINFO, PubMed-MEDLINE, Scopus and Web of Science).


Eligibility criteria: Records needed to be published between 2000 and 2020 and report qualitative methods and findings in English involving HCP participants regarding primary care for adult patients.


Data extraction and synthesis: Relevant data including participant quotations, authors’ observations, interpretations and conclusions were extracted, synthesised and analysed in a phased approach using a modified version of the Joanna Briggs Institute (JBI) Data Extraction Tool, as well as EPPI Reviewer and NVivo software. The JBI Critical Appraisal Checklist for Qualitative Research was used to assess methodological quality of included records.


Results: Thirty-one records involving >1032 HCP participants and 1823 HCP-patient encounters were reviewed. Findings included 143 approaches to values integration in clinical care, thematically analysed and synthesised into four themes: (1) approaches of concern; (2) approaches of competence; (3) approaches of communication and (4) approaches of congruence. Confidence in the quality of included records was deemed high.


Conclusions: HCPs incorporate patient values and preferences in healthcare through a variety of approaches including showing concern for the patient as a person, demonstrating competence at managing diseases, communicating with patients as partners and tailoring, adjusting and balancing overall care. Themes in this review provide a novel framework for understanding and addressing values integration in clinical care and provide useful insights for policymakers, educators and practitioners.


PROSPERO registration number: CRD42020166002.

Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1136/bmjopen-2022-067268

Authors


More by this author
Role:
Author
ORCID:
0000-0003-3139-6637
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Primary Care Health Sciences
Role:
Author
ORCID:
0000-0001-8187-0742
More by this author
Role:
Author
ORCID:
0000-0002-1009-1992


Publisher:
BMJ Publishing Group
Journal:
BMJ Open More from this journal
Volume:
12
Issue:
11
Article number:
e067268
Place of publication:
England
Publication date:
2022-11-18
Acceptance date:
2022-10-28
DOI:
EISSN:
2044-6055
ISSN:
2044-6055
Pmid:
36400731


Language:
English
Keywords:
Pubs id:
1305857
Local pid:
pubs:1305857
Deposit date:
2024-05-15

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