Scoping review of patients’ attitudes about their role and behaviours to ensure safe care at the direct care level

• Published in: Health expectations : an international journal of public participation in health care and health policy Vol. 23; no. 5; pp. 979 - 991
• Main Authors: Duhn, Lenora, Godfrey, Christina, Medves, Jennifer
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01-10-2020; John Wiley and Sons Inc
• Subjects: Ambulatory care; Attitudes; Behavior; Care and treatment; Communication; Database searching; direct care level; Families & family life; Global health; Health care; Humans; Internet/Web search services; Knowledge; Mapping; Online searching; patient attitudes; patient behaviours; patient engagement; Patient Participation; Patient Safety; Patients; Prevention; Primary care; Qualitative Research; Review; Safety; scoping review; Systematic review; Teaching methods; Trust; patient attitudes; patient safety; patient behaviours; patient engagement; direct care level; scoping review
• ISSN: 1369-6513; 1369-7625
• DOI: 10.1111/hex.13117

Background
To improve harm prevention, patient engagement in safety at the direct care level is advocated. For patient safety to most effectively include patients, it is critical to reflect on existing evidence, to better position future research with implications for education and practice.
Methods
As part of a multi‐phase study, which included a qualitative descriptive study (Duhn & Medves, 2018), a scoping review about patient engagement in safety was conducted. The objective was to review papers about patients’ attitudes and behaviours concerning their involvement in ensuring their safe care. The databases searched included MEDLINE, CINAHL and EMBASE (year ending 2019).
Results
This review included 35 papers about “Patient Attitudes” and 125 papers about “Patient Behaviours”—indicative of growing global interest in this field. Several patterns emerged from the review, including that most investigators have focused on a particular dimension of harm prevention, such as asking about provider handwashing, and there is less known about patients’ opinions about their role in safety generally and how to actualize it in a way that is right for them. While patients may indicate favourable attitudes toward safety involvement generally, intention to act or actual behaviours may be quite different.
Conclusion
This review, given its multi‐focus across the continuum of care, is the first of its kind based on existing literature. It provides an important international “mapping” of the initiatives that are underway to engage patients in different elements of safety and their viewpoints, and identifies the gaps that remain.