Autor(es): Seyfulayeva, Ayshe ; Fonte, Bianca Ferreira ; Alho, Ana Margarida ; Shaikh, Anum ; Nunes, Ana Beatriz ; Casaca, Pedro Gonçalves Carvalho ; Leite, Andreia ; Taha, Ayda ; Dhingra-Kumar, Neelam ; Sousa, Paulo
Data: 2025
Identificador Persistente: http://hdl.handle.net/10400.18/10588
Origem: Repositório Científico do Instituto Nacional de Saúde
Assunto(s): Health Policy; Patient Safety; Patient-Centred Care; Shared Decision Making; Perioperative Care; Cuidados de Saúde
Background: Surgical procedures present intricate challenges within healthcare delivery, often associated with higher risks of adverse events compared with non-surgical contexts. Patient and family engagement (PFE) throughout the perioperative journey is a possibility to enhance care quality, safety and patient-centredness. However, literature addressing PFE across the entirety of the perioperative journey remains sparse. Objective: The current scoping review aims to comprehensively map the existing interventions with PFE approach focused on improving patient safety across various types of surgical procedures throughout the perioperative journey. In addition, the review aims to understand the level and type of PFE approach adopted in this context. Eligibility criteria: Articles published in indexed peer-reviewed journals from 2003 to 2023, written in English, Portuguese or Spanish, that report on interventions with PFE approach targeting adult surgical patients, their families, caregivers, patient advocates and patient champions. The review includes articles reporting on both inpatient and ambulatory surgical patients. Methods: Following Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews framework, this review systematically searched PubMed, Web of Science, SCOPUS, CINAHL, and PsycINFO for relevant articles. Eligible interventions were categorised using PFE framework regarding the level of engagement and mapped according to the WHO Global Patient Safety Action Plan 2021-2030. Results: Out of 765 records initially identified, 32 met the eligibility criteria for data extraction and analysis, of which 40% originated from the USA, followed by the UK (18%) and Canada (12%). 47% of the interventions targeted 'multiple/all types' of procedures, 19% focused on cardiothoracic surgeries and 9% on gynaecological procedures or organ transplant. The majority of the interventions (88%) focused on PFE at the direct care level, predominantly adopting a consultation-based approach. Furthermore, 81% of eligible interventions emphasised patient information and education, 16% addressed codevelopment of policy and 3% of interventions focused on patient advocacy. Conclusion: The findings show a predominant focus on PFE interventions targeting patient safety at the direct care level, particularly in the provision of patient information and education. However, interventions at organisational and policy-making levels are notably scarce. Further investment is required to promote interventions engaging patients and families at broader organisational and policy-making levels.
What is already known on this topic: Prior research has shown that surgical patients are at 2.3 times higher risk of adverse events, highlighting the potential role of patient and family engagement (PFE) approach in improving patient safety and quality in healthcare. Nonetheless, the current body of literature falls short of providing a holistic understanding of PFE across the entire perioperative process, underscoring the necessity for more in-depth exploration. What this study adds: This study provides a comprehensive mapping of the interventions using PFE approach across various periods of the perioperative journey, highlighting their focus areas, geographical distribution and type of surgical procedure. The findings show that most of the interventions adopted consultation type of PFE approach with fewer using involvement or partnership and shared leadership. In addition, the study reveals a predominance of PFE interventions at the direct care level, particularly in patient information and education, while also identifying a scarcity of interventions targeting organisational and policy-making levels. How this study might affect research, practice or policy: The study highlights the pressing need for expanded PFE interventions at organisational and policy-making levels, as well as across the entire spectrum of the engagement continuum.
