Ferdinand C Mukumbang, Lucia Knight, Caroline Masquillier, Anton Delport, Neo Sematlane, Lorraine Tanyaradzwa Dube, Martina Lembani, Edwin Wouters
Household-focused interventions to enhance the treatment and management of HIV in low- and middle-income countries: a scoping review
BMC public health
patient involvement goals care decisionmaking shown enhance satisfaction affectivecognitive outcomes allocative efficiency reduce unwarranted clinical variation however involvement patients goals care planning within hospitals remains limited particularly mismatches shared understanding doctors patients present identify critically examine factors influencing goals care conversations doctors patients acute hospital illness realist systematic review following rameses standards protocol published prospero crd42021297410 review utilised realist synthesis methodology including scoping literature search generate initial theories theory refinement stakeholder consultation systematic literature search support program theory data collected medline pubmed embase cinahl psychinfo scopus databases 1946 14 july 2023 citation tracking google scholar opengrey utilized identify relevant grey literature studies selected based relevance rigor support theory development analysis included 52 papers supporting seven contextmechanismoutput cmo hypotheses findings suggest shared doctorpatient understanding relies doctors confident competent personable foster trusting relationships patients low doctor confidence often leads avoidance discussions moreover information provided patients often inconsistent biased procedurefocused lacks personalisation acute illness medical jargon poor health literacy high emotional states hinder patient understanding goals care conversations hospitals nuanced often suboptimal improve patient experiences outcome care interventions personalised tailored individual needs emphasizing effective communication trusting relationships among patients families doctors healthcare teams inclusion caregivers acknowledgment service level crucial achieving desired outcomes implications policy research clinical practice including training skills development doctors discussed