Patient experience studies in the circumpolar region: a scoping review

Abstract

Objectives: Patient experiences with health systems constitute a crucial pillar of quality care. Across the Arctic, patients' interactions with the healthcare system are influenced by challenges of access, historical inequities and social determinants. This scoping review sought to describe the range and nature of peer-reviewed literature on patient experience studies conducted within the circumpolar region.

Design: In a partnership between Danish/Greenlandic, Canadian and American research teams, a scoping review of published research exploring patient experiences in circumpolar regions was undertaken.

Data sources: Seven electronic databases were queried: MEDLINE, Embase, Scopus, 'Global Health 1910 to 2019 Week 11', CINAHL, PsycINFO and SveMed+.

Eligibility criteria: Articles were eligible for inclusion if they (a) took place in the circumpolar region, (b) reported patients' perspective and (c) were focussed primarily on patient experiences with care, rather than satisfaction with treatment outcome.

Data extraction and synthesis: Title and abstract screening, full-text review and data extraction was conducted by four researchers. Bibliometric information such as publication date and country of origin was extracted, as was information regarding study design and whether or not the article contained results relevant to the themes of Indigenous values, rural and remote context, telehealth and climate change. Two researchers then synthesised and characterised results relevant to these themes.

Results: Of the 2824 articles initially found through systematic searches in seven databases, 96 articles were included for data extraction. Findings from the review included unique features related to Indigenous values, rural and remote health, telehealth and climate change.

Conclusions: The review findings provide an overview of patient experiences measures used in circumpolar nations. These findings can be used to inform health system improvement based on patient needs in the circumpolar context, as well as in other regions that share common features. This work can be further contextualized through Indigenous methodologies such as sharing circles and community based participatory methods.

Keywords: primary care; public health; qualitative research; quality in health care.

Figure 1

Map of the circumpolar North and its regions. Map by Winfried Dallmann, Norwegian Polar Centre.

Figure 2

PreferredReporting Items for Systematic Reviews and Meta-Analyses (PRISMA) of the screening process. CP, circumpolar.

Figure 3

Country by study design (n=102), 3 of the 96 studies included three countries.

Figure 4

Reason for seeking care by study design (n=96).

Figure 5

Studies containing one or more of the four predefined categories (n=47)

Figure 6

Country by category (n=47).