Experiences and views of receiving and delivering information about recovery in acquired neurological conditions: a systematic review of qualitative literature

• Published in: BMJ open Vol. 11; no. 4; p. e045297
• Main Authors: Burton, Louisa-Jane, Forster, Anne, Johnson, Judith, Crocker, Thomas F., Tyson, Sarah F., Wray, Faye, Clarke, David J.
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 27.04.2021; BMJ Publishing Group
• Series: Original research
• Subjects: Brain research; Caregivers; Data collection; Nervous system; Neurology; Recovery (Medical); Stroke; Systematic review; Traumatic brain injury; Verbal communication; adult neurology; rehabilitation medicine; neurological injury
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-045297

ObjectiveTo review and synthesise qualitative literature relating to the views, perceptions and experiences of patients with acquired neurological conditions and their caregivers about the process of receiving information about recovery; as well as the views and experiences of healthcare professionals involved in delivering this information.DesignSystematic review of qualitative studies.Data sourcesMEDLINE, Embase, AMED, CINAHL, PsycINFO, Web of Science and the Cochrane library were searched from their inception to July 2019.Data extraction and synthesisTwo reviewers extracted data from the included studies and assessed quality using an established tool. Thematic synthesis was used to synthesise the findings of included studies.ResultsSearches yielded 9105 titles, with 145 retained for full-text screening. Twenty-eight studies (30 papers) from eight countries were included. Inductive analysis resulted in 11 descriptive themes, from which 5 analytical themes were generated: the right information at the right time; managing expectations; it’s not what you say, it’s how you say it; learning how to talk about recovery and manage emotions; the context of uncertainty.ConclusionsOur findings highlight the inherent challenges in talking about recovery in an emotional context, where breaking bad news is a key feature. Future interventions should focus on preparing staff to meet patients’ and families’ information needs, as well as ensuring they have the skills to discuss potential recovery and break bad news compassionately and share the uncertain trajectory characteristic of acquired neurological conditions. An agreed team-based approach to talking about recovery is recommended to ensure consistency and improve the experiences of patients and their families.