Patients' negative experiences with health care settings brought to light by formal complaints: A qualitative metasynthesis

Abstract

Introduction: Narratives of negative patient experiences expressed in complaints can help health care professionals reflect on their practices.

Aims: To synthesise evidence from qualitative primary studies on patients' negative experiences with different health care settings and to obtain a detailed picture of what patients find problematic while receiving health care.

Design: Metasynthesis inspired by Sandelowski and Barroso.

Methods: A protocol was published in the International Prospective Register of Systematic Reviews (PROSPERO). A systematic search was conducted in CINAHL (EBSCOhost), MEDLINE (EBSCOhost), PsycInfo (Ovid) and Scopus, on 20.04.2021. Backward and forward citations of included reports were searched for relevant studies and the search was completed in March 2022. Two researchers independently screened and appraised the included reports. A metasynthesis using reflexive thematic analysis and a metasummary were conducted.

Results: Twenty-four reports were included, and four main themes were extracted from the metasynthesis: (1) problems with access to health care services; (2) failure to acquire information about diagnosis, treatment and the expected patient role; (3) experiencing inappropriate care and bad treatment; (4) problems with trusting health care service providers.

Conclusions: Negative patient experiences impact patients' physical and psychological health, leading to suffering and hampering patients from involving themselves in their health care.

Relevance to clinical practice: Narratives of negative patient experiences aggregated from the findings provide knowledge about what patients need and expect from health care providers. These narratives can help health care professionals reflect on the way they interact with patients and improve their practice. Health care organisations need to prioritise patient participation.

Reporting method: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

Patient or public contribution: Findings were presented and discussed in a meeting with a reference group representing patients, health care professionals and the public.

Keywords: formal complaints; metasynthesis; patient complaints; patient experiences; patient participation; professional-patient relations.