Review: Experiences and preferences of counselling about living habits in healthcare – a systematic review of studies on the patient perspective

Abstract

Background Recent policy in Sweden states that patients in every part of health care are to be presented with health counselling concerning living habits: tobacco, alcohol, an inactive lifestyle and eating habits. This review aims to investigate experiences and preferences of counselling about living habits from the patient’s perspective.

Method A literature review of six major databases using a wide approach to detect studies of different methodologies, patient categories, health care settings and intervention types. Inclusion criteria were studies in any setting/category concerning patients’ experience of discussing living habits with a health care practitioner (HCP). Results came to merit synthesis and quality appraisal using only instruments for qualitative studies.

Results 21 studies are presented. With one exception all originate from primary care. Themes are presented under headlines: encouragement, empowerment & support; doctor-patient relationship; individualization & involvement; stigma; time and ongoing support; empathy; and attitudes not favoured by patients. Most studies are of good quality with the most common remark of not having discussed chosen methodology or not having discussed the researcher’s role in outcome.

Results are discussed in relation to Motivational Interviewing, Self-Determination Theory and Social Cognitive Theory. A review of qualitative studies had to take special emphasis to search strategy, quality appraisal and synthesis.

Conclusion/implication This review provides an overview of published studies in the field of patient experience. Further study is needed to widen the scope beyond Primary care and to secure findings in more controlled settings.