• JBI Database System Rev Implement Rep · Nov 2017

    Review

    Perceptions, experiences and preferences of patients receiving a clinician's touch during intimate care and procedures: a qualitative systematic review.

    • Chad O'Lynn, Adam Cooper, and Lisa Blackwell.
    • 1Chamberlain University: a Joanna Briggs Institute Affiliated Group, Chamberlain University College of Nursing, Chicago, Illinois, USA 2UCSF Centre for Evidence Synthesis and Implementation: a Joanna Briggs Institute Center of Excellence, San Francisco, California, USA.
    • JBI Database System Rev Implement Rep. 2017 Nov 1; 15 (11): 2707-2722.

    BackgroundClinical practice frequently involves the practitioner touching patients' bodies in areas that are highly personal. If inappropriately performed, such intimate touch may result in much anxiety, confusion and misinterpretation. Examination of evidence is necessary to guide practice in this area to mitigate risks and foster optimal clinician-patient relations and care.ObjectivesThe objective of this qualitative systematic review was to identify and synthesize findings on the perceptions, experiences and preferences of patients receiving a clinician's touch during intimate care and procedures INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review considered studies that included patients who had received a clinician's touch during intimate care and procedures.Phenomena Of InterestThe current review considered qualitative studies that evaluated patients' perceptions, experiences and preferences of a clinician's touch during intimate care and procedures.Types Of StudiesThe current review considered studies that collected qualitative data and included studies using designs such as phenomenology, grounded theory, ethnography, action research, qualitative description, focus group methodology and feminist research. In the absence of research studies, other text such as opinion papers and reports were considered.ContextThe current review considered studies that included patients' perceptions, experiences and preferences of a clinician's touch during intimate care and procedures. Intimate care is likely to occur in any clinical setting where patients need assistance with personal care, where physical examinations occur, or in settings were gynecologic, genitourinary, lower intestinal, dermatologic, cardiac or other procedures involving highly personal areas of the body are performed.Search StrategyA three-step search strategy was used to find published and unpublished studies in English from 1970 to 2016, searching various databases which included searches of reference lists of studies selected for appraisal.Methodological QualityIncluded studies were assessed for methodological quality independently by two reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) prior to inclusion. Of the two studies included in the review, one did not discuss ontological and epistemological assumptions, and the other did not include the personal assumptions and role of the researcher.Data ExtractionData were extracted using the data extraction tool from the JBI-QARI. The data extracted included details about the phenomenon of interest, populations and study methods.Data SynthesisQualitative findings were synthesized using JBI-QARI.ResultsTwo studies were included in this review. Seven findings were organized into three categories and one synthesized finding, "clinician respect". The finding suggests that clients prefer engaged and meaningful communication prior to and during an intimate touch encounter, expect autonomy over their bodies and desire shared decision making relative to how and by whom intimate touch is provided.ConclusionThe synthesized finding from this review suggests that:More research is needed to explore the perceptions and preferences for intimate touch among diverse populations, generations, cultures and contexts. Particular exploration is needed for populations with additional vulnerabilities to misunderstandings, anxiety and abuse, such as pediatric and geriatric patients, and patients with physical, mental and cognitive impairments.

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