Abstract
Objective: A scoping review to understand the global implementation of a Health Passport to inform the transitions of disabled people between community services of support, hospital or other care facilities.
Background: The definition of 'disability' by the World Health Organisation (WHO) and the Oxford Dictionary involves a physical or mental condition hindering certain activities. This study focuses on Health Passports (HP), held by individuals themselves, not electronic Hand Held Personal Medical Records (HHPMR). Despite wide use in diverse healthcare settings, the effectiveness of HP implementation remains inconsistent. Compared to the general population, adults with disabilities often face worse health outcomes, and factors contributing to this include lack of empowerment, reasonable adjustments, may have difficulty remembering information, experience poverty, and have cultural disparities. The relevance of health passports for Māori with disabilities is emphasised for societal equity, aligning with the UNCRPD and New Zealand's Disability Action Plan and associated strategies.
Methods: A scoping review of the literature was sourced from four databases: Medline, CINAHL, PsychINFO and Google Scholar (from 2013 to November 2023). The web was explored to ascertain grey literature. Articles were obtained from reference lists of the seven included studies. A standardised data extraction form from PRISMA (PRISMA-ScR) was used, and an iterative process was used to appraise the data based on the five stages from Arksey and O'Malley (2005). Data extraction and synthesis of this review was undertaken by two reviewers, the student researcher and her supervisor. If there had have been discrepancies a third reviewer would have been used. Our approach to conducting a scoping review was guided by the principles advocated by proponents of systematic reviews, emphasising the necessity for rigorous and transparent methods at each stage as noted in writing by Arksey and O'Malley (2005). Documentation of the process has been sufficiently detailed to facilitate replication by others, enhancing the reliability of the findings and addressing concerns about methodological rigor (Peters et al., 2015). The stages outlined for the framework we employed for conducting a scoping study by Arksey and O'Malley (2005) are as follows: Stage 1: Identifying the research question; Stage 2: Identifying relevant studies; Stage 3: Study selection; Stage 4: Charting the data; Stage 5: Collating, summarizing, and reporting the results.
Results: The literature highlights a gap in information regarding the utilisation and conceptualisation of digital Health Passports (HPs), distinct from Hand Held Patient Medical Reports (HHPMRs). Although studies extensively cover HHPMRs, a systematic evaluation is lacking of the specific benefits of digital personal health records, which could complement HPs. Various studies reveal inconsistencies in document titles, length, and content, with notable gaps in addressing safety concerns. Successful implementation of HPs relies on contextual factors such as the perceived needs of the patients, and desire for self-management among the identified population. Positive outcomes include enhanced self-advocacy and communication, aligning with findings from studies. While HPs are generally well-received, two randomised controlled trials did not demonstrate short-term measurable benefits, suggesting potential long-term advantages not explored in current studies.
Conclusion: People with intellectual and physical disabilities have both legal and moral rights to receive respectful, safe, and person-centred care all healthcare settings, which can significantly improve their healthcare experiences and outcomes. Achieving this requires supporting healthcare professionals in acquiring the necessary knowledge and skills for routine application in all healthcare settings. Such support can contribute to improving the overall experiences of adults and youth with intellectual and physical disabilities when accessing healthcare services. Nurses worldwide play a role in caring for individuals with intellectual and physical disabilities, and communication challenges. Health Passports (HPs) are valuable tools for enhancing safety and person-centred care, serving as a foundation for care planning. However, the varied formats of HPs may limit their effectiveness. To address this, nurses are encouraged to collaborate with others in developing a more standardized approach that better meets the needs of all stakeholders.