Meta synthesis of qualitative studies on the vocalization behavior of medical staff for patient safety

XIE Xinhua; WANG Fang; TANG Jiajie; ZHOU Xiangling; ZHANG Chi; ZHEN Yongqi

doi:10.3969/j.issn.1671-315x.2025.07.010

Abstract：Objective To systematically evaluate and integrate qualitative studies on medical staff's vocalization behavior for patient safety and gain a comprehensive understanding of their experiences and vocalization behavior for patient safety,and then to provide a basis for more effective interventions to promote their vocalization behavior for patient safety.Methods Cochrane Library,PubMed,Web of Science,CINAHL,Scopus,Medline,PsycINFO,Embase,China Biology Medicine Disc,China National Knowledge Infrastructure(CNKI),Wanfang Da-tabase,and VIP Database were systematically searched to collect qualitative studies on medical staff's vocalization behavior for patient safety from the establishment of the database to December 31,2024.The quality of the literature was evaluated using the quality evaluation criteria for qualitative research of the Australian JBI Evidence-Based Health Care Center.The Meta-synthesis method was used to systematically ana-lyze the literature data to ensure the comprehensiveness and credibility of the research results.Results A total of 13 documents were includ-ed,yielding 16 findings,which were summarized into 10 categories and comprehensively summarized into three integrated findings:healthcare professionals'lack of awareness of speaking up for patient safety,barriers to healthcare professionals'behavior of speaking up for patient safe-ty,and factors promoting healthcare professionals'behavior of speaking up for patient safety.Conclusion Medical staff have insufficient awareness of vocalization behavior for patient safety.Strict hierarchy,risk of interpersonal conflict,heavy workload,and seniority limit can hin-der their vocalization behavior.A positive safety culture,high-risk situation drives,outstanding personal ability,and leadership support can promote their vocalization behavior.Hospital managers need to strengthen policy management support,create a good supportive environment for voice,and take scientific promotion countermeasures to improve the vocalization behavior for patient safety.