BMJ Open Is Committed to Open Peer Review. As Part of This Commitment We Make the Peer Review History of Every Article We Publish Publicly Available

BMJ Open Is Committed to Open Peer Review. As Part of This Commitment We Make the Peer Review History of Every Article We Publish Publicly Available

BMJ Open: first published as 10.1136/bmjopen-2020-042973 on 5 October 2020. Downloaded from BMJ Open is committed to open peer review. As part of this commitment we make the peer review history of every article we publish publicly available. When an article is published we post the peer reviewers’ comments and the authors’ responses online. We also post the versions of the paper that were used during peer review. These are the versions that the peer review comments apply to. The versions of the paper that follow are the versions that were submitted during the peer review process. They are not the versions of record or the final published versions. They should not be cited or distributed as the published version of this manuscript. BMJ Open is an open access journal and the full, final, typeset and author-corrected version of record of the manuscript is available on our site with no access controls, subscription charges or pay-per-view fees (http://bmjopen.bmj.com). If you have any questions on BMJ Open’s open peer review process please email [email protected] http://bmjopen.bmj.com/ on October 1, 2021 by guest. Protected copyright. BMJ Open BMJ Open: first published as 10.1136/bmjopen-2020-042973 on 5 October 2020. Downloaded from Patient experience studies in the circumpolar region: a scoping review Journal: BMJ Open ManuscriptFor ID peerbmjopen-2020-042973 review only Article Type: Original research Date Submitted by the 21-Jul-2020 Author: Complete List of Authors: Ingemann, Christine; University of Southern Denmark Faculty of Health Sciences, National Institute of Public Health; University of Greenland, Institute of Nursing and Health Sciences Hansen, Nathaniel; Tufts University School of Medicine Hansen, Nanna; University of Southern Denmark Faculty of Health Sciences, National Institute of Public Health Jensen, Kennedy; Dartmouth College Geisel School of Medicine, Larsen, Christina; University of Southern Denmark Faculty of Health Sciences, National Institute of Public Health Chatwood, Susan; University of Alberta School of Public Health Quality in health care < HEALTH SERVICES ADMINISTRATION & Keywords: MANAGEMENT, PUBLIC HEALTH, QUALITATIVE RESEARCH, PRIMARY CARE http://bmjopen.bmj.com/ on October 1, 2021 by guest. Protected copyright. For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 1 of 35 BMJ Open 1 2 3 4 BMJ Open: first published as 10.1136/bmjopen-2020-042973 on 5 October 2020. Downloaded from 5 6 7 8 9 I, the Submitting Author has the right to grant and does grant on behalf of all authors of the Work (as defined 10 in the below author licence), an exclusive licence and/or a non-exclusive licence for contributions from authors 11 who are: i) UK Crown employees; ii) where BMJ has agreed a CC-BY licence shall apply, and/or iii) in accordance 12 with the terms applicable for US Federal Government officers or employees acting as part of their official 13 duties; on a worldwide, perpetual, irrevocable, royalty-free basis to BMJ Publishing Group Ltd (“BMJ”) its 14 licensees and where the relevant Journal is co-owned by BMJ to the co-owners of the Journal, to publish the 15 Work in this journal and any other BMJ products and to exploit all rights, as set out in our licence. 16 17 The Submitting Author accepts and understands that any supply made under these terms is made by BMJ to 18 the Submitting Author Forunless you peer are acting as review an employee on behalf only of your employer or a postgraduate 19 student of an affiliated institution which is paying any applicable article publishing charge (“APC”) for Open 20 Access articles. Where the Submitting Author wishes to make the Work available on an Open Access basis (and 21 intends to pay the relevant APC), the terms of reuse of such Open Access shall be governed by a Creative 22 Commons licence – details of these licences and which Creative Commons licence will apply to this Work are set 23 out in our licence referred to above. 24 25 Other than as permitted in any relevant BMJ Author’s Self Archiving Policies, I confirm this Work has not been 26 accepted for publication elsewhere, is not being considered for publication elsewhere and does not duplicate 27 material already published. I confirm all authors consent to publication of this Work and authorise the granting 28 of this licence. 29 30 31 32 33 34 35 36 37 http://bmjopen.bmj.com/ 38 39 40 41 42 43 44 45 on October 1, 2021 by guest. Protected copyright. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 2 of 35 1 2 3 1 Patient experience studies in the circumpolar region: a scoping review 4 BMJ Open: first published as 10.1136/bmjopen-2020-042973 on 5 October 2020. Downloaded from 5 6 2 Christine Ingemann*, Centre for Public Health in Greenland, National Institute of Public 7 3 Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark; 8 4 Greenland Centre for Health Research, Institute of Nursing and Health Research, 9 10 5 Ilisimatusarfik – University of Greenland, Nuuk, Greenland; [email protected]; 11 6 +4565507822; ORCID: 0000-0002-1390-4952 12 7 13 14 8 Nathaniel Fox Hansen*, Tufts University School of Medicine, Boston, Massachusetts, 15 9 United States; ORCID: 0000-0002-3368-9938 16 10 17 18 11 Nanna Lund Hansen,For Centre peer for Public review Health in Greenland, only National Institute of Public 19 12 Health, University of Southern Denmark, Copenhagen, Denmark 20 13 21 22 14 Kennedy Jensen, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, 23 15 United States 24 16 25 26 17 Christina Viskum Lytken Larsen, Centre for Public Health in Greenland, National 27 18 Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; 28 19 Greenland Centre for Health Research, Institute of Nursing and Health Research, 29 30 20 Ilisimatusarfik – University of Greenland, Nuuk, Greenland; ORCID: 0000-0002-6245- 31 21 4222 32 22 33 23 Susan Chatwood, University of Alberta, School of Public Health, Edmonton, 34 35 24 Yellowknife, Canada; 36 25 37 26 *corresponding authors http://bmjopen.bmj.com/ 38 39 27 Christine Ingemann ([email protected]) and Nathaniel Fox Hansen 40 28 ([email protected]) contributed equally to this paper. 41 29 42 43 30 Word count: 4,588 44 31 45 on October 1, 2021 by guest. Protected copyright. 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 1 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml Page 3 of 35 BMJ Open 1 2 3 33 Patient experience studies in the circumpolar region: a scoping review 4 BMJ Open: first published as 10.1136/bmjopen-2020-042973 on 5 October 2020. Downloaded from 5 6 34 7 8 35 KEYWORDS 9 10 36 patient experience, patient satisfaction, circumpolar, arctic, scoping review, Indigenous, 11 12 37 rural healthcare, telehealth 13 14 38 15 16 39 ABSTRACT 17 18 40 Objective: PatientFor experiences peer of healthcare review and health systemsonly constitute a crucial pillar 19 20 41 of wellness and the quality of care itself. Across the Arctic, patients’ interactions with the 21 22 42 healthcare system are colored by challenges of access, historical inequities, and social 23 24 43 determinants. Though it is well understood that these challenges affect care outcomes, 25 44 prior research across the Arctic has explored patient experiences only inconsistently, with 26 27 45 isolated research efforts that address various components of the care experience. The aim 28 29 46 of this scoping review was to identify and describe peer-reviewed literature on patient 30 47 experience studies conducted within the circumpolar region. Our objective was to 31 32 48 determine the extent, range and nature of studies conducted, and to summarize and 33 34 49 disseminate findings relevant to patient experiences. 35 36 50 Design: In an international partnership between Danish/Greenlandic, Canadian, and 37 http://bmjopen.bmj.com/ 38 51 American research teams, a scoping review of published research exploring patient 39 40 52 experiences in circumpolar regions was undertaken. 41 42 53 Results: Of the 2,824 articles initially found through systematic searches in seven 43 44 54 databases, 96 articles were included for data extraction. Findings from the review 45 55 included unique features related to Indigenous values, rural and remote health, climate on October 1, 2021 by guest. Protected copyright. 46 47 56 change, and telehealth. 48 49 57 Discussion: The review findings provide an overview of patient experiences measures 50 51 58 currently used in circumpolar nations. These findings may be used to guide future studies 52 53 59 of patient experiences. These findings could be complimented by consensus and 54 60 participatory approaches that would build on Indigenous values present in circumpolar 55 56 61 nations, and further inform how we understand patient experiences. These findings can 57 58 62 be used to inform health system improvement and guide health policy decisions that will 59 60 2 For peer review only - http://bmjopen.bmj.com/site/about/guidelines.xhtml BMJ Open Page 4 of 35 1 2 3 63 respond to patient needs in the circumpolar context and other nations who share common 4 BMJ Open: first published as 10.1136/bmjopen-2020-042973 on 5 October 2020. Downloaded from 5 64 features related to Indigenous values, rural and remote context, and climate change 6 7 65 impacts. 8 9 66 10 11 67 ARTICLE SUMMARY 12 13 68 Strengths and limitations of this study 14 15 69 This scoping review represents the most comprehensive and detailed examination of 16 17 70 existing literature on patient experiences in the circumpolar region.

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