Communication guidelines for healthcare professionals working with adults with changed cognitive capacity and their carers: A scoping review with implications for neuro-oncology.

Effective communication in healthcare is pivotal to delivering quality care, with complexity increasing when people have cognitive impairment (PwCI). Cognitive impairments can be subtle to profound changes in executive function. Tailoring communication to these individuals and their families is challenging for healthcare professionals (HCPs). Substantial work has been completed in establishing training programs and guidelines to develop the communication skills of HCPs, including for PwCI. However, cognitive impairment-specific communication training has not translated through to oncology. This review distilled HCP communication guidelines for PwCI to underpin a training resource for HCPs working in neuro-oncology. The review followed Joanna Briggs Institute scoping review methods and is reported using the PRISMA-ScR format. Data was sourced from academic, published studies and grey literature using search terms on HCP communication guidelines for working with people with cognitive impairment (e.g. brain injury, dementia). Search criteria were restricted to communication between HCPs and adults in non-residential care settings. Initial searches yielded 6257 results after duplicate removal. Title and abstract screening identified 603 results for full-text review. 43 studies were identified for data extraction. Key elements for HCP communication were distilled into six categories: 1) concepts in communication - theoretical ideas supporting quality communication; 2) presentation and delivery – how HCPs share content and information; 3) behaviour and actions – undertaken by HCPs to support communication; 4) environment elements – how environments support interactions; 5) engaging with families – strategies for balancing carer communication; and, 6) organisational factors – systems that support quality communication. Building on expertise from related health areas, these six key elements establish a clear strategy for HCPs to tailor communication to better accommodate PwCI and their families and are central to our development of communication skills training for HCPs in neuro-oncology. • There are six key elements that support quality communication between healthcare professionals, people with cognitive impairment, and their families. These elements include conceptual frameworks in communication, organisational and environmental factors, and strategies used by healthcare professionals. • Tailoring communication for people with cognitive impairment entails healthcare professionals modifying their presentation, delivery, behaviour, and actions during a clinical consultation. • It is important to engage with carers, acknowledge their role and expertise, and balance carer communication with the patient’s needs and agency.