Full data abstraction table.

Background
Healthcare services regularly receive patient feedback, most of which is positive. Empirical studies suggest that health services can use positive feedback to create patient benefit. Our aim was to map all available empirical evidence for how positive patient feedback creates change in healthcare settings.
Methods
Empirical studies in English were systematically identified through database searches (ACM Digital Library, AMED, ASSIA, CINAHL, MEDLINE and PsycINFO), forwards and backwards citation, and expert consultation. We summarise the characteristics of included studies and the feedback they consider, present a thematic synthesis of qualitative findings, and provide narrative summaries of quantitative findings.
Results
68 papers were included, describing research conducted across six continents, with qualitative (n = 51), quantitative (n = 10), and mixed (n = 7) methods. Only two studies were interventional. The most common settings were hospitals (n = 27) and community healthcare (n = 19). The most common recipients were nurses (n = 29). Most outcomes described were desirable. These were categorised as (a) short-term emotional change for healthcare workers (including feeling motivated and improved psychological wellbeing); (b) work-home interactional change for healthcare workers (such as improved home-life relationships); (c) work-related change for healthcare workers (such as improved performance and staff retention). Some undesirable outcomes were described, including envy when not receiving positive feedback. The impact of feedback may be moderated by characteristics of particular healthcare roles, such as night shift workers having less interaction time with patients. Some factors moderating the change created by feedback are modifiable.
Conclusion
Further interventional research is required to assess the effectiveness and cost-effectiveness of receiving positive feedback in creating specific forms of change such as increases in staff retention. Healthcare managers may wish to use positive feedback more regularly, and to address barriers to staff receiving feedback.

研究背景
医疗服务机构常会收到患者反馈，其中大部分为正向反馈。已有实证研究表明，医疗服务方可借助正向反馈为患者带来获益。本研究旨在系统梳理所有可获取的实证证据，以阐明患者正向反馈如何在医疗场景中催生变革。

研究方法
通过数据库检索（ACM数字图书馆（ACM Digital Library）、AMED、ASSIA、CINAHL、MEDLINE及PsycINFO）、正向与反向引文追踪以及专家咨询，系统识别英文文献中的实证研究。本研究对纳入研究的基本特征及所考察的反馈类型进行总结，对定性研究（qualitative）结果开展主题合成，并对定量研究（quantitative）结果进行叙述性综述。

研究结果
最终纳入68篇文献，其研究覆盖六大洲，采用的研究方法包括定性研究（n=51）、定量研究（n=10）及混合方法研究（mixed methods）。其中仅2项为干预性研究（interventional）。最常见的医疗场景为医院（n=27）与社区医疗服务（n=19）。最常见的反馈接收者为护士（n=29）。多数报道的研究结局均为正向获益，可分为以下三类：（a）医护人员的短期情绪变化，包括获得工作动力与心理健康水平提升；（b）医护人员的工作-家庭互动层面的变化，例如家庭生活关系改善；（c）医护人员的工作相关变化，例如工作绩效提升与员工留存率提高。同时亦有部分负向结局被报道，例如未获得正向反馈时医护人员产生的嫉妒情绪。正向反馈的影响效应可能会受到特定医疗岗位特征的调节，例如夜班医护人员与患者的互动时间相对较少。部分可调节正向反馈所催生变革的因素是可被调整改善的。

研究结论
未来仍需开展更多干预性研究，以评估正向反馈在促成特定变革（如提升员工留存率）方面的有效性与成本效益。医疗管理人员可考虑更常态化地应用正向反馈，并针对性破除医护人员获取反馈的障碍。