Key Aspects of Out-of-Hospital Care for Patients With Tracheostoma: A Scoping Review

Abstract

Patients with tracheostoma require extensive out-of-hospital care. This scoping review mapped the literature on tracheostomy care strategies, care deficiencies, and support needs post-surgery to identify key aspects that must be addressed in a comprehensive tracheostomy care approach. We searched 3 databases (Medline, Cochrane Library, and Web of Science), covering publications from 2015 to 2023. Papers on tracheostomy care delivery, starting from hospital discharge to intersectoral out-of-hospital care, and studies on the needs of patients and caregivers were included, considering both tracheotomized and laryngectomized populations. Following double screening, data on study characteristics and research focus were extracted, and thematic analyses were conducted. Each study was labeled based on its primary research focus. We included 79 studies, which we grouped into 7 primary themes: “competency-based initiatives,” “integrated interprofessional care models,” “exercises-based initiatives,” “family caregivers’ perspectives,” “patient perspectives,” “medical providers’ perspectives,” and “assistive devices.” Two emerging themes included “dysphagia care” and “tracheostomy care during the pandemic.” We propose a framework for out-of-hospital tracheostomy care encompassing 4 key areas—Competence, Cooperation, Participation, and Assistive Devices—emphasizing the importance of education, multidisciplinary collaboration, social integration, and tailored assistive devices.