Risk Communication Approaches Research Articles

When Politics Meets Pandemic: How Prime Minister Netanyahu and a Small Team Communicated Health and Risk Information to the Israeli Public During the Early Stages of COVID-19.

BackgroundThe coronavirus brought the world’s leaders to the center of the media stage, where they not only managed the COVID-19 pandemic but also communicated it to the public. The means they used to communicate the global pandemic reveal their strategies and the narratives they chose to create in their nation’s social consciousness. In Israel, the crisis broke out after three election cycles, such that the government in charge of the crisis was an interim government under the leadership of Prime Minister Benjamin Netanyahu, who was operating under three criminal indictments. This study sought to examine the ways in which Prime Minister Netanyahu and two senior Israel Ministry of Health officials—Director General Moshe Bar Siman Tov and Prof. Sigal Sadetsky, Head of Public Health Services—communicated information about the health crisis in Israel during what has been termed the first wave and the beginning of the second wave.Methods and SampleThe research adopted qualitative methods (discourse, content and thematic analysis) to analyze the communication strategies and compare them to health and risk communication. Triangulated data collection from different data sources was used to increase the credibility and validity of the results. The research sample comprised the following sources from March 3 through June 21, 2020: transcripts of 19 press conferences and 12 press interviews, 95 emergency regulations signed by Prime Minister Netanyahu, and 52 articles in major Israeli newspapers.ResultsNetanyahu and the Health Ministry Director General used an apocalyptic narrative to communicate COVID-19 to the public. The main strategies used in constructing this narrative were intimidation, lack of information transparency, giving the public conflicting instructions contrary to the health and risk communicating approach, and using a health crisis to promote political intentions and actions.ConclusionCommunicating health crises to the public, particularly ongoing crises like COVID-19, requires that leaders implement the health and risk communication approach and create a cooperative narrative that does not rely on a strategy of intimidation, but rather on empathy and on fact-based and transparent information.

Cross-Sectional and Medico-Legal Investigations of Covid-19 Response, Ghana

From the 12th of March 2020, Ghana took bold steps against Covid-19, aimed at controlling the spread among the population, protecting against community infections, treating those with the disease and ensuring public trust in the healthcare delivery system. This cross-sectional survey, assessed the effectiveness of Ghana’s risk communication, legal framework and response approaches to the Covid-19 Pandemic. The first part was a Cross-Sectional approach. The authors used data collected on-line via a self-reported questionnaire between 16th March and 16th April from [127] participants. Differences in mean scores and other factors associated with awareness; as a function of risk communication; to Covid-19, knowledge of safety protocols, and practices towards the disease, were conducted using univariate and multivariate data analytical methods. The second approach was a literature review of Ghana’s legal framework existing prior to the outbreak of Covid-19 and those enacted by Parliament during the emergency period towards the management of the pandemic. A content analyses of the legal framework, to assess official compliance with the framework in relation to the aim of this study was conducted. The majority of the study participants were knowledgeable about how Covid-19 was transmitted. An independent samples t-test was performed to determine if a difference existed between the mean scores of COVID-19 knowledges for males and females. The outcome variable was found to be normally distributed and equal variances are assumed based upon results of Levene’s test (F (125) = 0.097, p-value = 0.756). There was no significant difference in knowledge scores (with minimum = 1, and maximum = 3) for males (mean = 1.61, standard deviation = 0.665) and females (mean = 1.56, standard deviation = 0.698; t- value t (125) =0.374, p-value = 0.709, two-tailed). The magnitude of the difference in the means (mean difference = 0.054, 95% confidence interval: -0.234, 0.343) and the effect size was very small (Cohen d = 0.08). The independent samples t-test was also performed to test the hypothesis that males and females were associated with statistically significant different COVID-19 awareness mean scores. The test showed no significant difference in the awareness scores for males and females. The results from the content analyses of the legal framework show there was lax adherence of government to the legal framework for Pandemic response on these dimensions: Planning and Coordination; Surveillance, Situation monitoring and Assessment; Prevention, Containment and Management; Communications; and Social Mitigation. It further shows that neither the existing legislation nor the Executive Instruments, E. I. 63 - 66, and 164 directed at Covid-19 administrative and epidemiologic controls, have helped to stop the spread of Covid-19, considering the uptick of new infections of Covid-19. Covid-19 has exposed the lack of effective risk communication modalities in Ghana and the government’s lack of adherence to the legal framework on disasters and emergencies in general, a vacuum which is filled by social media.

From ‘good’ intentions to principled practices and beyond: ethical issues in risk communication

AbstractEthical issues emerge whenever a decision or action has the potential to affect another person (Sellnow et al. 2008: 147) This chapter summarizes and critically addresses the evolution of risk communication approaches through the lens of ethical issues. The growth and the consolidation of risk communication as an independent, cross-cutting discipline appear to be strictly connected to the growing concern for both public's and individual recipients’ needs and rights.

COVID-19 initial preparedness and response in Vietnam during the first six months of the pandemic and the lessons for Sendai framework implementation

Purpose This paper aims to analyze the current responses applied in Vietnam to the Coronavirus disease (COVID-19) pandemic and link these measures to priority actions highlighted in the Sendai Framework for Disaster Risk Reduction (SFDRR). From there, strengths, limitations and recommendations on applying the SFDRR to build the pandemic resilience in the future are discussed. Design/methodology/approach The authors synthesize literature on response measures to the COVID-19 pandemic in Vietnam from January to June 2020 and compare to four priority actions of the SFDRR including understanding risk, strengthening governance, investing in risk reduction for resilience and enhancing preparedness for effective response and resilient recovery. Findings Vietnam has effectively controlled the pandemic with 401 infected cases and no death so far. Well preparation, timely policies’ implementation, risk communication and comprehensive approaches are key strategies. These measures are same as the four priority actions in the SFDRR. Originality/value To the best of the authors’ knowledge, this is the first study in Vietnam to link the COVID-19 response and the SFDRR, which can serve as an important example for other countries in responding to the pandemic. Some measures have surpassed SFDRR’s guidance, especially preventive responses applied nationwide with strong political will and the community’s commitment accompanied by sanctions. Cultural factors such as the habit of using masks to prevent air pollution have contributed to the good observance of wearing mask regulations during the pandemic. However, some areas that need more attention include specific solutions for vulnerable groups, limiting fake news and ensuring patient privacy.

Terrestrial and airborne laser scanning and 2-D modelling for 3-D flood hazard maps in urban areas: new opportunities and perspectives

The development of a shared understanding of current flood risk amongst stakeholders is one of the main goals of flood risk management. This priority suggests that stakeholders must understand the possible impacts on their property and assets, and measures they can take to mitigate the risk. Nowadays, flood maps are considered to be a potentially valuable tool for improving this understanding, but some drawbacks related to the use of flood maps for risk communication has been highlighted in the literature. An alternative and novel approach is provided by 3-D representations of flood inundation, so that supplementing flood maps with 3D visualization techniques is increasingly seen as a powerful tool with which to engage people with flood hazards. In this context, the detailed representation of the urban areas is important not only to set an accurate out-of-bank river model, essential for reliable simulations of flow dynamics inside the urban districts, but could be also a key element for the generation of realistic 3D views able to enhance risk perception and communication. In the framework described so far, 3D point cloud data provided by a terrestrial laser scanner could play an interesting role. Therefore, the main novelty introduced by this work is the combination of 2D flood simulations, 3D visual techniques and airborne/terrestrial laser scanning in order to develop new approaches for risk communication and perceptions. The potential of the methods developed here has been discussed in relation to a hypothetical flood event of the Crati river, flowing through the old city of Cosenza (South of Italy).

Brief report - “Every little thing gonna be all right” (at least for me): Dispositional optimists display higher optimistic bias for infection during the Italian COVID-19 outbreak

Dispositional optimism (DO) and optimistic bias (OB) in risk perception are two distinct phenomena and previous studies about their reciprocal relationship report contrasting results. In the present study, we focused on the relationship between DO and OB when reporting the personal and the other persons' risk about COVID-19. We hypothesized that, when facing a largely uncontrollable risky situation (like the recent pandemic), dispositional optimists would defensively increase their OB about the current risks. A convenience sample of 414 Italian participants aged 18 or older were recruited. They completed a questionnaire investigating past protective behaviors, DO, perceived personal and other persons' COVID-19-related risk. Results of the mixed regression model showed that more optimistic people were more likely to underestimate their COVID-19 personal risk over the other's person risk. These results shed light on the relationship between different forms of optimism and provide useful insight about the potential implications of risk communication approaches to face the current pandemic.

Assessing the Reliability of Relevant Tweets and Validation Using Manual and Automatic Approaches for Flood Risk Communication.

While Twitter has been touted as a preeminent source of up-to-date information on hazard events, the reliability of tweets is still a concern. Our previous publication extracted relevant tweets containing information about the 2013 Colorado flood event and its impacts. Using the relevant tweets, this research further examined the reliability (accuracy and trueness) of the tweets by examining the text and image content and comparing them to other publicly available data sources. Both manual identification of text information and automated (Google Cloud Vision, application programming interface (API)) extraction of images were implemented to balance accurate information verification and efficient processing time. The results showed that both the text and images contained useful information about damaged/flooded roads/streets. This information will help emergency response coordination efforts and informed allocation of resources when enough tweets contain geocoordinates or location/venue names. This research will identify reliable crowdsourced risk information to facilitate near real-time emergency response through better use of crowdsourced risk communication platforms.

FDA postmarketing safety labeling changes: What have we learned since 2010 about impacts on prescribing rates, drug utilization, and treatment outcomes.

Prior literature reviews have identified gaps in understanding of how postmarketing safety labeling changes and related FDA communications impact key clinical and behavioral outcomes. We conducted a review of newly published studies on this topic to determine what new evidence exists and to identify which gaps may still remain. We believe that this information can support FDA as it develops and implements future risk communication approaches. We searched PubMed and Embase for studies published between January 1, 2010, and August 7, 2017 that examined the impact of labeling changes or associated FDA safety-related communications. For each study, we extracted information on research design and findings for key clinical outcomes and behaviors. We also conducted a ROBINS-I review to identify potential for bias in the research design of each study. We found that the estimated impacts of FDA labeling changes on several key outcomes-including adverse events-varied. Labeling changes also yielded unintended consequences on drug prescribing in some cases, despite low provider adherence. Finally, some studies we reviewed exhibited potential for bias due to confounding, among other factors. The new studies we reviewed contain many of the same limitations identified in previously published reviews. While there are several challenges to conducting this research there is substantial room for improvement in the quality of the evidence base. More information, particularly with respect to the types of populations and medications affected by labeling changes, is needed to support the development of more effective and targeted safety communications.

Flood risk perceptions and coping capacities among the retired population, with implications for risk communication: A study of residents in a north Wales coastal town, UK

Flood risk communication strategies have been ineffective for older adults as they have failed to accommodate diversity, viewing retired populations as homogenous. There have been calls from academics and NGOs to develop more detailed understandings of older adults' risk experiences to inform disaster risk reduction (DRR) and communication approaches. We conducted in-depth interviews with twelve members of the retired population, of which the majority happened to be members of a local church, in a flood risk area of north Wales, UK, in 2018 to ascertain risk perceptions, coping capacities, and risk communication preferences to inform more age-centred approaches. Results present retired population are a diverse group with varying perceptions and capacities. While personal risk perceptions were low overall, coping capacities varied and were primarily social in nature, which can be sustained despite mobility or other limitations typical of older age. Participants expressed preference for traditional/interpersonal risk communication methods, such as telephone calls or home visits. A key recommendation from this study is that risk communication and DRR practices should adopt people-centric approaches that are co-produced and respect the differentiated vulnerabilities, capacities and needs of at-risk populations. This study and its findings are important is providing a more nuanced picture of the vulnerabilities and capacities of the particularly at-risk population of older adults. We must ensure that future DRR research, policies and practices focus on all experiences of at-risk populations, not only the dominant narratives or extremes of groups, to capture differences within groups’ abilities to support more effective community DRR.

Workers’ exposure to nano-objects in R&D laboratories: An integrated risk management and communication approach

The growing development of emerging and enabling technologies, including nanotechnologies, calls for a responsible approach to identify, evaluate, prevent and communicate health and safety (H&S) concerns related to them. This study proposes a methodology to manage the potential risks related to research and development (R&D) activities on nanomaterials (NMs), combining qualitative risk evaluation, on-site exposure assessment and communication tools. This methodology gives an example of an evidence-based approach to address uncertainties related to workers’ exposure in NMs use and production. It originates from a standardized Control Banding (CB) approach, in which the hazard bands are combined with the exposure potential, in order to define the level of control measures required in the workplace. Field measurements, data collection and off-line analysis have been employed to integrate the CB model and to obtain an improved risk management tool. It has been tested in a R&D laboratory in which NMs with different dimensionalities were manufactured and used: graphene, nanowires and nanoparticles. The final outcome is a risk analysis included in a pictogram (NanoLabel) associated to each process phase and laboratory, indicating the specific level of risk and primary management measures, addressed to R&D personnel, H&S players and other workers involved. It is a dynamic system that can be adapted to the different R&D activities and to the different competences and skills of target personnel. Results shows the approach address workers’ exposure to NMs with promising applications also in industrial contexts.

Risk communication approaches for preventing private groundwater contamination in the Republic of Ireland: a mixed-methods study of multidisciplinary expert opinion

The mechanisms of private-well groundwater contamination are uniquely complex, necessitating a multisector communicative approach to risk management, premised on behaviour promotion. In countries such as the Republic of Ireland (ROI), characterised by oftentimes high groundwater contamination risk and concurrently limited user awareness, incorporation of multidisciplinary, ‘expert-based’ knowledge may facilitate design of evidence-based, practical interventions. Expert interviews represent an efficient form of expert consultation, enabling ease of access to niche information and comparison of procedure, but remain under-utilised within the groundwater management literature. In response, the current study elicited opinion from 50 experts across four broad categories (communications, engineering/science, policy, and risk assessment) via a mixed-methods interview study. Semi-structured qualitative interviews were undertaken with experts from the ROI (n = 25) and European/North American countries (n = 25) and examined using thematic (qualitative) and bivariate statistical (quantitative) analyses. Experts noted financial cost, knowledge and social norms as primary barriers to adopting private-groundwater and other health risk-prevention behaviours. Lack of organisational knowledge as a communication barrier was significantly related to expert category (p = 0.034) and highlighted by a majority of communications experts (95%) compared to policy (75%), risk assessment (67%) and engineering/science (50%) experts. The most frequently suggested communication activities comprised events (24%), radio segments (22%), workshops (24%) and community meetings (30%), allied with family-oriented, discursive approaches to information delivery. Study findings may be used by both national (Irish) and international stakeholders in myriad hydrogeological contexts to develop educational outreach strategies and contribute to the existing groundwater-management-knowledge base.

Willingness of the UK Public to Volunteer for Testing in Relation to the COVID-19 Pandemic

Background: The World Health Organization declared the rapid spread of COVID-19 around the world to be a global public health emergency. The spread of the disease is influenced by people’s willingness to adopt preventative public health behaviours, such as participation in testing programmes and risk perception can be an important determinant of engagement in such behaviours. Methods: In this study, we present the first assessment of how the UK public (N=778) perceive the usefulness of testing for coronavirus and the factors that influence a person’s willingness to test for coronavirus.Findings: None of the key demographic characteristics (age, gender, education, disability, vulnerability status, or professional expertise) were significantly related to the respondents’ willingness to be tested for coronavirus. However, closely following the news media was positively related to willingness to be tested. Knowledge and perceptions about Coronavirus significantly predicted willingness to test, with three significantly contributing factors: worry about the health and social impacts to self and family; personal susceptibility; and concerns about the impacts of coronavirus on specific demographic groups. Views on testing for coronavirus predicted willingness to test, with the most influential factors being importance of testing by need; negative views about widespread testing and mistrust in doctor’s advice about testing. Interpretation: Implications for effective risk communication and localised public health approach to encouraging public to put themselves forward for testing are discussed. We strongly advocate for effective communications and localised intervention by public health authorities, using media outlets to ensure that members of the public get tested for SARs-CoV2 when required.Funding Statement: None.Declaration of Interests:The authors report no conflicts of interest. Ethics Approval Statement: The study received a favourable ethical opinion from the Kingston University Research Ethics Committee.

Supporting informed decision-making about vaccination: an analysis of two official websites

ObjectiveTo analyze the content of two official French-speaking websites that are used to inform the general public about recommended vaccines in France and Quebec. Study designQualitative content analysis. MethodsAll pages that inform and educate parents regarding childhood vaccination were downloaded and analyzed according to evidence-informed risk communication metrics. ResultsA total of 32 webpages, 14 videos, and two infographics were included in the analysis. The following were the most frequent risk communication approaches: ‘debunking common misconceptions about vaccination’ or ‘answering common questions about vaccines.’ Harm and benefit information focused primarily on the risks of vaccine-preventable diseases and the risks of adverse events after immunization. Most materials used qualitative terminology to describe the risk (e.g., vaccines are among the safest tools, adverse events are rare). Very few materials provided numeric likelihood of harms and benefits. When numeric information was stated, they were only presenting the risks of the diseases or number of cases in an outbreak. The approaches used to debunk misconceptions generally focused on the myth itself rather than the correct information. Few materials used visual aids (e.g., graphics, pictures, icons arrays, etc.) to convey important information. ConclusionsIt is often assumed that misinformation and rumors about vaccination found online is a leading cause of the increase in vaccine hesitancy. Existing communication materials could be improved to better align with best practices in risk communication. Given the availability of confusing and conflicting vaccine narratives, it is crucial that authoritative communication materials aim to build trust and support informed choices about vaccination.

Communicating Risk in Enhancing Disaster Preparedness: A Pragmatic Example of Disaster Risk Communication Approach from the Case of Smong Story

Communicating risk has been widely accepted as a key strategy in mitigating the the impact of disasters. The concepts and practices of risk communication have been evolving since the 1980s due to the complexity and diversity of risk, developments in the communication sciences, and the complex nature of stakeholders and media. Failure to communicate risk may lead to an increase in the number of fatalities in future events. In this study, disaster risk communication (DRC) is proposed based on Lasswell’s communication model and seen as an interactive process of exchanging information and opinions about risk among individuals, groups, and institutions to help them reduce uncertainty and undertake appropriate decisions and actions in the event of disaster. This study also describes the case study of the Smong story, which was successfully used to convey a simple tsunami risk message and help people make appropriate decisions, undertake appropriate actions, and save lives during the 2004 Indian Ocean tsunami. It involves multiple factors, such as messages about the nature of risk and other messages, not strictly about risk, that express concerns, opinions, or reactions to risk or to legal or institutional arrangements for risk management in strengthening community preparedness before, during, and after disasters.

The effects of infographics and several quantitative versus qualitative formats for cardiovascular disease risk, including heart age, on people’s risk understanding

ObjectiveTo study how comprehension of cardiovascular disease (CVD) risk is influenced by: (1) infographics about qualitative risk information, with/without risk numbers; (2) which qualitative risk dimension is emphasized; (3) heart age vs. traditional risk format. MethodsFor aim 1, a 2 (infographics versus text) x 2 (risk number versus no risk number) between-subjects design was used. For aim 2, three pieces of information were tested within-subjects. Aim 3 used a simple comparison group. Participants (45–65 yrs old) were recruited through an online access panel; low educated people were oversampled. They received hypothetical risk information (20%/61yrs). Primary outcomes: recall, risk appraisals, subjective/objective risk comprehension. Secondary outcomes: behavioral intentions, information evaluations. ResultsInfographics of qualitative risk dimensions negatively affected recall, subjective risk comprehension and information evaluations. No effect of type of risk dimension was found on risk perception. Heart age influenced recall, comprehension, evaluations and affective risk appraisals. ConclusionInfographics of hypothetical CVD risk information had detrimental effects on measures related to risk perception/comprehension, but effects were mainly seen in undereducated participants. Heart age influenced perceptions/comprehension of hypothetical risk in a way that seemed to support understanding. Practice implicationsHeart age seems a fruitful risk communication approach in disease risk calculators.

Communicating Seismic Risk: the Geoethical Challenges of a People-Centred, Participatory Approach

The Sendai Framework for Disaster Risk Reduction (SFDRR) encourages scientists to participate in bottom-up risk communication approaches that directly engage hazard-prone populations. Effective communication of seismic risks not only has economic impacts in terms of hazard mitigation but also provides social value in potentially empowering the marginalized populations that disproportionately live in high-risk areas. This emphasis on community-focused disaster preparedness, however, presents a novel set of communication challenges for geoscientists. Few scientists have training in or experience of translating their science for lay publics, and conveying complex risk information is especially difficult in circumstances where scientific issues are socially contested and politically charged. Recognising that disaster threats can create troublesome information battlegrounds, this paper explores the ethical and practical aspects of seismic risk communication, motivated by an early-career earth scientists’ workshop in Istanbul that voiced the concerns of young geoscientists confronted firsthand by at-risk publics. Those concerns form the basis of a wider review of the risk communication issues that are likely to be encountered if community-centred participatory DRR approaches are to be adopted by earthquake science researchers.

Helping cancer patients quit smoking using brief advice based on risk communication: A randomized controlled trial

This randomized controlled trial aimed to examine the effectiveness of a smoking cessation intervention using a risk communication approach. A total of 528 smoking cancer patients were randomly allocated either into an intervention group (n = 268) to receive brief advice based on risk communication by a nurse counselor or a control group (n = 260) to receive standard care. Subjects in both groups received a smoking cessation booklet. Patient follow-ups were at 1 week and at 1, 3, 6, 9 and 12 months. No significant differences were found in self-reported point-prevalence 7-day abstinence between the intervention and control groups at 6 months (15.7% vs 16.5%; OR 0.94, 95% CI 0.59–1.50). The rate of at least 50% self-reported reduction of smoking at 6 months, was higher in the intervention group than in the control group (16.8% vs 12.3%; OR 1.43, 95% CI 0.88–2.35). The biochemically validated quit rate at the 6-month follow-up was higher in the intervention group than in the control group (5.2% vs 3.8%; OR 1.38, 95% CI 0.60–3.16). These data suggest that advice based on risk communication was not effective for quitting but improved the rate of smoking reduction among smoking cancer patients.

Healthy, Wealthy, and Wise? Exploring Parent Comparative Optimism About Future Child Outcomes

Objectives. Comparative optimism is present in parental predictions of their child’s long-term, obesity-related health outcomes and some of this optimism is unrealistic. An understanding of how comparative optimism relates to parents’ predictions of health versus other child outcomes could contribute to the development of interventions and strategies pediatricians can use to improve risk assessment. Methods. In a nationally representative survey, we asked American parents of 6- to 17-year-old children (n = 410) to estimate the chances that their child and “a typical child in their community” would be affected by overweight, get married, and complete a 4-year college degree by age 30, and the child’s future salary at age 30. We collected data on family demographic and health characteristics. We modeled the difference in parent predictions for their child versus the typical child using multivariate linear regressions. Results. Compared to the typical child, parents were less likely to predict that their child would be affected by overweight (−26.6 percentage points, 95% confidence interval [CI]: −35.6, −17.7) and more likely to predict that their child would complete a 4-year degree (16.7 percentage points, 95% CI: 2.5, 31.0). Parents predicted their child would have a higher income than the typical child at age 30 ($15,266, 95% CI: $7,487, $23,046). Parents did not predict that their child would be more likely than the typical child to be married by age 30 (−2.2 percentage points, 95% CI: −8.1, 3.7). Conclusions. Some parents appear to exhibit comparative optimism around their child’s future weight status, education, and economic outcomes, but not marriage. Future experimental work should assess whether risk communication approaches that consider optimism bias influence parent risk perception and parenting behaviors.

Understanding social acceptance of geothermal energy: Case study for Araucanía region, Chile

This research aims to explore public views and social attitudes toward the use of geothermal energy as a heating and electricity source in an area where the geothermal energy production technology has yet to be widely introduced. This case study focuses on the community that surrounds the Villarrica Volcano in the Araucania region of Chile. This area is considered to be one of the six high enthalpy geothermal zones in the Chilean Andes with the highest potential for geothermal energy production but actual production is nearly non-existent. Taking a risk communication approach, this research includes in-depth semi-structured interviews with local stakeholders. It suggests that there is a low level of understanding of the technology involved in geothermal energy production, and it highlights social barriers such as lack of trust, spiritual relationship to volcanoes, and uncertainty about environmental impact as factors that affect risk and public perception.

The experience of chemotherapy-induced peripheral neuropathy in adult cancer patients: a qualitative thematic synthesis.

The aim of this review was to systematically identify, appraise and synthesise qualitative research evidence on the experience of adult cancer patients living with chemotherapy-induced peripheral neuropathy (CIPN). A systematic search of the literature was performed in September 2015. Qualitative studies were included if they investigated CIPN and patient experience. Quality of the articles was appraised using an adapted version of the Critical Appraisal Skill Programme Checklist for Qualitative Research (CASP 2014). Themes were identified using the thematic synthesis approach proposed by Thomas and Harden [BMC Medical Research Methodology 8 (2008) 45]. Five articles presented findings generated by 88 patients who had all received neurotoxic chemotherapy. Sample sizes from included studies varied from 1 to 28 patients; all studies originated from America and were published between 2005 and 2015. Four analytical themes emerged: (1) CIPN is an unclear experience, (2) a less important risk, (3) impact on quality of life and (4) a feature of cancer survivorship. In conducting this synthesis, the lack of qualitative evidence in this specific condition is evident. Further studies are needed outside of America, to focus on CIPN risk communication approaches by healthcare professionals, patient understanding and perception of CIPN risk and interventions to promote early detection of CIPN including effective reporting and assessment.