Patient, family member and healthcare professionals' experiences of physiotherapy airway clearance techniques during hospital admission: a scoping review.

Introduction: Effective secretion management is crucial for hospitalised patients with retained secretions due to critical illness, chronic respiratory disease or infection. Airway clearance techniques (ACT), primarily physiotherapist-delivered and advocated in guidelines, support secretion removal. However, limited knowledge exists regarding the experiences of patients, family members and healthcare professionals involved in ACT. The aim of the present study was to explore the experiences of patients, family members and healthcare professionals of ACT in hospital settings. Methods: Following JBI (formerly Joanna Briggs Institute) recommendations and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist, searches were conducted in CINAHL Complete, EMBASE, MEDLINE ALL, PsycINFO and ProQuest Dissertations & Theses Global, from inception to 17 November 2025. Qualitative studies involving patients (≥16 years) receiving ACT, family members involved or healthcare professionals delivering ACT in the hospital setting were eligible. Screening and data charting were performed independently and in duplicate. Findings were synthesised descriptively and narratively. Results: Of 10 370 records identified, 11 studies met the inclusion criteria. Six studies reported primary themes related to ACT, while relevant source text from the remaining five studies was extracted and integrated into the narrative synthesis. Populations included healthcare professionals (physiotherapists, nurses, intensivists, internal medicine specialists; n=293) and patients (n=80). No studies included family members. Settings were predominantly intensive care units (ICU) (n=9), with two studies spanning ICU and ward settings. Four overarching themes emerged: three shared by patients and healthcare professionals (Knowledge, resources, and skills; Decision-making process; Perceived effects and outcomes), and one unique to healthcare professionals (Organisational factors). Conclusions: Current evidence on experiences of ACT is dominated by physiotherapists and ICU settings, with no studies capturing family perspectives and limited patient or wider multidisciplinary input across broader hospital contexts. More inclusive, stakeholder-informed research is needed to fully understand ACT use, impact and burden in clinical practice.