Understanding Power Distance in Healthcare: A Scoping Review

This review aimed to map the existing research and methodologies used and identify themes of power distance in healthcare. A systematic search for original studies was conducted in May 2023 in accordance with the Joanna Briggs Institute's guidelines for scoping reviews. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews were used for reporting. A total of 30 studies were included, and all were published between 2004 and 2022. Power distance as a moderator was evident in the research, influencing the relation between other variables. Three distinct themes of power distance in healthcare were identified: interpersonal, intrapersonal and cultural aspects of power distance. These themes illustrate the multilevel effects of power distance in healthcare. Based on current evidence, power distance is an impactful phenomenon in healthcare. Power distance has diverse direct and indirect impacts and is a valuable framework for describing healthcare's complex social inequalities. Power distance was directly linked with hierarchy and associated with a lack of collegiality. Awareness and understanding of power distance are valuable for healthcare leadership and research, aiding in the comprehension of employee outcomes, expectations and subtle cultural differences, though further research on power distance in healthcare is needed.