Humanization interventions in primary health care: an umbrella review

This umbrella review identified systematic and non-systematic reviews of quantitative and qualitative empirical studies on interventions aimed at promoting humanization in Primary Health Care (PHC). The objective of this umbrella review was to synthesize and compare the available evidence on interventions aimed at promoting humanization in PHC. It addressed two questions: (1) What are the main definitions and dimensions of humanization in healthcare identified in the existing body of research? and (2) Which interventions promote humanization in PHC, and what outcomes have they demonstrated?

The reviews were selected following PRISMA guidelines and eligibility criteria based on the PICOS strategy (population, interventions, comparators, outcomes, and study design). Records were identified in Web of Science (WoS), Scopus, and PubMed.

Twenty-five systematic and non-systematic reviews were included. The evidence shows consistent convergence in defining humanization in PHC as person-centered and relational care grounded in open communication, empathy, respect, and patient participation in decision-making. The most frequently studied interventions include person-centered communication styles, shared decision-making, reorganization of care processes (e.g., welcoming practices, continuity, and coordination), and organizational strategies targeting access and equity. These interventions are robustly associated with improvements in experiential outcomes, such as satisfaction, trust, participation, reduced decisional conflict, and strengthened therapeutic relationships, while effects on final clinical outcomes are more variable and context-dependent. Community-based, intercultural, and digital interventions were also identified, extending humanization toward social determinants, continuity of care, and reduced access barriers.

Findings showed that humanization in PHC aligns with classic Person-Centered Care frameworks, where patients' values, preferences, and life contexts guide clinical decisions. Relational micro-practices emerge as central quality mechanisms, yet their impact depends on enabling organizational conditions, including time, continuity, coordination, and institutional support. Overall, humanization appears as a system-level property rather than an isolated technique, requiring integrated, context-sensitive, and equity-oriented interventions to achieve sustained and meaningful effects.