Brown University Medical School, Providence, Rhode Island, USA.
J Int AIDS Soc. 2010 Jun 23;13 Suppl 2(Suppl 2):S3. doi: 10.1186/1758-2652-13-S2-S3.
Despite strong global interest in family-centred HIV care models, no reviews exist that detail the current approaches to family-centred care and their impact on the health of children with HIV. A systematic review of family-centred HIV care programmes was conducted in order to describe both programme components and paediatric cohort characteristics.
We searched online databases, including PubMed and the International AIDS Society abstract database, using systematic criteria. Data were extracted regarding programme setting, staffing, services available and enrolment methods, as well as cohort demographics and paediatric outcomes.
The search yielded 25 publications and abstracts describing 22 separate cohorts. These contained between 43 and 657 children, and varied widely in terms of staffing, services provided, enrolment methods and cohort demographics. Data on clinical outcomes was limited, but generally positive. Excellent adherence, retention in care, and low mortality and/or loss to follow up were documented.
The family-centred model of care addresses many needs of infected patients and other household members. Major reported obstacles involved recruiting one or more types of family members into care, early diagnosis and treatment of infected children, preventing mortality during children's first six months of highly active antiretroviral therapy, and staffing and infrastructural limitations. Recommendations include: developing interventions to enrol hard-to-reach populations; identifying high-risk patients at treatment initiation and providing specialized care; and designing and implementing evidence-based care packages. Increased research on family-centred care, and better documentation of interventions and outcomes is also critical.
尽管全球对以家庭为中心的艾滋病毒护理模式非常关注，但目前还没有审查详细介绍以家庭为中心的护理方法及其对艾滋病毒感染儿童健康影响的报告。进行了一项以家庭为中心的艾滋病毒护理方案的系统审查，以描述方案组件和儿科队列特征。
我们使用系统标准在在线数据库（包括 PubMed 和国际艾滋病协会摘要数据库）中进行了搜索。提取了有关方案设置、人员配备、提供的服务和登记方法以及队列人口统计学和儿科结果的数据。
搜索结果产生了 25 份出版物和摘要，描述了 22 个独立队列。这些队列包含 43 至 657 名儿童，在人员配备、提供的服务、登记方法和队列人口统计学方面差异很大。临床结果数据有限，但总体呈阳性。记录了极好的依从性、护理保留率以及低死亡率和/或失访率。
以家庭为中心的护理模式满足了感染患者和其他家庭成员的许多需求。主要报告的障碍涉及招募一名或多名家庭成员接受护理、早期诊断和治疗感染儿童、在儿童接受高效抗逆转录病毒治疗的头六个月内预防死亡，以及人员配备和基础设施限制。建议包括：制定干预措施以招募难以接触到的人群；在治疗开始时识别高危患者并提供专门护理；以及设计和实施基于证据的护理方案。增加对以家庭为中心的护理的研究以及更好地记录干预措施和结果也至关重要。
