Child and Adolescent Health Policy, MassGeneral Hospital for Children, Boston, Mass., USA.
Acad Pediatr. 2011 Mar-Apr;11(2):136-43. doi: 10.1016/j.acap.2010.12.014.
Family-centered care (FCC) has received widespread endorsement for use in care in the United States. In this study, we conducted a systematic review of evidence for FCC focusing specifically on family-provider partnership as the activity that constitutes FCC.
We found and reviewed articles from the medical, nursing, psychology, and sociology literature spanning 1986 to 2010. We also reviewed articles obtained through related references and through recommendations from key informants. Four sets of terms were used to search, including FCC, child/adolescent, children with special health care needs (CSHCN, defined broadly or by condition), and a relevant outcome.
Twenty-four studies met the review criteria. Eight were cross-sectional studies from the National Survey of Children With Special Health Care Needs, and 7 were reports of randomized, controlled trials. Of the 24 articles reviewed, 13 examined populations of CSHCN or similar populations, 6 examined children with asthma, and the remaining studied children with other specific conditions. We found positive associations of FCC with improvements in efficient use of services, health status, satisfaction, access to care, communication, systems of care, family functioning, and family impact/cost. There was little available evidence, however, for some outcomes, including cost and transition.
The available evidence suggests that FCC is associated with improved outcomes for CSHCN. With positive findings for most of the studies reviewed here and the compelling arguments for FCC, we recommend the use of this approach by individuals and organizations.
以家庭为中心的护理（FCC）在美国已得到广泛认可，适用于各种护理工作。本研究对以家庭-医护人员伙伴关系为 FCC 活动的具体内容的 FCC 证据进行了系统评价。
我们从医学、护理、心理学和社会学文献中查找并回顾了 1986 年至 2010 年的文章。我们还通过相关参考文献和关键知情人的建议获得了文章。使用了四组术语进行搜索，包括 FCC、儿童/青少年、有特殊医疗需求的儿童（广义或按疾病定义）和相关结果。
符合审查标准的研究有 24 项。其中 8 项来自国家特殊医疗需求儿童调查的横断面研究，7 项为随机对照试验报告。在审查的 24 篇文章中，13 项研究了 CSHCN 或类似人群，6 项研究了哮喘儿童，其余的研究了患有其他特定疾病的儿童。我们发现，FCC 与服务利用效率、健康状况、满意度、获得医疗服务的机会、沟通、医疗体系、家庭功能和家庭影响/成本的改善呈正相关。然而，对于一些结果，包括成本和过渡，几乎没有可用的证据。
现有证据表明，FCC 与 CSHCN 结局的改善有关。鉴于这里审查的大多数研究都有积极的发现，并且有充分的理由支持 FCC，我们建议个人和组织采用这种方法。
