Center of Excellence for Rehabilitation Medicine Utrecht, Brain Center University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
BMJ Open. 2019 Apr 23;9(4):e026768. doi: 10.1136/bmjopen-2018-026768.
Family group decision-making (FGDM) is a structured decision-making process, aiming to shift the balance of power from professional towards the person in need and their family. It differentiates from other family-centred meetings by the presence of three key elements: (1) plan with actions/goals, (2) family driven, (3) three phases of meetings gradually increasing empowerment. FGDM studies are increasing in different settings in adult healthcare/welfare, although effectiveness is unknown at this date.
(1) to systematically review the presence of the three FGDM key elements in family-centred interventions in adult care and welfare, (2) to evaluate the effectiveness of FGDM interventions.
Systematic review.
A total of 14 relevant electronic databases and 1 academic search machine were searched until February 2018. First, family-centred studies were selected with controlled trial designs in adult healthcare/welfare. Second, interventions were categorised as FGDM if all three key elements were present.
Studies were examined concerning their (1) characteristics (2) quality/level of evidence (3) presence of FGDM key elements and (4) results.
Six articles from three studies on family-centred interventions were selected from a total of 1680 articles. All were of low quality. One study (two articles) met all criteria for an FGDM intervention, describing the efficacy of family group conferences among social welfare recipients on mental health outcomes. Although the intervention group showed significantly better outcomes after 16-23 weeks; no differences were seen at the 1-year follow-up.
Controlled studies of both family-centred interventions and FGDM are still low in quantity and quality. No conclusions on FGDM effectiveness can be drawn. Further high-quality intervention studies are required to evaluate the impact of FGDM on adults in need, including their families; as well as evaluation research detecting possible barriers and facilitators influencing FGDM implementation.
CRD42017077585.
家庭小组决策（FGDM）是一种结构化的决策过程，旨在将权力从专业人员转移到有需要的人和他们的家庭手中。它通过三个关键要素与其他以家庭为中心的会议区分开来：（1）有行动计划/目标，（2）以家庭为导向，（3）会议分三个阶段逐渐增强授权。FGDM 研究在成人保健/福利的不同环境中不断增加，尽管目前尚不清楚其效果。
（1）系统回顾成人保健和福利中以家庭为中心的干预措施中 FGDM 的三个关键要素的存在情况，（2）评估 FGDM 干预措施的效果。
系统综述。
共检索了 14 个相关电子数据库和 1 个学术搜索引擎，检索截止日期为 2018 年 2 月。首先，选择了具有成人保健/福利中对照试验设计的以家庭为中心的研究。其次，如果存在所有三个关键要素，则将干预措施归类为 FGDM。
研究考察了它们的（1）特征（2）质量/证据水平（3）FGDM 关键要素的存在情况和（4）结果。
从总共 1680 篇文章中选择了三篇以家庭为中心的干预措施研究的六篇文章。所有文章的质量都很低。一项研究（两篇文章）符合 FGDM 干预措施的所有标准，描述了家庭小组会议对社会福利接受者心理健康结果的效果。虽然干预组在 16-23 周后表现出明显更好的结果；但在 1 年随访时没有差异。
以家庭为中心的干预措施和 FGDM 的对照研究在数量和质量上仍然较低。不能得出 FGDM 有效性的结论。需要进一步开展高质量的干预研究，以评估 FGDM 对有需要的成年人及其家庭的影响；以及评估研究，以发现影响 FGDM 实施的可能障碍和促进因素。
PROSPERO 注册号：CRD42017077585。
