Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON, Canada.
Dalla Lana School of Public Health, Institute for Work and Health, University of Toronto, 481 University Avenue, Suite 800, Toronto, ON, Canada.
BMC Health Serv Res. 2019 Aug 13;19(1):564. doi: 10.1186/s12913-019-4394-5.
Families play an important role meeting the care needs of individuals who require assistance due to illness and/or disability. Yet, without adequate support their own health and wellbeing can be compromised. The literature highlights the need for a move to family-centered care to improve the well-being of those with illness and/or disability and their family caregivers. The objective of this paper was to explore existing models of family-centered care to determine the key components of existing models and to identify gaps in the literature.
A scoping review guided by Arksey & O'Malley (2005) examined family-centered care models for diverse illness and age populations. We searched MEDLINE, PsycINFO, CINAHL and EMBASE for research published between 1990 to August 1, 2018. Articles describing the development of a family-centered model in any patient population and/or healthcare field or on the development and evaluation of a family-centered service delivery intervention were included.
The search identified 14,393 papers of which 55 met our criteria and were included. Family-centered care models are most commonly available for pediatric patient populations (n = 40). Across all family-centered care models, the consistent goal is to develop and implement patient care plans within the context of families. Key components to facilitate family-centered care include: 1) collaboration between family members and health care providers, 2) consideration of family contexts, 3) policies and procedures, and 4) patient, family, and health care professional education. Some of these aspects are universal and some of these are illness specific.
The review identified core aspects of family-centred care models (e.g., development of a care plan in the context of families) that can be applied to all populations and care contexts and some aspects that are illness specific (e.g., illness-specific education). This review identified areas in need of further research specifically related to the relationship between care plan decision making and privacy over medical records within models of family centred care. Few studies have evaluated the impact of the various models on patient, family, or health system outcomes. Findings can inform movement towards a universal model of family-centered care for all populations and care contexts.
家庭在满足因疾病和/或残疾而需要帮助的个人的护理需求方面发挥着重要作用。然而，如果没有足够的支持，他们自己的健康和幸福也会受到影响。文献强调需要转向以家庭为中心的护理，以改善患者及其家庭照顾者的福祉。本文的目的是探讨现有的以家庭为中心的护理模式，以确定现有模式的关键组成部分，并确定文献中的差距。
本研究采用 Arksey 和 O'Malley（2005 年）指导的范围综述方法，研究了针对不同疾病和年龄人群的以家庭为中心的护理模式。我们在 MEDLINE、PsycINFO、CINAHL 和 EMBASE 中检索了 1990 年至 2018 年 8 月 1 日期间发表的研究。纳入了描述任何患者群体和/或医疗保健领域的以家庭为中心的模式发展或描述以家庭为中心的服务提供干预措施的开发和评估的文章。
搜索共确定了 14393 篇论文，其中 55 篇符合我们的标准并被纳入。以家庭为中心的护理模式最常用于儿科患者群体（n=40）。在所有以家庭为中心的护理模式中，共同的目标是在家庭背景下制定和实施患者护理计划。促进以家庭为中心的护理的关键组成部分包括：1）家庭成员与医疗保健提供者之间的合作，2）考虑家庭背景，3）政策和程序，以及 4）患者、家庭和医疗保健专业人员的教育。这些方面有些是普遍的，有些是特定于疾病的。
本综述确定了以家庭为中心的护理模式的核心方面（例如，在家庭背景下制定护理计划），这些方面可以应用于所有人群和护理环境，以及一些特定于疾病的方面（例如，特定于疾病的教育）。本综述确定了需要进一步研究的领域，特别是与以家庭为中心的护理模式中护理计划决策与病历隐私之间的关系。很少有研究评估各种模式对患者、家庭或卫生系统结果的影响。研究结果可以为向所有人群和护理环境提供通用的以家庭为中心的护理模式提供信息。
