Aim: The aim of this study was to summarize reviews of family-focused care interventions that support families with a family member with a long-term condition across the life course.
Design: Umbrella review.
Data sources: Medline (1946-2019), Cochrane Database of Systematic Reviews (2019), Database of Abstracts of Reviews of Effect and EMBASE (1947-2019), CINAHL (1981-2019), Health Technology Assessment Database (2019) and PsycInfo (1806-2019).
Review methods: All authors independently undertook title/abstract screening, data extraction and quality appraisal on a cluster of papers, working in groups of two or three to reach a consensus. The AMSTAR tool was used to appraise the quality of the studies and descriptive syntheses were undertaken.
Results: Fifteen reviews met the selection criteria. Overall family-focussed care and associated terms were poorly defined. Typically interventions were educational or psychological therapy/counselling with the goal of empowering individuals to manage their condition. There is some evidence that family-focused care interventions can improve clinical/biological health measures and self-care outcomes such as treatment adherence. Multicomponent psychosocial interventions that include cognitive-behavioural therapy, skills training, education and support and are focused on wider family members appear to improve family relationships and martial functioning.
Conclusion: Long-term conditions have an impact on individual and family health and well-being, yet the impact of family-focused care interventions on family outcomes was overall inconclusive. A better understanding of how family-focused care interventions improve the health and well-being of individuals and their families is needed to promote the inclusion of family-focused care into practice.
Impact: Supporting people with a long-term condition is a key health and social care priority. Family-focused care interventions have potential to improve the health and well-being of individuals and families, but there is a need to evaluate their clinical and cost-effectiveness. The findings from this review could be used by funding bodies when commissioning research for long-term conditions.
目的: 本项研究旨在总结以家庭为中心的护理干预措施的评估结果,且此等干预措施为家庭成员患有贯穿整个生命历程的慢性病的家庭提供支持帮助。 设计: 全面评估。 数据来源: Medline(1946年-2019年)、Cochrane系统评价数据库(2019年)、疗效评价文摘数据库和EMBASE(1947年-2019年)、CINAHL(1981年-2019年)、卫生技术评估数据库(2019年)以及Psychino(1806年-2019年)。 评估方法: 所有作者独立地对一组论文进行标题/摘要筛选、数据提取和质量评估,以两人或三人为一组开展工作,以达成一致意见。采用AMSTAR工具评估研究的质量,并进行描述性综合汇总。 结果: 共有15篇评估论文符合筛选标准。总体以家庭为中心的护理及相关术语定义不明。典型的干预措施为进行教育或心理治疗/咨询,期以使个人能够管理自己的病情。有证据表明,以家庭为中心的护理干预措施可以改善临床/生物健康措施以及诸如治疗依从性的自我护理结果。面向更广泛的家庭成员且涵盖认知行为疗法、技能训练、教育和支持在内的多成分社会心理干预措施似乎可改善家庭关系和训练功能。 结论: 慢性病影响了个人及家庭的健康和幸福,但以家庭为中心的护理干预措施对家庭结果的影响总体上不确定。因此,仍需进一步了解以家庭为中心的护理干预措施如何改善个人及其家庭的健康和幸福,从而推动以家庭为中心的护理实践的运用。 影响: 为患有慢性病的人群提供支持帮助是健康与社会保健事业中一项重要的优先事项。以家庭为中心的护理干预措施可帮助改善个人及家庭的健康和幸福,但仍需对其临床和成本效益展开评估。这项评估工作的结果可供资助机构在委托进行慢性病研究时使用。.
Keywords: family nursing; family-focused care; life course; long-term conditions; umbrella review.
© 2020 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.