Family-centred approaches to healthcare interventions in chronic diseases in adults : A quantitative systematic review

Background
Increasingly there is a focus on self-care strategies for both malignant and non-malignant conditions. Models of self-care interventions have focussed on the individual and less on the broader context of family and society. In many societies, decision-making and health seeking behaviours, involve family members.

Objective
To identify elements of effective family-centred self-care interventions that are likely to improve outcomes of adults living with chronic conditions.

Design
Review paper.

Data sources
MEDLINE (Ovid), CINAHL, Academic Search Complete, PsychInfo and Scopus between 2000–2014.

Review methods
Quantitative studies targeting patient outcomes through family-centred interventions in adults were retrieved using systematic methods in January, 2015. Search terms used were: ‘family’, ‘spouse’, ‘carer’, ‘caregiver’, ‘chronic’, ‘chronic disease’, ‘self-care’, ‘self-management’ and ‘self-efficacy’. Reference lists were reviewed. Risk of bias assessment was performed using the Cochrane Collaboration's tool. Data were reported using a narrative summary approach.

Results
Ten studies were identified. Improvements were noted in readmission rates, emergency department presentations, and anxiety levels using family-centred interventions compared with controls. Elements of effective interventions used were a family-centred approach, active learning strategy and transitional care with appropriate follow-up.

Conclusions
Involving the family in self-care has shown some positive results for patients with chronic conditions. The benefits of family-centred care may be more likely in specific socio-cultural contexts.

Limitations
The review has year limits and further research needs to identify support for both the patients and family caregivers.