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.