Achieving Family-Integrated Care for Older Patients with Major Neurodegenerative and Mental Health Conditions: A Systematic Review of Intervention Characteristics and Outcomes

为患有严重神经退行性疾病和精神健康问题的老年患者实现家庭整合式照护:干预特征和结果的系统评价

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Abstract

National and international aged care frameworks recommend family-integrated care to enhance care quality and outcomes, supported by evidence demonstrating improvements in patient and clinician experiences. Yet uncertainty remains about how to integrate family carers effectively in diverse healthcare models and settings for neurodegenerative and mental health conditions. A systematic integrative review was conducted to answer two research questions: how do the studies describe the integration of family carers in health services design and delivery for older patients with neurodegenerative and mental health conditions? And what is the evidence for family-integrated care models impacting the health and wellbeing of these older patients? Structured and iterative searches of five databases (CINAHL, Medline (Ovid), Web of Science, PsycINFO, and ProQuest) and the Google Scholar search engine identified 2271 records. A Covidence screening process resulted in 14 studies for review, comprising randomised controlled trials, mixed methods studies, qualitative studies, and quasi-experimental designs. The following four themes emerged from the evidence synthesis: (1) family participation in service delivery, (2) health and wellbeing outcomes, (3) satisfaction with care, and (4) service dynamics in enabling family-integrated care successfully. This review highlights that while family-integrated care models contribute to positive health and wellbeing outcomes for older patients with neurodegenerative and mental health conditions, challenges remain for implementation due to the extent and variability in integration strategies, a lack of rigorous evaluation, and an absence of standardised frameworks.

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