Peer-reviewed article
Current applications and future perspectives of family-integrated care in the pediatric intensive care unit: a narrative review from concept to practice.
Li Y, Liu N, Bao Y ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a narrative review of family-integrated care (FIC) in pediatric intensive care units, examining how families can participate in their child's care through communication, decision-making, rehabilitation, and psychosocial support. The review synthesizes evidence from 2015 onwards on how FIC is being applied in practice and what barriers exist to its implementation. Current evidence suggests FIC may improve family experience and communication, but long-term effects on children's outcomes need more research. The review identifies the need for clearer definitions, standardized implementation approaches, and better outcome measures that reflect both child and family needs.
Key points
- FIC involves family participation in bedside care, communication, shared decision-making, rehabilitation, and end-of-life planning
- Practice has shifted from restricted visitation policies to partnership-based models of care
- Current evidence shows potential improvements in family experience, communication, parental confidence, and some psychosocial outcomes
- Implementation barriers include structural, cultural, linguistic, and resource constraints
- Effects on long-term child outcomes and post-intensive care syndrome in children require further pediatric-specific evaluation
Limitations
This is a narrative review synthesizing existing literature rather than primary research, so it cannot establish causal relationships or provide definitive evidence on intervention effectiveness. The review does not provide specific quantitative outcome data and relies on studies of varying quality and design.
Abstract
Background and objective Family-integrated care (FIC), grounded in the principles of family-centered care (FCC), has become an important approach for supporting children and families during pediatric intensive care. Although post-intensive care syndrome in pediatrics (PICS-p) provides one important rationale for family engagement, the scope of FIC extends beyond PICS-p to include bedside participation, communication, shared decision-making, rehabilitation, psychosocial support, and transition planning. This narrative review aims to synthesize current applications, reported benefits, implementation barriers, and future priorities for FIC in the pediatric intensive care unit (PICU). Methods We conducted a narrative review of literature on FIC/FCC in pediatric critical care. Searches were performed in PubMed/MEDLINE, CINAHL, Embase, Web of Science, and the Cochrane Library, with emphasis on contemporary literature from 2015 to April 2026 and inclusion of selected foundational papers when conceptually necessary. Eligible evidence included observational, qualitative, mixed-methods, quality-improvement, pre-post, interventional, guideline, and review literature relevant to family participation in PICU care. Key content and findings The review identifies several recurring themes: the transition from restricted visitation to partnership-based care; practical family participation in routine care, communication, shared decision-making, rehabilitation, and end-of-life contexts; patient- and family-centered outcomes; structural, cultural, linguistic, and resource-related barriers; and the role of interdisciplinary teams, institutional policy, staff education, and digital tools in supporting implementation. Conclusions Current evidence suggests that FIC may improve family experience, communication, parental confidence, and selected psychosocial outcomes, while its effects on long-term child outcomes and PICS-p require further pediatric-specific evaluation. Future work should prioritize clearer definitions, standardized implementation models, inclusive study designs, and pragmatic outcome measures that reflect both child and family priorities.