Strategies to promote effective staff-family relationships in the care of older people in residential aged care settings: A systematic review

BACKGROUND: In residential aged care settings, the relationships between family members and care staff are recognised as a factor in high quality care. OBJECTIVE: To determine the effectiveness of interventions designed to promote constructive staff-family relationships in the care of older people in aged care facilities. DESIGN: Systematic review and planned meta-analysis. METHODS: A systematic review was conducted using a comprehensive search, updating a previous review. Searches were conducted in seven electronic databases to 17 December 2024. Risk of bias was assessed by two independent reviewers using the Cochrane Risk of Bias Tool (ROB-2) and Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I). Statistical analysis was not possible due to incomplete data reporting in most studies. GRADE Certainty of Evidence was conducted using the GRADEPro GDT software. RESULTS: There were nine studies identified. Studies reported outcome measures that reflected characteristics of a constructive staff-family relationship, the experience of staff, the experience of family and outcomes relevant to older people receiving care. There was moderate certainty of evidence that an intervention designed to promote a constructive staff-family relationship might lead to small absolute benefits for older people, particularly reduction in hospital transfers. The evidence for quantifiable benefits for staff and family members was highly uncertain. CONCLUSIONS: Through a comprehensive review and evidence evaluation, we have identified that interventions to promote staff-family relationships require long term organisation and staff commitment, may require high intensity and durations to achieve a sustained impact, and the outcomes may be better evaluated using person-level analysis and qualitative data. REGISTRATION NUMBER: Prospero: CRD42023453919.