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Navigating practical challenges in a patient- and family-centred care model

Isaac K. S. Ng

Isaac K. S. Ng

Department of Medicine, National University Hospital, Singapore

NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore

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Li Feng Tan

Li Feng Tan

NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore

Healthy Ageing Programme, Alexandra Hospital, Singapore

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Desmond B. Teo

Desmond B. Teo

NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore

Fast and Chronic Programmes, Alexandra Hospital, Singapore

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Norshima Nashi

Corresponding Author

Norshima Nashi

NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore

Division of Advanced Internal Medicine, Department of Medicine, National University Hospital, Singapore

Correspondence

Norshima Nashi, Division of Advanced Internal Medicine, Department of Medicine, National University Hospital, Singapore, 5 Lower Kent Ridge Road, Singapore 119074.

Email: [email protected]

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First published: 28 May 2025

Funding: None.

Conflict of interest: None.

Abstract

The importance of familial involvement in patient care has been increasingly recognised in recent years, leading to the conceptualisation of a patient- and family-centred care model. In this care model, families are seen as allies in patient care and are actively integrated into various caregiving and decision-making roles. In both inpatient acute and critical care settings as well as outpatient chronic disease management, studies have found that familial involvement can lead to significant benefits in patient care, from stronger psychosocial support in the recovery process, medication compliance and reduced hospital re-admission rates to overall improvement in patient satisfaction and quality of life. Yet, for all its purported benefits, there are unique challenges faced in implementing and navigating a family-integrated model of care, such as upholding patient autonomy and confidentiality in decision-making in order not to compromise the physician–patient fiduciary relationship, handling intra-familial conflicts and navigating practical challenges of familial engagement in hospital care. Therefore, in this article, we aim to describe comprehensively the role of familial integration in patient care and discuss how physicians can pre-empt and manage challenges that may be encountered in the process.

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