Summary of best evidence on parental involvement in neonatal intensive care units: integrating family-centered and family-integrated care models.

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Original abstract

Family-Centered Care (FCC) and Family-Integrated Care (FICare) are widely adopted models in Neonatal Intensive Care Units (NICUs), designed to foster parental involvement and support both neonatal and family outcomes. This review synthesizes and critically appraises the best available evidence on FCC and FICare interventions to inform their implementation, adaptation, and scale-up across diverse health systems and cultural contexts. Guided by the 6S evidence model, a top-down search identified relevant guidelines, best practices, evidence summaries, expert consensus statements, systematic reviews, and meta-analyses published up to 20 May 2025. Two reviewers independently performed study selection, methodological appraisal, and data extraction, with evidence graded using the Joanna Briggs Institute system. A total of 25 publications were included: three clinical guidelines, three best practice documents, four expert consensus statements, and fifteen systematic reviews and meta-analyses. Synthesis revealed seven key domains: core components of FCC/FICare models, implementation strategies, clinical outcomes, safety considerations, cultural adaptability, ethical considerations, and digital health applications. From these, 28 high-quality recommendations were formulated. Overall, FCC and FICare consistently improved neonatal outcomes and enhanced family well-being. Structured parent education, psychosocial support, environmental optimization, and interdisciplinary collaboration emerged as essential elements for effective implementation. Digital health tools may serve as valuable adjuncts but should complement rather than replace relational and presence-based care. Addressing cultural, ethical, and organizational barriers is critical to achieving equitable and sustainable integration. These findings reinforce FCC/FICare as a foundational model for advancing neonatal care globally.

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