Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications
Care for U.S. children living with serious illness and their families at home is a complex and patchwork system. Improving home-based care for children and families requires a comprehensive, multilevel approach that accounts for and examines relationships across home environments, communities, and s...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/9/8/1115 |
| _version_ | 1797446348126027776 |
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| author | Jackelyn Y. Boyden Douglas L. Hill Gwenn LaRagione Joanne Wolfe Chris Feudtner |
| author_facet | Jackelyn Y. Boyden Douglas L. Hill Gwenn LaRagione Joanne Wolfe Chris Feudtner |
| author_sort | Jackelyn Y. Boyden |
| collection | DOAJ |
| description | Care for U.S. children living with serious illness and their families at home is a complex and patchwork system. Improving home-based care for children and families requires a comprehensive, multilevel approach that accounts for and examines relationships across home environments, communities, and social contexts in which children and families live and receive care. We propose a multilevel conceptual framework, guided by Bronfenbrenner’s ecological model, that conceptualizes the complex system of home-based care into five levels. Levels 1 and 2 contain patient and family characteristics. Level 3 contains factors that influence family health, well-being, and experience with care in the home. Level 4 includes the community, including community groups, schools, and providers. Level 5 includes the broader regional system of care that impacts the care of children and families across communities. Finally, care coordination and care disparities transcend levels, impacting care at each level. A multilevel ecological framework of home-based care for children with serious illness and families can be used in future multilevel research to describe and test hypotheses about aspects of this system of care, as well as to inform interventions across levels to improve patient and family outcomes. |
| first_indexed | 2024-03-09T13:40:16Z |
| format | Article |
| id | doaj.art-6340286df95b4081aabfb82b35cc7ac4 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-09T13:40:16Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-6340286df95b4081aabfb82b35cc7ac42023-11-30T21:08:00ZengMDPI AGChildren2227-90672022-07-0198111510.3390/children9081115Home-Based Care for Children with Serious Illness: Ecological Framework and Research ImplicationsJackelyn Y. Boyden0Douglas L. Hill1Gwenn LaRagione2Joanne Wolfe3Chris Feudtner4Justin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USAJustin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USAJustin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USADepartment of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USAJustin Michael Ingerman Center for Palliative Care, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USACare for U.S. children living with serious illness and their families at home is a complex and patchwork system. Improving home-based care for children and families requires a comprehensive, multilevel approach that accounts for and examines relationships across home environments, communities, and social contexts in which children and families live and receive care. We propose a multilevel conceptual framework, guided by Bronfenbrenner’s ecological model, that conceptualizes the complex system of home-based care into five levels. Levels 1 and 2 contain patient and family characteristics. Level 3 contains factors that influence family health, well-being, and experience with care in the home. Level 4 includes the community, including community groups, schools, and providers. Level 5 includes the broader regional system of care that impacts the care of children and families across communities. Finally, care coordination and care disparities transcend levels, impacting care at each level. A multilevel ecological framework of home-based care for children with serious illness and families can be used in future multilevel research to describe and test hypotheses about aspects of this system of care, as well as to inform interventions across levels to improve patient and family outcomes.https://www.mdpi.com/2227-9067/9/8/1115pediatricsserious illnesshome-based careecological frameworkmultilevel research |
| spellingShingle | Jackelyn Y. Boyden Douglas L. Hill Gwenn LaRagione Joanne Wolfe Chris Feudtner Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications Children pediatrics serious illness home-based care ecological framework multilevel research |
| title | Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications |
| title_full | Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications |
| title_fullStr | Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications |
| title_full_unstemmed | Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications |
| title_short | Home-Based Care for Children with Serious Illness: Ecological Framework and Research Implications |
| title_sort | home based care for children with serious illness ecological framework and research implications |
| topic | pediatrics serious illness home-based care ecological framework multilevel research |
| url | https://www.mdpi.com/2227-9067/9/8/1115 |
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