Patient- and family-centered care across acute, community, and long-term care settings: an updated umbrella review of care elements, delivery modalities, and stakeholder-related outcomes

Patient- and family-centered care (PFCC) is a core approach to high-quality care delivery that emphasizes shared decision-making and responsiveness to the needs of both patients and their families. The previous umbrella review synthesized PFCC evidence across heterogeneous care contexts but did not systematically compare care elements, delivery modalities, and stakeholder-related outcomes across care settings. This umbrella review aimed to synthesize and compare recent evidence on PFCC care elements, delivery modalities, and stakeholder-related outcomes across these settings. We conducted an umbrella review updating and extending the 2018 umbrella review of PFCC, focusing on systematic reviews evaluating PFCC interventions involving patients, family members, and healthcare providers. Six databases (PubMed/MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, and Google Scholar) were searched for systematic reviews published between September 2017 and May 2026. Three reviewers independently screened studies, extracted data, and assessed methodological quality. Due to heterogeneity in the intervention components, comparators, and outcomes, the findings were synthesized narratively and categorized according to care setting, PFCC care elements, delivery modality, and stakeholder-related outcomes. Of the 63 included systematic reviews, 21 addressed acute care, 35 community care, and 7 long-term care settings. Acute care emphasized family involvement and education, with predominantly short-term outcomes. Community care showed the broadest range of PFCC elements and outcomes, including patient self-efficacy, autonomy, quality of life, and caregiver-related outcomes. In long-term care, patient environmental support and healthcare-provider education and training were most prominent, while family outcomes were less frequently reported. In-person delivery predominated across settings, with hybrid and digital approaches concentrated mainly in community care. Shared decision-making and dignity care were identified across settings but were not consistently represented. PFCC should be understood not as a single intervention model, but as a context-sensitive care delivery strategy that varies across acute, community, and long-term care settings. Digital and hybrid approaches may complement this strategy by supporting communication, continuity, accessibility, and coordination, although evidence remains concentrated in community care. Future research should prioritize approaches that promote autonomy, dignity, and meaningful participation in care and decision-making across settings. PROSPERO CRD42024564509. Registered 26 July 2024. Not applicable.