ReviewParents’ and health professionals’ perceptions of family centred care for children in hospital, in developed and developing countries: A review of the literature
Introduction
The separation of the family from the hospitalized child has long been reported as detrimental to the physical, emotional and psychological wellbeing of the child and family (Bowlby, 1953, Robertson, 1962, Spitz, 1945). The concept of FCC was developed in Britain following the seminal research by Bowlby (1952) and the Platt Report (1959). FCC held the family as important in the emotional and psychological care of the hospitalized child (Alsop-Shields and Mohay, 2001, Jolley and Shields, 2009).
In 1992, the Institute for Family Centred Care (IFCC) was established in America whose primary role was to develop leadership strategies, resources and programmes for policy-makers, administrators, direct service providers, educators, design professionals, and patient and family leaders to facilitate a patient and family centred care approach (Institute for Family Centred Care, n.d.). This is in line with the United Nations Convention on the Rights of the Child (UNCRC) that clearly states every child has the right to self-determination, dignity, respect, non-interference and the right to make informed decisions (United Nations, 1989). The IFCC took over the role of the Association for the Care of Children's Health (ACCH). The IFCC and ACCH developed 9 elements that characterize FCC health services (Johnson, 1990, Shelton et al., 1987, Trivette et al., 1993). Trivette et al. (1993) further developed 13 evaluative items that describe the features of these 9 elements of FCC as set out in Table 1.
The first nursing research to explore FCC was conducted by Goodell (1979) and a plethora of international, national and local research has followed. Despite extensive research and literature reviews into FCC confusion continues to exist over the definition, benefits, burden, characteristics and realities of effectively operationalizing and measuring this care for policy-makers, organizations, healthcare professionals, parents and children (Ahmann and Johnson, 2000, Corlett and Twycross, 2006, Coyne, 2008, Shields, 2001, Shields et al., 2006, Shields et al., 2009). Despite this FCC has been formalized into many international, national and local government policies and embraced by healthcare professionals and families (Chenery, 2007, Coyne and Cowley, 2007, Crawford, 2000).
For the purposes of this review the following definition of FCC was used:
Family centred care is a way of caring for children and their families within health services which ensures that care is planned around the whole family, not just the individual child/person, and in which all the family members are recognized as care recipients (Shields et al., 2009; Shields et al., 2006, p. 1318).
The parent in this context includes the primary caregiver to the child being the child's natural or adoptive parents, step-parents or any other parent–child relationship that fits this context. This review differs from previous literature reviews as the set inclusion criteria, to include primary research studies published or unpublished in English between 1997 and 2009, that include data from both the healthcare professional and the parents’ perspective, aim to increase the rigor of the results and reduce confounding factors or bias from articles that only portray one perspective. Previous literature reviews have reported on themes summarized from articles where either the healthcare professional's, child's and/or parents’ perceptions are portrayed (Coyne, 2008, Shields et al., 2006, Shields et al., 2009). This timeframe was chosen to build on existing literature reviews and to ensure that the papers were more recent and relevant to the present healthcare context as compared to the 1970s or 1980s (Shields et al., 2006, Shields et al., 2009).
Section snippets
Objective
The aim of this systematic review was to explore the available literature on the attitudes towards, and experiences of FCC by healthcare professionals and parents during the hospitalization of a child.
Design
A systematic review involving a comprehensive search, inclusion and quality appraisal was undertaken drawing principally on key electronic databases of the health literature, augmented with reference list searching.
Search methods
A bibliographic search of English language publications from 1997 to 2009 indexed
Results
The search strategy generated 2370 hits where 245 unique citations were identified. The majority of articles were excluded because they did not meet the inclusion criteria for timeframe, degree of family centeredness, methodological quality or the study did not include both the healthcare professional's and the parents’ perspective. Following a review of the papers fourteen papers were identified. A review of the article reference lists led to the inclusion of one further paper. A flowchart for
Discussion
The importance of communication between parents and healthcare professionals differed between studies. Parents in Australia, England, Thailand and Indonesia were primarily concerned with treatment and recovery whereas the staff considered communication with the child and family as the most important factor (Roden, 2005, Shields and King, 2001a, Shields and King, 2001b). It may be that this difference could be attributed to cultural constructions such as medical dominance, class, religion,
Conclusions
This review highlights that globally, regardless of country, culture, population or healthcare setting, similar issues were raised by parents and healthcare professionals in relation to child and family experiences and needs. In all of the studies a lack of knowledge or resources were common themes reported by healthcare professionals that facilitated an ‘ad hoc’ operationalized FCC practice. This review reinforces the ongoing debate over whether FCC is an organizational strategy to save costs
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2019, International Journal of Africa Nursing SciencesThe scope of family-centred care practices, and the facilitators and barriers to implementation of family-centred care for hospitalised children and their families in developing countries: An integrative review
2020, Journal of Pediatric NursingCitation Excerpt :The health system barriers indicated in this review centre around leadership, support, policy and resources. These barriers have also been reported in developed countries (Coyne et al., 2011; Foster et al., 2010; Harrison, 2011; Kuo et al., 2012; Shields et al., 2012). The studies evaluated in the current review have some weaknesses.
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