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Rethinking family-centred care for the child and family in hospital
Mary M Tallon1, Garth E Kendall, Paul D Snider
1Curtin University, Perth, WA, Australia.
Insights
This paper proposes an alternative family-centered care (FCC) model to optimize child health and development by supporting families. Evidence from community nursing suggests this approach is highly effective for seriously ill children.
Area of Science:
- Pediatric Nursing
- Developmental Psychology
- Family Health
Background:
- Recent challenges question the effectiveness of traditional family-centered care (FCC).
- Parents in hospital settings report feeling unsupported and uncertain about their role.
- Lack of evidence linking FCC to improved child health outcomes necessitates exploring new models.
Purpose of the Study:
- To present and discuss an alternative model of family-centered care (FCC).
- Focuses on optimizing health and developmental outcomes for children through family support.
- Aims to guide the care of children in hospital settings.
Main Methods:
- An integrative review of theory and evidence-based literature.
- Explored multidisciplinary research in epidemiology, psychology, sociology, anthropology, and neuroscience.
- Included nursing literature on partnership building, communication, and FCC.
Main Results:
- Discusses benefits of integrating bioecological models, resource frameworks, and empowerment theories into FCC.
- Highlights the nurse-family partnership model for enhancing FCC.
- No direct hospital-based evidence exists, but community nursing data suggests high likelihood of improved outcomes.
Conclusions:
- The proposed FCC model offers a promising approach to enhance pediatric care.
- Theoretical concepts can underpin a universal nursing theory applicable across ages and settings.
- Further research in hospital settings is warranted to validate community-based findings.
Aims And Objectives:
This paper presents and discusses an alternative model of family-centred care (FCC) that focuses on optimising the health and developmental outcomes of children through the provision of appropriate support to the child's family.
Background:
The relevance, meaning and effectiveness of FCC have been challenged recently. Studies show that parents in hospital often feel unsupported, judged by hospital staff and uncertain about what care they should give to their child. With no convincing evidence relating FCC to improved child health outcomes, it has been suggested that FCC should be replaced with a new improved model to guide the care of children in hospital.
Design:
This integrative review discusses theory and evidence-based literature that supports the practice of an alternative model of FCC that is focused on the health and developmental outcomes of children who are seriously ill, rather than the organisational requirements of children's hospitals.
Methods:
Theories and research findings in a wide range of disciplines including epidemiology, psychology, sociology, anthropology and neuroscience were accessed for this discussion. Nursing literature regarding partnership building, communication and FCC was also accessed.
Discussion:
This paper discusses the benefits of applying a bioecological model of human development, the family and community resource framework, the concepts of allostatic load and biological embedding, empowerment theory, and the nurse-family partnership model to FCC.
Conclusion:
While there is no direct evidence showing that the implementation of this alternative model of FCC in the hospital setting improves the health and developmental outcomes of children who are seriously ill, there is a great deal of evidence from community nursing practice that suggests it is very likely to do so.
Relevance To Clinical Practice:
Application of these theoretical concepts to practice has the potential to underpin a theory of nursing that is relevant for all nurses irrespective of the age of those they care for and the settings within which they work.
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