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Perceptions of family-centred services in a paediatric rehabilitation programme: strengths and complexities from
G G Arcuri1, A E McMullan1, A E Murray1,2
1School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
Insights
Family-centred services (FCS) in pediatric rehabilitation are complex to implement. While parents are satisfied, institutional barriers and communication issues hinder optimal delivery, requiring systemic interventions for improvement.
Area of Science:
- Pediatric Rehabilitation
- Healthcare Delivery
- Family-Centered Care
Background:
- Family-centered services (FCS) represent best practice in pediatric rehabilitation, emphasizing parent-provider partnerships.
- Despite evidence supporting FCS, successful implementation faces significant challenges.
- This study investigated parent and healthcare provider (HCP) perceptions of FCS and identified implementation barriers and facilitators.
Purpose of the Study:
- To measure parent and HCP perceptions of family-centered service provision in pediatric rehabilitation.
- To identify barriers and facilitators impacting the delivery of family-centered services.
Main Methods:
- A mixed-methods approach was employed, involving parents and HCPs in a pediatric rehabilitation program.
- Parents completed the Measure of Processes of Care-20 and participated in interviews.
- HCPs completed the Measure of Processes of Care-Service Providers and participated in a focus group.
Main Results:
- Parents reported high satisfaction with communication, support, respect for diversity, and collaboration within FCS.
- Communication methods and psychosocial needs were identified as facilitators and detractors of FCS.
- Institutional barriers were highlighted by both parents and HCPs as areas needing improvement, with HCPs identifying more issues.
Conclusions:
- The implementation of FCS is complex and significantly influenced by institutional barriers.
- Further investigation into FCS is warranted, with a focus on systemic interventions to enhance delivery.
Background:
Family-centred services (FCS) are best practice in paediatric rehabilitation and describe philosophies and approaches to medical care that emphasize the partnership and involvement of parents. While evidence supports FCS, there are complexities to its successful implementation. This mixed-methods study aimed to measure the extent to which parents and the healthcare provider (HCP) perceive service provision as being family centred, and to describe barriers and facilitators to the delivery of FCS.
Methods:
Parents of children participating in a rehabilitation programme and HCPs providing services participated in this study. Parents completed the measure of processes of care-20 and participated in interviews, while HCPs completed the measure of processes of care-service providers and participated in a focus group.
Results:
Quantitative analysis revealed that parents were mostly satisfied with features of FCS, which included communication and support between parents and HCPs, respect of diversity and parental collaboration and participation. Parents identified communication methods and psychosocial needs as areas that facilitated but sometimes detracted from FCS. Institutional barriers led to the identification of areas for improvement identified by multiple stakeholders. HCPs identified more areas for improvement than parents.
Conclusion:
When considering these barriers, it is evident that implementation is a complex process, impacted by institutional barriers. FCS needs to be investigated further, and systemic interventions should be used to facilitate its implementation.
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