Family-Centered practice in a Brazilian rehabilitation network service

Family-centered practice (FCP) is widely accepted as a best practice in pediatric rehabilitation. However, its implementation in Brazil is incipient, and systematic documentation of the extent to which it has been achieved is not available.

To determine parents' and service providers' perceptions of family-centeredness and specific areas in need of improvement in four rehabilitation hospitals.

A total of 107 caregivers and 89 service providers responded to the Measure of Processes of Care-20 (MPOC-20) and the Measure of Processes of Care for Service providers (MPOC-SP), respectively. The MPOC questionnaires evaluate FCP from the point of view of parents and rehabilitation professionals. Domain scores within each questionnaire were compared with Kruskal-Wallis and Mann-Whitney tests. MPOC items with low scores (from 1-4 out of 7 by 33% or more of respondents) were considered to indicate weaknesses in service delivery.

Median MPOC-20 scores varied from 5.2 (4.7, 5.8) (Providing General Information) to 7.0 (6.0, 7.0) (Enabling and Partnership). The Providing General Information scores were significantly lower than those of other domains (p <  0.003). The MPOC-SP scores varied from 4.8 (4.0, 5.8) (Providing General Information) to 6.1 (5.8, 6.6) (Treating People Respectfully). Scores for Treating People Respectfully were significantly higher (p <  0.0001) and Providing General Information scores significantly lower (p <  0.0001) than those of the other domains. Most items with high percentages of low scores were from the domain Providing General Information.

Except for Providing General Information, the results indicated that services implement FCP "to a fairly great extent," comparing favorably to international data. Provision of information can be improved.