Abstract
Complex care in the arena of child health is a growing phenomenon. Although considerable research is taking place, there remains limited understanding and agreement on the concept of complex care needs (CCNs), with potential for ambiguity. We conducted a systematic concept analysis of the attributes, antecedents, and consequences of children’s CCNs from a multidisciplinary perspective. Our data sources included PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. Inclusion criteria included publications in peer-reviewed journals between January 1990 and December 2017, written in the English language. One hundred and forty articles were included. We found that children’s CCNs refer to multidimensional health and social care needs, in the presence of a recognized medical condition or where there is no unifying diagnosis.Conclusion: Children’s CCNs are individual and contextualized, are continuing and dynamic, and are present across a range of settings, impacted by family and healthcare structures. There remain extensive challenges to caring for these children and their families, precluding the possibility that any one profession can possess the requisite knowledge or scope to singularly provide high-quality competent care.What is Known:• Complex care is a growing phenomenon and population prevalence figures show that there is an increasing number of children with complex care needs (CCNs). However, the concept has not been systematically analyzed before, leaving it generally ill-defined and at times confusing.What is New:• This is the first time this concept has been systematically analyzed and this analysis provides a much-needed theoretical framework for understanding the multidimensional nature of CCNs in children.• Children’s CCNs refer to multidimensional health and social care needs in the presence of a recognized medical condition or where there is no unifying diagnosis. They are individual and contextualized, are continuing and dynamic, and are present across a range of settings, impacted by family and healthcare structures. It is clear that the very nature of CCNs precludes the possibility that any one profession or discipline can possess the requisite knowledge or scope for high-quality competent care for this population.
Highlights
Complex care is a growing phenomenon and population prevalence figures show that there is an increasing number of children with complex care needs (CCNs) [36, 47, 146]
It is clear that the very nature of CCNs precludes the possibility that any one profession or discipline can possess the requisite knowledge or scope for high-quality competent care for this population
The aim of this paper is to report on a systematic analysis of the concept of CCNs
Summary
Complex care is a growing phenomenon and population prevalence figures show that there is an increasing number of children with complex care needs (CCNs) [36, 47, 146]. Evolutionary concept analysis seeks to go beyond offering a dictionary definition of a concept It does this by breaking apart the cluster of key characteristics that through common use collectively form the real definition of a concept [109]. Examination of these characteristics is critical to understanding the concept. According to Rodgers [109], it is necessary to understand the antecedents, defined as events or phenomena usually found prior to concept occurrence, and the consequences that follow as a result. A thorough knowledge of the attributes, antecedents, and consequences of CCNs from a multidisciplinary perspective is important, given the wide engagement of many disciplines in the care of these children. Without a clear conceptual foundation, there is ambiguity which in turn can compromise the quality of research or theory construction as the area develops [134]
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