Family-centred care of children and young people in the acute hospital setting: A concept analysis.

Abstract

To provide an operational definition of family-centred care as it applies to hospitalised children. The objective was to provide clarification of the concept by comprehensively analysing the evidence. Terms associated with family-centred care include partnership-in-care, negotiated care, parental participation/involvement in care, care-by-parent and child-centred care. The absence of a universally accepted definition contributes to its inconsistent implementation. Concept analysis is acknowledged as a form of inquiry to develop the knowledge base of nursing. Rodgers' evolutionary approach to concept analysis was used as a guiding framework. The systematic literature search yielded 30 theoretical papers; the results are outlined on a PRISMA flow diagram. Surrogate terms identified include partnership-in-care, negotiated care and parent participation. Parental participation in care, the development of respectful and trusting partnerships, information sharing and all family members as care recipients were identified as attributes to family-centred care. There is limited evidence that family-centred care enhances the child's, parents' and families' experience of hospitalisation and is associated with reduced anxiety for parents. There is a lack of attention to cultural and societal changes, which impact on those receiving and delivering care. While we know that family-centred care is widely endorsed and enhances well-being, there is a lack of empirical evidence about the impact on health outcomes for children. While children's nurses have been applying some elements of family-centred care to their clinical practice for decades, the concept continues to evolve. Further research examining the effects of family-centred care for children, their families, healthcare professionals and healthcare organisations reflecting cultural diversity and norms must be conducted. This research should include the effects of family-centred care on parents caring for their child in hospital, how family-centred care supports parents to make healthcare decisions and the outcomes of family-centred care for children and families.