Concept Of Family-centered Care Research Articles

Assessing the maturity of the “Family Centered Care” concept: A review of concept analyses studies

BackgroundConcept analysis studies play major role in clarifying and operationalizing concepts. This approach has been used to clarify and advance knowledge about the concept of Family Centred Care (FCC). The concept of FCC has been studied by many nursing scholars using different methods. AimThis review aimed to combine outcomes of concept analysis studies to assess the level of maturity of the concept of Family Centred Care. MethodsFormal electronic databases (MEDLINE and CINAHL) and informal (Google Scholar) were searched using the terms “Family Centred Care” and “concept analysis”. The Morse concept maturity evaluation approach was used to appraise the retrieved studies. Results35studies were identified of which12 met the inclusion criteria and were included in the analysis. Three studies used Walker and Avant concept analysis methodology, three applied the Rodgers evolutionary model while six applied modified mixed/hybrid approaches. While a few provided a definition of FCC, none have been able to confirm the maturity of the concept. This review summarized the different trials to analyze the concept of FCC supporting the rethinking of the model and emergence of new models such as Child and Family Centred Care (CFCC). ImplicationsConcept analyses should be done periodically to assess the maturity of emerging concepts. Previously published FCC concept analyses manuscripts show the concept has evolved and gained significant recognition and acceptance over time. A clearer definition of FCC supports its positive impact on patient outcomes. A comprehensive FCC tool that can evaluate the effective delivery of FCC is needed.

Concepts of family-centered care at the neonatal and paediatric intensive care unit: A scoping review

BackgroundUnderstanding family-centred care (FCC) concepts is critical for its implementation in any context. The researchers synthesised studies on FCC in neonatal and paediatric critical care units in order to present its concepts and gaps in the literature to guide further research in the area. MethodThe study used the JBI methodology, and the PRISMA-ScR guidelines confirmed the final report. The search for material, with the use of library sources, used Medline via PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Google Scholar, and Wiley Library online for papers published in English from 2015 to 2019 and updated to 2023. ResultsFrom 904 references, 61 studies were identified for inclusion. The majority of the studies (29; 55.77%) were qualitative ethnography and phenomenology. Four themes and ten subthemes emerged from the data to support the main concepts of FCC. ConclusionTo guide its useful integration and implementation, more research on family-centred care in neonatal and paediatric intensive care units, involving families, staff, and managers, should be undertaken. Practice implicationFindings presented in this review may provide a guide for nurses to adjust nursing interventions for critically ill neonates and children in intensive care units.

Concept Analysis of Family-Centered Care in Childhood Cancer: An Evolutionary Approach.

The purpose of this article is to further develop the concept of family-centered care (FCC) in childhood cancer using Rodgers' evolutionary method of concept analysis. A search of the existing literature related to the overarching concept of FCC revealed several concept analyses specific to hospitalized children and children with chronic illness; however, none of these were specific to children with cancer. Five defining attributes of FCC in childhood cancer were identified through this concept analysis: ripple effect, customized care, family functioning, collaboration, and communication. A definition of FCC in childhood cancer is offered based on identified characteristics of the concept. Findings of this concept analysis provide a starting point for on-going development of the concept of FCC in childhood cancer and may facilitate more rigorous nursing studies involving FCC in childhood cancer.

Application of nursing presence to family-centered care: Supporting nursing practice in pediatric oncology.

In pediatric care settings, family-centered care (FCC) is an integral way to ensure family involvement in their child's care and has been known to improve health outcomes and families'psychosocial well-being. Similarly, nursing presence is deemed beneficial in the formation of authentic nurse-patient relationships and is known to facilitate healing and improve satisfaction for the patient and their family. The objective of this article is to explore how nursing presence supports FCC by closely examining the four concepts of FCC as described by Institute for Patient- and Family-Centered Care: dignity and respect, information sharing, participation, and collaboration. A case study is also presented to demonstrate how nursing presence can be applied in FCC, when caring for a pediatric oncology patient. Nursing presence is essential in FCC since it plays a key role in the formation of relationships, a fundamental element in the four concepts. Attributes of nursing presence can be interwoven in the FCC framework and have positive clinical, social, and emotional outcomes for the patient and family. Although literature has explored associations between FCC and nursing presence, there is need for more scientific research to justify this argument to support the improvement of quality of family nursing care and strengthen the FCC model. The four concepts of FCC lay a foundation for a model of care that can be enhanced by nursing presence, potentially providing a remedy for depersonalization of healthcare by improving nurse patient relationships in pediatric care settings. Nursing presence becomes less ambiguous when enacted in a FCC framework, revealing attributes that may be cultivated in family nursing to improve therapeutic relationships among nurses and family caregivers.

Experiences and contextual practices of family-centered care in Ghanaian nicus: a qualitative study of families and clinicians

BackgroundFamilies, whether at home or at the hospital, should be a vital part of newborn care. However, most families are excluded from hospital care, particularly in neonatal intensive care units (NICUs). This is incompatible with the concepts of Family-Centered Care (FCC) and may compromise care continuity and family satisfaction following discharge from neonatal intensive care facilities. The purpose of this study was to examine FCC practices in Ghanaian neonatal intensive care units and provide the experiences and contextual practices of FCC from the perspectives of families and clinicians.MethodsThe study qualitatively examined the contextual practices of FCC from the perspectives of families and clinicians in neonatal intensive care units using an exploratory descriptive design. With the help of MAXQDA software, 36 transcripts were generated and their contents were analyzed.ResultsContextual practices of FCC, family experiences of FCC and clinician experiences of FCC emerged as three main categories from the data. Respect and dignity, culture and religion and a multidisciplinary approach were the contextual practices. Emotional stress, lack of information and coping strategies were all common family experiences. Support, counseling, education and financial problems have all been experienced by clinicians.ConclusionsShared decision-making, counseling and education, as well as respect/dignity amongst clinicians, managers and families using a multidisciplinary approach are the fundamental concepts of FCC approach in Ghana. Acceptance and integration of FCC approach into neonatal intensive care units may reduce the burden of care as well as improve the quality of care. Further studies are needed to map out strategies and interventions for the integration of FCC into intensive care units.

OVERVIEW OF THE SUPPORT SYSTEM OF IMPLEMENTATION OF THE FCC: FAMILY, NURSE, AND THE HOSPITAL ENVIRONMENT

The concept of family-centered care (FCC) in nursing practice, the attentive treatment of families, the dissemination of information to families in order to understand the condition and treatment, and including participation of parents in decision-making and treatment through cooperation of parents and nurses. Environmental support for hospital is needed in the deployment of FCC services. The aim of this study was to describe Family-Centered Care: Family, Nurse and Hospital Environment in RS. Dustira Kindergarten II. This study is a descriptive quantitative study conducted in July 2019, including 22 nurses and 37 children's parents in the inpatient unit with a total sampling technique. Analysis of information using questionnaires and analysis of data using frequency distribution. This study shows that family-centered care services based on support to parents showed that all parents (86.5 %) got good support. Services Family-Centered Review purpose on the role of nurses showed that all nurses (95.5 %) responded well and how more than half of the respondents (54.1 %) perceived family-Centered Care as a supportive environment. Supposed to support the harmony among households, nurses and hospitals is expected to create a family-centered care service (FCC). The hospital needs to improve facilities for enhanced comfort and healing of hospitalized children.

Parental presence during pediatric retrieval: the caregiver’s perspective

The presence of family at the bedside of critically ill children is recommended, as part of "family-centered care." The study aimed to understand if such recommendation was applied by our neonatal and pediatric retrieval team and the second aim was their perception of parental presence. We first conducted a 6-month monocentric prospective observational study where the transport teams had to rate parental presence after each retrieval. A second survey was filled out by all team members, to explore their perception of parental presence in a general manner, without referring to a specific transport. Three hundred seventeen questionnaires from the prospective survey were returned, with parents being present in the ambulance for 47% of retrievals. There was a significant difference in parental accompaniment between newborns (< 24 h) and older children. The parental presence was rated as neutral or positive for 99% of transportation, whereas approximately ¼ of the crew feared "a priori" parental presence during transport in the second survey.Conclusion: This study suggests at least one parent was present at almost half of the retrievals conducted in our sample during the study period. Very few negative experiences were reported in the prospective study by the caregivers who allowed parental presence. What is Known: •The concept of family-centered care is an approach that recognizes the importance of family engagement and involvement and encourages collaboration between families and healthcare professionals. •Parents wish to accompany their child. What is New: •The perception of parental presence, by transport team members, was neutral or positive in 99% of retrievals during the study. •Newborns' parents were less present during retrieval than older children's parents.

Nursing competencies for family-centred care in the hospital setting: A multinational Q-methodology study.

Aimto identify: (1) nursing competencies for FCC in a hospital setting; and (2) to explore perspectives on these competencies among Dutch and Australian professionals including lecturers, researchers, Registered Nurses and policy makers.DesignA multinational cross‐sectional study using Q‐methodology.MethodsFirst, an integrative review was carried out to identify known competencies regarding FCC and to develop the Q‐set (search up to July 2018). Second, purposive sampling was used to ensure stakeholder involvement. Third, participants sorted the Q‐set using a web‐based system between May and August 2019. Lastly, the data were analysed using a by‐person factor analysis. The commentaries on the five highest and lowest ranked competencies were thematically analysed.ResultsThe integrative review identified 43 articles from which 72 competencies were identified. In total 69 participants completed the Q‐sorting. We extracted two factors with an explained variance of 24%. The low explained variance hampered labelling. Based on a post‐hoc qualitative analysis, four themes emerged from the competencies that were considered most important, namely: (a) believed preconditions for FCC; (b) promote a partnership between nurses, patients and families; (c) be a basic element of nursing; and (d) represent a necessary positive attitude and strong beliefs of the added value of FCC. Three themes appeared from the competencies that were considered least important because they: (a) were not considered a specific nursing competency; (b) demand a multidisciplinary approach; or (c) require that patients and families take own responsibility.ConclusionsAmong healthcare professionals, there is substantial disagreement on which nursing competencies are deemed most important for FCC.ImpactOur set of competencies can be used to guide education and evaluate practicing nurses in hospitals. These findings are valuable to consider different views on FCC before implementation of new FCC interventions into nursing practice.

Health Professionals' Perceptions and Practice of Family Centred Care for Children Injured in Road Traffic Accidents: A Qualitative Study in Ghana

The Family Centered Care (FCC) model is widely recognized as the standard for pediatric care practice in the context of families and hospitalized children. Healthcare professionals' knowledge of the FCC model is therefore central to its successful implementation. Nonetheless, there is paucity of scholarship in the Ghanaian context, regarding professionals' knowledge and practice of FCC. ObjectivesThis study, being the first in the Ghanaian context aimed to explore the perceptions of family centered care among healthcare professionals who provide the healthcare needs of children hospitalized through road traffic accidents. MethodTwenty-four (24) healthcare professionals were interviewed as part of a larger study which adopted a Grounded Theory approach. Data collection and analysis occurred concurrently. Here, we employed constant comparative methods to structure emerging categories and sub-categories. FindingsMost health professionals in the study perceived family centered care to mean family involvement, although obvious inconsistencies characterized existing practices. Based on contextual perspectives, three categories emerged, namely; parental involvement, communication and setting boundaries. ConclusionThe concept of FCC is a familiar terminology among health professionals. However, its principles, components and dimensions in the western context are alien to healthcare professionals in Ghana. A context-specific FCC model which reflects social values and cultural norms is therefore required for healthcare services to children and families in Ghana.

Pediatric Nurses' Perspectives on Family-Centered Care in Sri Lanka: A Mixed-Methods Study.

PurposeThis study was conducted to investigate nurses’ perceptions and performance of family-centered care (FCC) at a children’s hospital in Sri Lanka and to explore the feasibility of implementing FCC in the context of the Sri Lankan healthcare system.MethodsA convergent, parallel, mixed-methods design was applied to understand Sri Lankan nurses’ perspectives on FCC. In total, 157 nurses working at a large teritagy children’s hospital responded to a self-report survey and 18 nurses participated in focus group interviews.ResultsOf the factors of FCC, family participation in caring for children received the highest score (4.09±0.51) for perceptions, and information-sharing received the highest score (3.54±0.55) for performance. The qualitative data revealed the following five themes: (a) importance of the family in caring for children; (b) helping families during children’s hospitalization; (c) taking steps to implement FCC, even with imperfect knowledge; (d) barriers in the current situation; and (e) suggested strategies to promote FCC.ConclusionParticipants endorsed the concept of FCC and demonstrated some aspects of it in their day-to-day practice. The results indicate a clear knowledge deficit and several challenges, which need to be addressed to effectively implement FCC.

Health Care Providers’ Perceptions of Family-centered Care in Pediatrics

Purpose The purpose of this study was to identify and describe health care providers’ perceptions of family-centered care in pediatrics. Methods A qualitative descriptive study was designed. Data were collected from individual interviews using open-ended questions. Fifty-six pediatric health care providers participated in the study from January to April 2015. Data were analyzed using qualitative content analysis to identify the major perceptions of pediatric health care providers. Results The providers perceived that the concept of family-centered care has been incompletely implemented. Five themes (respecting a child's family, taking care of a child with the child's family, sharing information about children, supporting a child's family, a child's family participating in child care) with 11 sub-themes were identified in the providers’ experiences with families. To achieve the goal of family-centered care in pediatrics, medical and nursing conditions must be improved, education about family-centered care must be provided, and improvements should be made in the mindset of health care providers regarding patients and in families’ willingness to participate in care. Conclusion The findings from this study provide insight into pediatric health care providers’ perceptions of family-centered care. It will contribute to the establishment of a foundation for implementing family-centered care in pediatric nursing. Key words: 가족중심돌봄; 인식; 의료진; ì†Œì•„ì²­ì†Œë „ê³¼ Key words: Family-centered care; Perception; Health care provider; Pediatrics

Goal setting in paediatric rehabilitation for children with motor disabilities: a scoping review

Objectives: The three objectives of this scoping review were to (1) identify key conceptual/theoretical frameworks and the extent to which they are used to inform goal setting related to rehabilitation goal setting with children with motor disabilities, (2) describe research that has evaluated goal setting processes and outcomes, and (3) summarize the purposes of goal setting described in paediatric rehabilitation literature. Methods: The scoping review process described by Arksey and O’Malley was used to guide article selection and data extraction. Results: A total of 62 articles were included in the final review. While the concept of family-centered care was well represented, theoretical frameworks specific to goal setting (i.e. goal setting theory described by Locke and Latham, mastery motivation, social cognitive, personal construct, and self-determination theories) were rarely addressed. No articles reviewed addressed prominent behavior change theory. With the exception of the description of tools specifically designed for use with children, the role of the child in the goal setting process was generally absent or not well described. Few studies (n = 6) discussed the linkage between goals and intervention strategies explicitly. Only two studies in the review evaluated outcomes associated with goal setting. The primary purpose for goal setting identified in the literature was to develop goals that are meaningful to families (n = 49). Conclusion: The results highlight significant gaps in the literature explicating a sound theoretical basis for goal setting in paediatric rehabilitation and research evaluating the effects of goal qualities and goal setting processes on the achievement of meaningful outcomes.

Development of a Support System for Parents of Premature Infants

Background: The concept of family-centered care is increasingly being recognized at the international level. Objectives: Development of a support system for parents of premature infants (PPI), based on family-centered care and scientific evidences. Methods: The method is based on four key steps. 1) Explaining parents� needs, including comprehensive review of quantitative studies, meta-synthesis of qualitative studies conducted in Iran by search of Iranian databases (IranMedex, Magiran, and SID) and international resources (PubMed, Scopus, and Google Scholar) and comparative study. 2) A comprehensive review to identify effective interventions in supporting PPI and ranking interventions. 3) Designing a model to support PPI. 4) Evaluating designed system for supporting the PPI. Results: The results of this study identified five critical steps which the PPI experienced and 14 effective interventions to support them. Preconception: care before the next pregnancy; prenatal: preparing parents to see their baby for the first time, supporting parents in breastfeeding (BF), kangaroo care (KC) and infant massage; neonatal: spiritual self-care, individualized behavioral and developmental care programs, using scales to assess infant�s behavior, supporting parents in BF, KC and infant massage, support forums for parents, relieving parents� stress, sharing information and communication, family nurture interventions, supporting parents in transferring between neonatal units (NU), facilitating collaborative care in NU; discharge: discharge planning, support forums for parents, sharing information and communication and home: home support programs, individualized behavioral and developmental care programs, supporting parents in BF, KC and infant massage. Support forums for parents, sharing information and communication. Conclusions: Our proposed system provides a parent-centered system which can be implemented to provide high-quality care for PPI. © 2017, Iranian Journal of Pediatrics.

Family-Centered Care in Neonatal Intensive Care Units: Combining Intensive Care and Family Support.

Advances in treatment in neonatal intensive care units (NICU) for preterm and sick newborns have improved the mortality rate of patients, but admission to the NICU may disrupt parent-infant interaction, with adverse consequences for infants and their families because of physical, psychological, and emotional separation. The concept of family centered care (FCC), in which family members are part of the care team and infants are close to the family, is important and has become popular in NICU. In 2013, we created a team called "Kodomo-Kazoku Mannaka" to promote FCC in Japan, and visited the NICU at Uppsala University Hospital in Sweden, which is internationally famous for FCC. Since this fruitful visit, we have been promoting FCC in Japan by exhibitions and presentations of the FCC ideas at academic conferences and using internet services. A questionnaire survey conducted in 2015 revealed that the importance and the benefits of FCC in NICU are recognized, although there are some barriers to FCC in each facility. It is hard to change facilities and social systems right away, but it is easier and more important to change people's minds. Our role is to spread the concept of FCC and to help each facility find its own way to adopt it. We will continue to make efforts encourage to promote FCC in Japan.

Parenting and Nursing Issues Faced by Parents During the Hospitalization of Their Preterm Infants

Preterm labor is often a sudden event that impacts significantly on the health of the premature infant and on parenting behaviors. The prognosis for premature infants correlates positively with the effectiveness of parenting. Therefore, encouraging parental functions is important. The present paper reviews the literature on the concept of family-centered care in the contexts of premature-infant health problems, assesses the impacts of preterm birth on the parental role, and assesses the influences of parental dysfunction. We suggest that related interventions promote parental function in the five dimensions of parental bonding, confidence reinforcement, stress management, interpersonal support, and pre-discharge preparation. The intervention framework that is developed in the present paper is intended to assist clinical nurses to help parents use positive coping behavior to encourage healthy parental and family function and to promote the health of their premature infant.

Experiences of neonatal nurses and parents working collaboratively to enhance family centred care: The destiny phase of an appreciative inquiry project

Summary Aim The aim of this paper is to report on the process and experiences of neonatal nurses and parents who worked collaboratively in an appreciative inquiry (AI) project to enhance family centred care (FCC) in the neonatal unit with a focus on the destiny phase. Background The concept of FCC is internationally recognised as an ideal way of caring for hospitalised children however, research suggests health professionals experience difficulties integrating FCC principles into daily practice. A fundamental principle of FCC is the need to develop respectful partnerships between health professionals and parents of infants requiring neonatal care. AI offers a positive, strength based, participatory approach that promotes organisational learning and positive organisational change. AI facilitates change from the ground up and lends itself to building effective sustainable partnerships and collaborations. Design Qualitative interpretive approach. Methods Two focus groups (4 neonatal nurses in the first group and 2 neonatal nurses, 1 physiotherapist and 1 occupational therapist in the second) and four individual face-to-face interviews were conducted (2 neonatal nurses and 2 parents of infants previously discharged from the neonatal unit) (total n =12). Data were analysed using thematic analysis. Results Data analysis revealed four key themes: ‘creating a physical and mental space', ‘building and maintaining momentum', ‘ongoing organisational support' and ‘continuing collaborations'. Conclusion Parents and health care professionals worked collaboratively to facilitate FCC. Implications for future practice/research AI provides a framework that enables parent–nurse collaboration needed to develop action plans that can form the catalyst for organisational change in health care research and practice.

Improving care for transitional-stage clients in the emergency department: a family-centered approach

The focus of emergency departments on resolving immediate threats to patient survival and wellbeing distinguishes their services from those provided by all other hospital departments. The high-pressure environment in the emergency department is a source of significant stress for patients and their families, with some experiencing serious physical and mental impacts that result in high tension, acute stress, anxiety, and other mental and physical reactions. The concepts of family-centered care and transition theory have been shown to help promote a sense of wellbeing and adjustment to unfamiliar experiences. Therefore, these concepts may be applied to help facilitate the successful transition of patients and their families to the emergency department and thus help maintain normal family functions during the transition from the emergency department to other departments.

Psychosocial risk screening for children and adolescents at diabetes onset

erson-centred care highlights the importance of knowing the person behind the patient in order to engage that person as an active partner in his/her care and treatment. 1 When a child gets diabetes the whole family needs to be involved and the parents are often the primary caregivers. We therefore suggest that the concept of family-centred care is more suitable in this context. Taking care of diabetes ‐ for example, selfmanagement of diabetes ‐in children and adolescents is an active and proactive process that involves activities and goals, and is continuously ongoing. It involves shared but shifting responsibility for diabetes care and decision making between the child and their parents, and it is a process that also involves health care staff. 2 To be able to plan the treatment and care together with the parents and the child, it is necessary to know/ collect data regarding the family’s abilities and needs. The incidence of type 1 diabetes among children and

A personal nursing philosophy in practice

The use of a nursing philosophy as the basis for nursing practice promotes the proper application of nursing knowledge as well as the development of further nursing theory and knowledge. My personal philosophy of nursing seeks to encompass the art of conveying nursing science holistically with compassion and dignity. To illustrate this nursing philosophy, the four nursing metaparadigm concepts are described in relation to nursing as both a science and an art. Nursing science and art are also discussed in relation to nursing as a profession. The concepts of family-centered care and developmental care highlight the practice of nursing as an art. The use of nursing knowledge in practice is discussed through the use of nursing's five ways of knowing, nursing theories, borrowed theories, and nursing's paradigms. The concept of the nurse scholar and the further development of nursing knowledge is identified as a priority. Supportive examples from my nursing experience working in a Neonatal Intensive Care Unit (NICU) are utilized to highlight the importance of nursing knowledge development and the provision of optimal patient care.

The POPPY Study: Developing a Model of Family‐Centred Care for Neonatal Units

The concept of family-centred care in neonatal practice has become increasingly recognised internationally. The underlying philosophy puts parents and the family at the centre of health care and promotes "individualised, flexible care." To develop the first international model of family-centred care based on strong parental collaboration in the synthesis of robust research evidence to generate the philosophy, principles, model, and indicators for implementation. METHODS AND SYNTHESIS: Seven key steps were followed to develop the POPPY model of care collaboratively with parents. Step 1 drew on the POPPY systematic review to identify effective interventions. Step 2 drew on the POPPY qualitative study to identify good parent experiences. Step 3 identified the philosophy and principles of the POPPY model of care. Step 4 identified the key stages of the POPPY model of care. Step 5 populated the POPPY model of care with data from steps 1 and 2. Step 6 developed the indicators of family-centred care; and Step 7 undertook some initial testing with parents and practitioners. Seven key stages of the parents' journey through their neonatal unit experience were identified and formed the architecture of the POPPY model of care. These include: before admission to the unit, admission, early days, growing and developing, transfers between units and between levels of care, preparing for discharge, and transition to home and at home. A philosophy, a set of principles to underpin the model, and a set of indicators to guide implementation in neonatal units were developed. The POPPY model of family-centred care provides the first robust, collaboratively developed, parent-centred model, which can be implemented to deliver high quality care to parents of preterm infants. Implementing the POPPY model could help neonatal units to develop parent-focused services which better meet parents' needs for information, communication and support, key elements of family-centred care.