Concept Of Family-centered Care Research Articles

A Critical Pathway for Successful Outpatient Ureteral Reimplantation: A Nursing Perspective

Vesicoureteral reflux is a common pediatric urologic condition. Traditionally, surgical treatment of this condition requires a hospital stay of 1 to 6 days. Our experience has shown that both unilateral and bilateral extravesical ureteral reimplantation can be performed safely in the ambulatory surgery setting. Our perianesthesia care revolves around the concept of family-centered care. We have found that the key to our critical pathway involves both the patient and the family in every part of perianesthesia care. This "team" approach can be adapted for any pediatric procedure.

Pain Management: What is the Role of the Parent

Family-centered care (FCC) in the neonatal intensive care unit (NICU) is an approach to caring that values the individual needs, expectations and values of the patient and family. Family-centered care is a mutually respectful relationship that can help redefine care; shape policies; alter NICU design; and improve physical, emotional, and financial outcomes. The core concepts of FCC, as outlined in 1992 by the Institute For Family-Centered Care include (1) dignity and respect, (2) information sharing, (3) participation, and (4) collaboration. It is believed that these core concepts will change the neonatal environment, as we know it. The core concepts of FCC are easily integrated into pain management in the NICUwhen parents and family are included in the process. For the past 2 decades, there have been tremendous advancements in our understanding of the neurobiology of pain, its mechanisms of pain transmission, and the immediate and long-term consequences of unmanaged pain. There are now evidence-based guidelines that assist clinicians in accurately assessing pain and choosing the appropriate pharmacologic and nonpharmacologic interventions to alleviate the symptoms. These significant developments not only respect the health and safety of infants but also value their individuality as a person. It is without a doubt that pain assessment and management reflect the first core concept of FCC. However, when considering the remaining core concepts of FCC, it is no longer appropriate to manage infant pain without including the infant and family. Only a few studies have examined the role of parents in the assessment andmanagement of pain, their perceptions of their infant's pain, or their satisfaction with the pain practices in the NICU. Until these concepts are clearly embraced, full integration of FCC is not possible. The first example of parents' concerns about their infant's pain was documented in a story in the Washington Post about their son who had had cardiac surgery without the benefit of analgesia or anesthesia. The poignant story that gained national attention was the catalyst that encouraged other parents to express both their feelings and frustrations about their infants' unrelieved pain and the impact of watching their infant in pain. Since that time, only a handful of studies have

Family-Centered Theory: Origins, Development, Barriers, and Supports to Implementation in Rehabilitation Medicine

Bamm EL, Rosenbaum P. Family-centered theory: origins, development, barriers, and supports to implementation in rehabilitation medicine. The concept of family-centered care was introduced to the public more than 4 decades ago, stressing the importance of the family in children's well being. Since then, family-centered values and practices have been widely implemented in child health. The purpose of this article is to offer an overview of the development and evolution of family-centered theory as an underlying conceptual foundation for contemporary health services. The focus includes key concepts, accepted definitions, barriers, and supports that can influence successful implementation, and discussion of the valid quantitative measures of family-centeredness currently available to evaluate service delivery. The article also provides the foundation, and proposes questions, for future research.

Family‐centred care – are we ready for it? An Australian perspective

Family‐centred care – are we ready for it? An Australian perspective

Family member presence in the pediatric emergency department

Traditionally, family members were excluded from viewing invasive procedures and cardiopulmonary resuscitation in the pediatric emergency department. The concept of family-centered care in the emergency department has now become more widespread. Consequently, family member presence during routine invasive procedures such as venipuncture, intravenous cannulation, urethral catheterization, and lumbar puncture has become more accepted. Survey evidence indicates parents' overwhelming desire to be present for invasive procedures and cardiopulmonary resuscitation. Healthcare provider opinions about family witnessed resuscitation lack similar uniformity. Variations in approval of witnessed resuscitation are influenced by occupation, level of training and experience, and prior exposure to family member presence practices. Although several organizations formally support family presence policies, citing benefits for grieving relatives, critics point to a lack of rigor in a large body of the research cited to underpin these endorsements. We review the literature from the perspective of pediatric emergency physicians, offer suggestions for family member presence, and provide directions for future study.

Minority ethnic families and family-centred care.

Family-centred care has generally treated families as though they were all two-parent families. For most minority ethnic families, this treatment is especially inappropriate because a greater percentage of the children are cared/live in non-traditional households, their families are heterogeneous and are primarily oriented towards extended families. However, the involvement of the extended family in family-centred care remains non-existent. This therefore suggests that there currently exists a lack of appreciation in appropriately implementing the concept of family-centred care among minority ethnic families. For this aspect of family-centred care to be explored, this article will provide an overview of the child-rearing styles of minority ethnic families including the role of extended family in child care, before discussing the need to involve the extended family in family-centred care. This analysis should enhance the general awareness of children's nurses and may facilitate a more comprehensive family-centred care to minority ethnic children and their families.

How do nurses learn about family-centred care?

How do student nurses develop their understanding of the nebulous and ill-defined concept of family-centred care? Semi-structured interviews were used to explore how 10 child branch students described the concept and how they perceived the development of their understanding of it. According to the students, the concept incorporates interaction between the child, family and nurses to provide holistic care. Students learnt through reflection and by applying theory to practice. Although the practice they observed was varied, some of the students used more experienced nurses as role models. These findings emphasize the importance of clarifying the concept of family-centred care, of monitoring and updating the practice of supervisors in clinical areas and of encouraging reflection to help bridge the theory/practice gap.

Family-centred care within contemporary British paediatric nursing.

The concept of family-centred care is such a cherished tenet of paediatric nursing to be almost above critique. Yet a close examination of the place and meaning-in-practice of family-centred care is long overdue if the term is not to lapse into mere cliché or slogan.

Postpartum (Neonatal) Sibling Visitation

A fundamental goal of maternal newborn care is to foster parent-newborn-family relationships; therefore, the concept of family-centered care should be integrated into every aspect of perinatal services.1 Sibling visitation is consistent with the concept of family-centered perinatal care. Parents respond very favorably to the opportunity for sibling visits.2 Children who visit their mothers after the birth of a sibling have been reported to be more responsive to their mothers and siblings than nonvisiting children.3 In two studies of sibling visits to neonatal intensive care units, there were no adverse effects noted.4,5 Umphenour6 and Wranesh7 have both demonstrated no effect of bacterial colonization of neonates with the institution of sibling visitation to normal neonates. In a controlled study of sibling visitation to a neonatal intensive care unit, Maloney and associates4 demonstrated no increase in infectious disease rates in those infants who were visited. Due to differences in hospital facilities and personnel, it is essential that each hospital develop its own set policies for sibling visitation. Guidelines should be developed with input from nursing, pediatric, obstetric, and infectious disease personnel. The following guidelines can be used for institution of antipartum visitation by children: 1. Siblings should not have been exposed to known communicable diseases (eg, chickenpox). 2. Siblings should not have fever or symptoms of acute illness such as upper respiratory tract infection or gastroenteritis. 3. Children should be prepared in advance for their visit. 4. Children should be supervised by parents or a responsible adult during the entire hospital visit. Because limited data are available, there is a need for continued evaluation and reporting of the risks and benefits of sibling visitation.