Principles Of Family-centered Care Research Articles

Psychometrics of the modified family-centered care assessment short version for childhood obesity

BackgroundIncorporating principles of family-centered care into pediatric weight management interventions can improve the effectiveness and quality of treatment and reduce attrition rates. To assess the family-centeredness of interventions, reliable, valid, and easy-to-administer scales are needed. The purpose of the study was to develop a shortened version of the modified Family Centered Care Assessment (mFCCA) and assess its psychometric properties.MethodsThe mFCCA, a scale to assess the family-centeredness of interventions for childhood obesity, was administered to families following the Connect for Health randomized control trial evaluating the effectiveness of a primary care-based pediatric weight management intervention. We iteratively removed items from the mFCCA and used Rasch modeling to examine the reliability and validity of the shortened scale.ResultsWe included data from 318 parents and the exploratory factor analysis showed the presence of a single factor. The results of the Rasch modeling demonstrated acceptable internal consistency of the scale (0.7) and strong validity as evidenced by the overall model fit and range of item difficulty. Following the psychometric analyses, we reduced the number of items from 24 to 8 items.ConclusionThe mFCCA short version demonstrates good psychometrics and can be used to evaluate the family-centeredness of childhood obesity interventions with reduced participant burden, thereby improving outcomes for children with obesity.Trial registrationClinicaltrials.gov NCT02124460 registered on April 24, 2014.

Family-centred care as a mediator in the relationship between parental nurse support and parental stress in neonatal intensive care units

BackgroundWithin the NICU, there is a delicate equilibrium between providing assistance to parents by nurses and prioritising family-centred care (FCC). The FCC assumes the role of a mediator, effectively conveying compassion. The intricate dynamics between FCC, parental nurse support, and parental stress in neonatal intensive care units (NICUs) necessitate comprehensive investigation.ObjectiveThis study examines the mediating effect of FCC on the relationship between parental nurse support and parental stress in NICUs.MethodsThis cross-sectional observational study used convenience sampling to select 223 parents (202 mothers) from Mansoura City hospitals in Egypt. Data were collected using the Nurse Parent Support Tool (NPST), Family-Centered Care Self-Assessment Tool (FCCS-NICU), and the Parental Stressor Scale: NICU (PSS: NICU). Mediation analysis was used to examine the relationships between variables.ResultsNurse support was positively associated with FCC (β = 0.81, p < 0.001) and negatively related to parental stress (β=-1.156, p < 0.001). FCC was found to reduce parental stress (β=-0.18, p < 0.001). Mediation analysis confirmed that FCC partially mediated the relationship between nurse support and parental stress (indirect effect β = 0.145, 95% CI: 0.055–1.007).ConclusionsThis study highlights a significant association in the mediating role of FCC between nurse support and parental stress. Strengthening FCC practices can be an effective strategy for nurses to support parents and alleviate their stress in NICU settings.Implications to practiceNICUs should implement FCC-oriented training for nurses, foster a culture that supports FCC principles, and develop policies to establish FCC as a cornerstone of neonatal care.

Impact of family-centered Care on Parenting Role and Sense of Competence in Parents of Preterm Neonates: a quasi-experimental study

BackgroundImplementing a family-centered care approach can empower parents to care for their premature infants, positively influencing their sense of competence and parenting role. This study aims to investigate the impact of family-centered care within the context of newborn care on the sense of competence and parenting role of parents with preterm infants who were hospitalized in neonatal intensive care units (NICUs) in Iran. MethodsThis quasi-experimental study employed a design with two groups in neonatal intensive care units (NICUs) located in Kerman, Iran. The research sample consisted of 90 parents. The intervention group received training based on the principles of family-centered care and actively participated in caring for their infants in the intensive care unit. Both groups completed the Parenting Sense of Competence Scale and the Parenting Role Tasks Questionnaire before the intervention, seven days after the intervention, and three months after the intervention. ResultsFollowing the implementation of the family-centered care intervention, the experimental group exhibited a relatively higher increase in the sense of competence score (83.42±6.66) compared to the control group (57.60±9.45). Similarly, the experimental group had a higher mean parenting role score (87.95±6.45) than the control group (54.77±11.80). ConclusionThe study findings suggest that implementing the family-centered care program develops training packages based on the principles of family-centered care for nurses working in neonatal intensive care units. This training will help parents of hospitalized infants enhance their sense of competence and improve their parenting role.

Implementation of evidence-based practice in paediatric nursing care: Facilitators and barriers

BackgroundEvidence-based practice (EBP) is widely recognised in healthcare as a means of improving patient outcomes by incorporating patient preferences, clinical experience, and rigorous research. Although it has demonstrated potential in promoting healthcare, increasing patient safety, and reducing costs, there are still challenges in implementing and applying EBP in practice. The aim of this study was to explore the barriers and facilitators identified by nurses concerning the implementation of EBP in the care provided to children and their families. MethodsTwo focus groups were held with a total of 32 nurses from a paediatric unit of a university hospital. The qualitative data were organised using NVivo, and thematic analysis was undertaken following Bardin’s three-phase process. FindingsThree categories emerged: Facilitators for the Implementation of EBP, Barriers to the Implementation of EBP, and Family and Child-Centred Care in Clinical Practice. The main facilitators are the presence of mentors, institutional recognition, an environment that promotes EBPs, and the interest and motivation of the team. The main barriers highlighted were unassertive intradisciplinary and interdisciplinary communication, time management, tradition, and inexperience in research. Organisations must implement policies that promote environments conducive to EBP. ConclusionIt is crucial to prioritise ongoing professional development, integrate this practice into nursing education, promote innovative organisational cultures, and embrace the principles of Family-Centred Care. Nurses recognise the importance of mentors as key to implementing this practice.

Perceived family-centered care and post-traumatic stress in parents of infants cared for in the paediatric cardiac intensive care unit.

Family-centred care (FCC), while a core value of paediatric hospitals, has not been well-studied in the paediatric cardiac intensive care unit (PCICU). To describe parents' perceptions of FCC provided by nurses in the PCICU during their infant's recovery from neonatal cardiac surgery and explore associations of perceptions of FCC on parent post-traumatic stress (PTS) 4 months post-discharge. Data obtained from a previously conducted randomized clinical trial (RCT) on telehealth home monitoring after neonatal cardiac surgery at three free-standing paediatric hospitals were analysed from a subset of 164 parents who completed the FCC Scale at hospital discharge, which measures a parent's experience of nursing care that embodies core principles of FCC. The RCT intervention was provided after hospital discharge, having no influence on parent's perception of FCC. The intervention also had no effect on PTS. Perceived FCC was lowest for items 'nurses helped me feel welcomed' and 'nurses helped me feel important in my child's care'. Having 12%-19% points lower perception of FCC at hospital discharge was associated with parent experience of six or more PTS symptoms, at least moderate PTS symptom severity, or PTS disorder diagnosis at 4-month follow-up. Every 10% increase in parental perceptions of FCC was associated with less PTS symptoms (β = -0.29, SE = 0.12; p = .02) and lower PTS symptom cluster scores of arousal (β = -0.18, SE = 0.08; p = .02). Parents who perceived lower FCC during their infants' hospitalization were at increased risk for the development of PTS symptoms, more PTS symptom severity and PTS disorder diagnosis 4-months post-discharge. Nurses have a prominent role to support the implementation of FCC for infants with cardiac defects and their parents. FCC may positively influence overall parent mental health and well-being, reducing the trauma and distress of the PCICU experience.

Psychometrics of the modified Family-Centered Care Assessment short version for childhood obesity.

Incorporating principles of family-centered care into pediatric weight management interventions can improve the effectiveness and quality of treatment and reduce attrition rates. To assess the family-centeredness of interventions, reliable, valid, and easy-to-administer scales are needed. The purpose of the study was to develop a shortened version of the modifed Family Centered Care Assessment (mFCCA) and assess its psychometric properties. The mFCCA, a scale to assess the family-centeredness of interventions for childhood obesity, was administered to families following the Connect for Health randomized control trial evaluating the effectiveness of a primary care-based pediatric weight management intervention. We iteratively removed items from the mFCCA and used Rasch modeling to examine the reliability and validity of the shortened scale. We included data from 318 parents and the exploratory factor analysis showed the presence of a single factor. The results of the Rasch modeling demonstrated acceptable internal consistency of the scale (0.7) and strong validity as evidenced by the overall model fit and range of item difficulty. Following the psychometric analyses, we reduced the number of items from 24 to 8 items. The mFCCA short version demonstrates good psychometrics and can be used to evaluate the family-centeredness of childhood obesity interventions with reduced participant burden, thereby improving outcomes for children with obesity. Clinicaltrials.gov NCT02124460 registered on April 24, 2014.

The processes and outcomes related to 'family-centred care' in neuromotor and functional rehabilitation contexts for children with cerebral palsy: A scoping review.

The aim of this study is to identify the main processes and outcomes related to family-centred care (FCC) in neuromotor and functional rehabilitation of preschool children with cerebral palsy (CP). FCC is considered a reference for best practices in child rehabilitation. CP is the most common cause of physical disability in childhood with repercussions on functionality. There is a gap in knowledge of the practical principles of FCC, and it is necessary to develop a reference model for the practice of child rehabilitation professionals. In this scoping review, the main databases selected were as follows: LILACS; Pubmed; Embase; The Cochrane Library; CINAHL (EBSCO); Scopus; Web of Science; PEDro (Physiotherapy Evidence Database); Open Gray and other banks of thesis. The terms combined in the search strategy were as follows: 'Family-centered', 'Family-centred' and 'CP'. Inclusion criteria are as follows: studies on preschool-aged children with CP, undergoing family-centred functional therapeutic interventions (FCFTI) with outcomes on bodily structures and functions and/or activities and/or participation. The main participatory care methods identified were home intervention, environmental enrichment, collaborative realistic goal setting, planning of home-based activities and routine, child assessment feedback, family education/training, family coaching, encouraging discussion, observation of therapist and supervised practice. The main relational care qualities identified were as follows: respect, active listening, treat parents as equals, clear language, respect parents' ability to collaborate, demonstrate genuine care for the family, appreciate parents' knowledge and skills, demonstrate competence, experience and commitment. The main outcomes identified in children were improvement in motor and cognitive function and the child's functional ability. The main parentaloutcomes identified were empowerment, feeling of competence, self-confidence, motivation and engagement. The main differences in FCFTI programs refer to the parental education/guidance component and the amount of intervention carried out by parents. It is possible that the elements chosen by the therapist in a FCFTI depend on characteristics of the child and caregivers.

Factors influencing the development and implementation of pediatrics in family-centered care model: A scoping review

Introduction: Family-Centered Care (FCC) in neonatal healthcare emphasizes collaborative efforts between medical staff and families. This approach, rooted in mutual respect and active family participation, aims to enhance infant care outcomes. However, understanding the underlying forces behind FCC interventions remains challenging due to the diverse methods employed in healthcare practices. Methods: We conducted a scoping review in June 2023. We searched Embase, Medline, CINAHL, Web of Science, Cochrane Library, Joanna Briggs Institute (JBI), PubMed, and PsycINFO. Inclusion criteria encompassed English language studies on Family-centered care and related factors, without date or geographic restrictions. Results: Fifteen pertinent studies meeting the inclusion criteria were identified. Five pivotal components of modern FCC emerged: effective communication, active patient and family involvement, robust family support systems, organizational considerations, and the nurturing attitude of nurses. Discussion: Family-centered care emerges as a comprehensive healthcare approach focusing on the interdependence of patients, healthcare professionals, and families. By recognizing this interconnection, FCC seeks to ensure the satisfaction and well-being of all stakeholders. Implementing FCC strategies presents challenges, emphasizing the need for continuous exploration and refinement. Conclusion: Embracing family-centered care principles enriches patient-centered healthcare by involving families as active partners in the care process. Acknowledging the integral role of families enhances care quality and contributes to improved patient outcomes. Ongoing research and dialogue are essential for refining FCC models, ensuring successful implementation, and fostering patient-centered healthcare environments.

Reliability and validity of the training satisfaction questionnaire for family members (TSQ-FM) entering the ICU during an isolation disease outbreak

BackgroundThe presence of family members in an isolated ICU during an isolation disease outbreak is restricted by hospital policies because of the infectious risk. This can be overcome by conferring to family members the skill and the ability to safely don and doff the personal protective equipment (PPE) through a nurse-led training intervention and assess their satisfaction, to respond to the need to define a safe, effective and quality care pathway focused on Family-Centered Care (FCC) principles. Objectivethe study aimed to build a valid and reliable instrument for clinical practice to assess family members’ satisfaction to allow ICU nurses to restore family integrity in any case of infectious disease outbreak that requires isolation. MethodsA cross-sectional study was conducted to test the psychometric properties. The questionnaire was constructed based on a literature review on the needs of family members in the ICU. 76 family members were admitted to a COVID-ICU. Cronbach's coefficient, Geomin rotated loading, and EFA were applied to assess the reliability and validity of the instrument. ResultsThe Kaiser-Mayer-Olkin (KMO) measure was 0.662, the Bartlett sphericity test showed a significant p-value (χ²=448.33; df=45; p < 0.01), Cronbach's alpha coefficient was.896. A further CFA analysis confirmed that all fit indices were acceptable. The results showed satisfactory validity and reliability, which could be generalized and extended to any outbreak of isolation disease. ConclusionsThis study provides a valid and reliable instrument for clinical practice to maintain family integrity in the dyadic relationship between the patient and the family member, even during an emergency infectious disease outbreak that requires isolation.

Impacts of Integrating Family-Centered Care and Developmental Care Principles on Neonatal Neurodevelopmental Outcomes among High-Risk Neonates.

Integrating family-centered care (FCC) and developmental care (DC) principles in neonatal care settings may improve neurodevelopmental outcomes for high-risk neonates. However, the combined impact of FCC and DC has been underexplored. This study aimed to investigate the effects of integrated FCC and DC on neurodevelopment and length of hospital stay in high-risk neonates. A quasi-experimental pre-post study was conducted among 200 high-risk neonates (<32 weeks gestation or <1500 g) admitted to neonatal intensive care units (NICU) in Saudi Arabia. The intervention group (n = 100) received integrated FCC and DC for 6 months. The control group (n = 100) received standard care. Neurodevelopment was assessed using the Bayley Scales of Infant Development-III. Length of stay and readmissions were extracted from medical records. The intervention group showed significant improvements in cognitive, motor, and language scores compared to controls (p < 0.05). The intervention group had a 4.3-day reduction in the mean length of stay versus a 1.4-day reduction in controls (p = 0.02). Integrated care independently predicted higher cognitive scores (p = 0.001) and shorter stays (p = 0.006) in regression models. Integrating FCC and DC in neonatal care enhances neurodevelopmental outcomes and reduces hospitalization for high-risk neonates compared to standard care. Implementing relationship-based, developmentally supportive models is critical for optimizing outcomes in this vulnerable population.

Nurses' experiences of provision family-centred care in the postresuscitation period: A qualitative study.

This study aimed to explore nurses' experiences of providing family-centred care in the postresuscitation period. An exploratory-descriptive qualitative design was used. In this qualitative study, in-depth, semi-structured interviews were conducted with 22 nurses in three educational hospitals. There were six participants who completed follow-up interviews to resolve questions generated during initial interviews. Data were analysed using conventional content analysis. Five main categories were extracted: continuous monitoring, facilitation of attendance, involvement in care, informing and emotional support. Despite the lack of organizational policies and guidelines, nurses explained how they work to provide family-centred care for families, especially those they assessed as having less possibility of aggressive behaviour and those with a better understanding of their loved one's condition. To provide postresuscitation family-centred care, nurses facilitated family attendance, involved them in some basic nursing care, and provided information and emotional support to the family members. Nurses attempted to follow the basic principles of family-centred care in the postresuscitation period. However, to improve the provision of care by nurses, it is necessary to embed family-centred care principles in institutional policies and guidelines and to conduct training for nurses. Iranian nurses are interested in engaged families in the postresuscitation period. Correct implementations of such care that include all families need institutional policies and guidelines. No patient or public contribution.

Application of Trauma-Informed Care Principles to Care Needs Identified by Mothers of NICU-Hospitalized Children

Systematic uptake of family-centered care (FCC) interventions remains challenging and frequently suboptimal in many neonatal intensive care units (NICUs). Across NICUs in the United States, integrating family members as partners in infant caregiving and decision-making has not been well supported and routine screening and provision of psychological support for parents remains inadequate. Trauma-informed care (TIC) may offer a more comprehensive approach to NICU care which can encompass FCC principles and promote family recovery and resilience by recognizing and responding to the traumas experienced by NICU infants and families. The current paper aimed to understand needs identified by mothers of NICU-hospitalized children and reports a focused analysis of one-on-one interview data (n = 13 mothers) collected during a larger mixed methods study. Reflexive thematic analysis was used to understand needs identified by mothers and to explore how these needs aligned with TIC principles. Six themes were identified and subsequently examined in the context of the principles of TIC: I Just Had No Control, That Really Caught Us Off Guard, So Much Was Already Taken Away, We’re People and There Needs To Be More Support and Practices Which Helped. Mothers’ care needs were found to align with TIC principles. Findings suggest that implementation of TIC principles in NICU settings can support parental presence, participation in infant care, and mental health and support the potential of TIC as a more comprehensive approach to meeting the needs of NICU parents.

Parental Participation in Their Infants’ Procedural Pain Alleviation with Nonpharmacologic Methods in Estonia

BackgroundAim: To describe parent's participation in their infants’ procedural pain alleviation using nonpharmacologic methods in neonatal and neonatal intensive care units. MethodA descriptive cross-sectional survey study was carried out in four Estonian hospitals between 2019 and 2020. Data were collected by using a validated questionnaire comprised of three sections: (1) background information of parents and infants; (2) nonpharmacologic methods used by parents; and (3) parental guidance by nurses on the methods. Altogether 280 questionnaires were distributed to parents and 232 of them were received back. Finally, 189 of them were included in the study (response rate 67.5%). The data were analyzed using descriptive and analytical statistics. Analysis of open-ended questions followed principles of inductive content analysis. ResultsMost participants reported using nonpharmacologic methods, such as holding and placing the infant in a more comfortable position, nearly always/always (61%, 62%, respectively). However, rarely used methods included skin-to-skin contact (7%), breastfeeding the infant (7%), and listening to recorded music (3%). While studying a correlation between the parents’ use of nonpharmacologic methods and their guidance, we found a correlation among all nonpharmacologic methods. However, almost half (48%) of the parents reported that the nurses advised them “sometimes” or “nearly always/ always” to go elsewhere during painful procedures rather than participating in alleviation of the infant´s pain. ConclusionsThe parents reported using mostly the nonpharmacologic methods that were easy to implement and did not require thorough instructions in preparation. In addition, it seemed that parents wanted to be more involved in their infant's pain alleviation, but they were advised not to take part in painful procedures and pain alleviation for various reasons. Therefore, more attention should be paid to the principles of family-centered care. As health care providers, we should welcome all families as team members to involve in their infants’ pain alleviation in the neonatal and neonatal intensive care units.

The Swedish version of EMPATHIC-30 translation and initial psychometric evaluation.

One way to measure quality of care is by measuring satisfaction of provided care among patients and their families. EMpowerment of PArents in THe Intensive Care 30 (EMPATHIC-30) is a self-reported questionnaire grounded on the principles of FCC aiming to measure parents' satisfaction with paediatric intensive care. There is lack of Swedish questionnaires measuring satisfaction with paediatric intensive care based on family-centered care principles. The aim was to translate the instrument EMpowerment of PArents in THe Intensive Care 30 (EMPATHIC-30) into the Swedish language and evaluate psychometrically the Swedish version in a paediatric intensive care context. The instrument EMPATHIC-30 was translated and adapted to Swedish context, thereafter, assessed by expert panels consisting of nurses (panel one; n=4; panel two; n=24) and parents (n=8) with experience in paediatric intensive care. Construct validity, item characteristics and reliability were tested in a cohort of 97 parents whose child had been treated for at least 48 h at two out of four Paediatric Intensive Care Unit (PICUs) in Sweden. Parents whose child died during hospitalisation were excluded. The Swedish version of EMPATHIC-30 showed an acceptable internal consistency with Cronbach's alpha coefficient for the total scale 0.925. Cronbach's alpha on the domain level varied between 0.548-0.792 with the lowest coefficient in the domain Organisation. Inter-scale correlation revealed acceptable correlations for both subscales (0.440-0.743) and between total scale and subscales (0.623-0.805), which demonstrated good homogeneity for the instrument in its entirety. One problem regarding the domain Organisation and especially the item "It was easy to contact the pediatric intensive care unit by telephone" was revealed, which indicated that the item needs to be reformulated or that the factor structure needs to be further evaluated. The findings from the current study indicated that the Swedish version of EMPATHIC-30 has acceptable psychometric properties and can be used in Swedish PICUs. Using EMPATHIC-30 in clinical practice can give an indication of the overall quality of family-centered care at the PICU.

What Are Parents' Experiences With Their Child's Hearing Aid Use in the First 5 Years?

Parents are required to make informed choices for their children regarding the use of hearing amplification after hearing loss has been diagnosed. If parents choose a listening and spoken language approach for their child where the development of age appropriate spoken language is the parents' goal, then the early fitting and frequent use of hearing aids is crucial. Within the framework of family centered care, parents have the ultimate responsibility for supporting their child's hearing aid use. However, few studies have focused on parents' insights regarding the aspects that shape hearing aid use in the early years. Thus the aim of this study was to explore parents' firsthand experiences with their child's hearing aid use in the first 5 years. Understanding parents' insights will help improve service provision to optimize outcomes for children with hearing loss. The study utilized a prospective qualitative design to explore parents' firsthand experiences with their child's hearing aid use. Purposive sampling was used to recruit 12 parents who participated in semi-structured interviews. Parents' responses were analyzed using thematic analysis. Three overarching themes were conceptualized, namely: (a) towards hearing aids - journey into the wilderness; (b) adjusting to hearing aids - it's the journey, not the destination; and (c) support for my child's hearing aid use - it's not where you are going, it's who you have beside you. Each theme was further divided into categories and subcategories. This study identified that parents have much to contribute to service providers' understanding regarding the aspects that shape consistent hearing aid use in young children. Parents shared many insights such as the emotionally daunting nature of the first few months post hearing loss confirmation, the influence of family support, and the importance of building connections and understanding about hearing loss and hearing aid use within their social networks. Based on these insights, the authors provide recommendations for clinical best practice that draw upon key principles of family centered care. They consist of practical suggestions including strategic support to overcome less optimal hearing aid use and ways to facilitate parent support within their familial and communal networks.

Family-Centered Practices and Caregiver Mental Health in a Developmental Intervention for Young Children With Congenital Zika Syndrome

The goal of this study was to describe the provision of intervention services to children with congenital Zika syndrome (CZS) in a large health care institution located in Recife, Brazil, and family factors related to intervention involvement, through the lens of family-centered developmental–behavioral pediatric care principles. Caregivers (N = 50) of children with CZS who were receiving services at a public rehabilitation hospital participated a cross-sectional survey study. Among caregivers, 22% reported a low number of both child and caregiver intervention contacts, 26% reported a high number of child contacts but low caregiver contacts, and 52% reported both high child and caregiver contacts with intervention staff in the past 3 months. Caregiver stress scores were higher and coping strategies were lower in the low child and caregiver intervention contact group. Most caregivers reported high levels of family-centered practices. In regression models, low family resources was associated with higher depression and stress and low coping strategy use, whereas higher support was associated with higher coping. This study adds to the small literature exploring intervention services provided to children with CZS with a particular emphasis on family-centered care principles. It is recommended that intervention programs in Brazil evaluate the availability and accessibility of family resources and develop strategies to help connect families to resources that promote caregiver mental health and child outcomes.

Interdisciplinary social needs response team: A community case study in social needs targeted care during the COVID-19 pandemic and beyond.

This case study illustrates the role and value of a social needs response team during times of crisis and beyond. The COVID-19 pandemic resulted in two simultaneous crises-the infectious disease crisis and the socioeconomic crisis. Unemployment and lost wages, housing and food insecurity, and increased childcare needs are just a few examples of the socioeconomic needs that skyrocketed during the COVID-19 pandemic. At the start of the pandemic, the University of Pennsylvania Health System (UPHS) formed an interdisciplinary team of physicians, social workers, nurse practitioners and students of these professions to reimagine social needs screening in a way that could reach people during the pandemic and provide sustainable support for individual's evolving social needs. The Social Needs Response Team (SNRT) at UPHS utilized various secure platforms to keep members of the team connected with each other and their patients. Orientations for participating students included training on how to employ principles of crisis intervention theory, empathetic inquiry, and patient-led and family-centered care to best uncover and serve the needs of their patients. Alongside the illustrative case study, this piece details guiding principles and concepts that are essential to integrating social needs targeted care.

Optimization of support for relatives-Family-centered care in intensive care medicine

Based on shared experiences and values, the patient and their families form arelational unit. This social unity is especially valid in the situation of illness. Patients' relatives in intensive care units experience an exceptional emotional situation, associated with uncertainty, feelings of being overwhelmed, fear, and the desire for the best possible medical care. The principles of family-centered intensive care offer orientation and relief not only for the patients and their relatives, but also for the interprofessional team. Related measures, such as open visiting hours, appreciative communication, interprofessional team structures, and internal hospital standards can support all those involved in shaping and overcoming this critical situation together.

Clinicians' and Managers' Views and Experiences of Audiology and Speech-Language Pathology Service Provision for Culturally and Linguistically Diverse Families of Young Children With Hearing Loss.

This study aimed to gather the views and experiences of clinicians and managers on early intervention audiology and speech-language pathology services for culturally and linguistically diverse (CALD) families of children with hearing loss. This qualitative descriptive study involved 27 semistructured interviews with audiologists, speech-language pathologists, and managers working with CALD families of young children with hearing loss. Purposeful sampling was used to recruit participants from three hearing centers working with these families. Interviews were analyzed using thematic analysis. Analysis of the data resulted in five themes: (a) There were perceived added complexities for CALD families in accessing and being involved in services and receiving information; (b) there were perceived family-provider relationship complexities, cultural differences, and service delivery challenges in working with CALD families; (c) clinicians and managers used various strategies for service provision of CALD families; (d) involving interpreters benefited service provision but was challenging at times; and (e) looking to the future and recommendations for clinical practice. Current practices reflect some principles of family-centered care for CALD families of young children with hearing loss. Families and services may benefit from more support regarding family-provider partnerships, information materials and child assessments, working with interpreters, and center support for time and resources. https://doi.org/10.23641/asha.20044427.

The Journey: Parental Expectations and Perceptions of Therapy Services for Children With Down Syndrome.

The researchers sought to identify and describe parents' expectations and perceptions of therapy services received by their children with Down syndrome. This study used a qualitative descriptive approach conducted in 2 phases: individual semi-structured parent interviews followed by focus groups. Analysis of interview transcripts served as the basis for development of codes, categories, and themes describing parents' beliefs, values, and opinions of their children's therapy. Within the metaphor of The Journey, 3 major themes emerged: Where are we going? Who's driving the car? What I really need for this trip. Parents value the principles of family-centered care and want a partnership with therapists in caring for their children. Therapists can help parents of children with Down syndrome navigate their children's therapy services by establishing a relationship of trust and by communicating with respect, understanding, and compassion.