A Multisite Study of Health Professionals’ Perceptions and Practices of Family-Centered Care

Abstract

Family-centered care (FCC) has been promoted as the optimal philosophy for children and families in their interactions with health professionals. Furthermore, FCC is a health care delivery model that seeks to fully involve families in the care of children through an approach that is respectful and supportive. This multisite survey was undertaken to determine the differences in health professionals’ perceptions and practices of FCC and to examine factors that influence those perceptions and practices. Findings revealed that although advances have been made in recognizing the key elements of FCC, difficulties remain in implementing these elements. The “dilemma of helping,” the potential lack of interprofessional collaboration, the design of the health care delivery system, as well as the potential lack of continuing education and mentoring programs are proposed as explanations for these findings.

Involving Parents in Managing Their Child's Long-Term Condition—A Concept Synthesis of Family-Centered Care and Partnership-in-Care

“…Figure 3 illustrates that the key antecedents of family-centred care and partnership-in-care identified through in our concept synthesis are: a theory-practice gap, unclear roles and boundaries, entrenched professional practices and attitudes towards working with families, and lack of organisational or managerial guidelines or policies specifically aimed at supporting the implementation of patient-centred care.  Gap exist between theory and practice (Coyne, 2011;Coyne et al 2013b;Hughes, 2007;Murphy & Fealy, 2007)  Operationalising family-centred care is hindered by individual health professions attitudes towards, values and perception of and family-centred care (Ladak et al 2013;Maccdonald et al 2012)  Unclear roles and boundaries between parents and health professionals, entrenched professional practices with health professionals retaining role of decision maker, care prescriber and care giver (Bridgeman, 1999;Bruce et al 2002;Coyne, 2013a;Hughes, 2007;Murphy & Fealy, 2007;Paliadelis, et al 2005)  Inadequate nursing assessment and documentation relating to role negotiate; lack of knowledge and skills in relation to implementing family-centred care; operates without effective sharing of information, and collaboration or negotiation with families (Bruce et al 2002;Coyne 2013a;Holm, et al 2003;MacKay & Gregory, 2011)  Lack of organisational, managerial support, guidelines or policies hinders the implementation and consistency of embedding family centred care in practice of familycentred care (Coyne, 2011;Davies 2013, Coyne 2013bMacKay & Gregory, 2011MacKean et al 2005)  The design and organisation of the care environment can be facilitator or a barriers to embedding family to care into practice (Beck, 2009;Coyne et al 2013b;Coyne, 2011;Koller et al 2006;Bruce et al 2002)  Model outdated and does not reflect current practice' partnership professional rather tha...…”

“…Valuing parents' knowledge and experiences  Know the family and developing effective parent-professional relationship (Davies, 2012;Murphy & Fealy, 2007)  Collaborate and share decisions about child's care (Coyne, 2011;MacLean et al 2007)  Effective communication skills (MacKean et al 2005)  Build trust, listen to parent concerns, value parents knowledge of their child (Fereday, et al 2010;Ford, 2011)  Respecting and being sensitive to individual family's context (Raghavendra, et al 2007) Supporting parents in their role as care giver  Provide opportunities for information sharing (Bruce, et al 2002;Coyne, 2011;Coyne, 2013b;Holm, et al 2003;Koller, 2006;)  Facilitate parents to involved in the child care; clarify and negotiate roles (Coyne, 2011;Holm, et al 2003;Hughes, 2007)  Professionals have and share specialised knowledge to support family (Davies, 2012)  Design services round the child and family needs (Bruce, et al 2002)  Maintain contact and going support (Coyne & Cowley, 2007;Ford, 2011)  Mutual exchange of information about the child's specific health issues (Ford, 2011;Lam, et al 2006;Lee, 2007) Incorporating parents' expertise into clinical and psychosocial care…”

Positive Effects of a Nursing Intervention on Family-Centered Care in Adult Critical Care

“…Family-centered care is based on the "belief that patients and their families should participate in decisions related to their own health care." 22(p625) In family-centered care, a patient's family is an essential element in the patient's wellbeing 3,5,22,23 and helps protect and support that wellbeing. 12,14,24 Family-centered care is far more than what may be experienced in some pediatric units, which often have a narrowly focused philosophy of family-centered care.…”

Occupational therapists' attitudes toward family-centered care

“…The family-centered care philosophy maintains that families must be provided with full information about their child. Families are to be treated with respect and with care and are to be considered a partner with the professionals in the care of their young child (Bailey, Buysee, Edmondson, & Smith, 1992;Bruce et al, 2002). The law specifically supports family involvement at all levels of service delivery.…”

“…Professionals in early intervention report three types of barriers to the familycentered care process: professional, system, and family (Bailey, et al, 1992;Bruce et al, 2002;Hamilton, Roach, & Riley, et al, 2003). Concerning the first barrier, familycentered care practices reflect a major change from previous practice and people are typically resistant to major changes in work demands (Bailey, et al).…”