mikkelsen g. & frederiksen k. (2011) Family-centred care of children in hospital – a concept analysis. Journal of Advanced Nursing67(5), 1152–1162.

Abstract
Aim.  This paper reports a concept analysis of family-centred nursing care of hospitalized children.

Background.  Family-centred care describes a practice aimed towards involving the family in all aspects of care. Previous analyses explore the colloquial use of the concept. An increasing amount of scientific papers apply the concept with seemingly little consistency in use.

Data sources.  A systematic literature search including articles from 1951 to 2009 resulted in a sample of 25 research articles.

Review methods.  A theoretical concept analysis influenced by Risjord’s distinction between theoretical and colloquial analyses and based on the principles developed by Morse, Hupcey and Penrod was used to examine the structure and scientific maturity of the concept.

Findings.  There is good agreement on the defining attributes of the concept, but they are described by sub concepts in need of clarification. The relationship between family and professionals is characterized by a mutual dependency and shared responsibility for the child’s care, which may have both positive and negative consequences and holds potential areas of conflict not fully explained by the attribute of partnership. The nature of partnership remains unclear and it may therefore not yet be a relevant attribute. The concept is defined from the perspective of professionals and families, mostly represented by mothers. Few attempts have been made to operationalize the concept.

Conclusion.  Family-centred care is a partially mature and highly abstract concept. Developing a theory of family-centred care could position the concept in a theoretical context and should also include the perspective of the sick child.

Family-centred care of children in hospital - a concept analysis.

‘Chatting’: an important clinical tool in facilitating mothering in neonatal nurseries



Aim. This paper explores the use of ‘chat’ or ‘social talk’ as an important clinical tool that can assist nurses achieve family-centred care in neonatal nurseries.



Background. The study was undertaken to increase knowledge of women’s experiences of mothering in the neonatal nursery and the relationship they share with nurses.



Method. The discussion presented is elicited from a grounded theory analysis of over 60 hours of interview data with 28 women, a thematic analysis of 50 hours of interviews with 20 nurses and a content analysis of 398 tape-recorded interactions between nurses and parents.



Findings. The analysis identifies the importance of the nurse–mother relationship and demonstrates that it is both the context and method by which nursing care is delivered. We found the verbal exchanges that take place between nurse and mother influence a woman’s confidence, her sense of control and her feelings of connection to her infant. It appears from the data that the nurse’s ability to effectively ‘engage’ the mother is dependent on the use of language that expresses care, support and interest in parents.



Conclusions. The data suggests that ‘chatting’ is the strategy and the process through which positive interactions are initiated, maintained and enhanced. This study confirms that nurses’ language acts as a powerful clinical tool that can be used to assist parents in gaining confidence in caring for their infants and in becoming ‘connected’ to infants resident in nurseries.

‘Chatting’: an important clinical tool in facilitating mothering in neonatal nurseries

Hospitalized children with chronic illness: Parental caregiving needs and valuing parental expertise

coyne i., o’neill c., murphy m., costello t. & o’shea r. (2011) What does family-centred care mean to nurses and how do they think it could be enhanced in practice. Journal of Advanced Nursing67(12), 2561–2573.

Abstract
Aim.  This paper is a report of the qualitative findings of a multisite survey in seven children’s units in Ireland. In this survey, nurses caring for children identified their practice and perception of family-centred care.

Background.  International research has identified inconsistencies with the provision and application of family-centred care in practice. Existing research studies illustrate barriers to family-centred care including nurses’ attitudes to families and a lack of support and resources for the philosophy.

Method.  A descriptive survey design was employed to collect data in 2008–2009. Questionnaires were distributed to nurses (n = 750) which yielded a response rate of 33% (n = 250). The nurses completed a 47-item questionnaire which examined nurses’ perceptions and practices of family-centred care, the quantitative findings of this study will be reported in another publication. The questionnaire contained two open-ended questions and the data from these questions are reported here.

Findings.  While nurses accept family-centred care as an ideal philosophy for the care of children and their families, the implementation of family-centred care in practice would seem to present challenges for nurses. The majority in this study indicated that they required further organizational and managerial support to fully implement family-centred care practices. Two interrelated themes were identified ‘the components of family-centred care’ and ‘enhancing family-centred care’.

Conclusion.  To provide good quality family-centred care nurses need adequate resources, appropriate education, support for managers and support from other healthcare disciplines.

What does family-centred care mean to nurses and how do they think it could be enhanced in practice.

The delivery of family centered care (FCC) occurs within varied pediatric care settings with a belief that this model of care meets the psychosocial, emotional, and physical needs of the hospitalized child and family. The aim of this review was to explore the attitudes, experiences, and implementation of FCC from many studies and to facilitate a wider and more thorough understanding of this practice from a diverse sample of parents, hospitalized children, and their health care providers within a pediatric critical care setting. A metasynthesis is an integration of qualitative research findings based on a systematic review of the literature. Thirty original research articles focusing on family-centered care experiences from the hospitalized child's, parents', and health care providers' perception published between 1998 and 2011 met the criteria for the review. Nine syntheses from 17 themes emerged from the synthesis of the literature: Prehospital, Entry into the Hospital, Journeying Through Unknown Waters, Information, Relationships, The hospital Environment, The Possibility of Death, Religion and Spirituality, and The Journey Home. The individual cultures of the critical care units helped create and reinforce the context of parental needs where satisfaction with communication, information, and relationships were interconnecting factors that helped maintain the positive or negative experiences for the parent, hospitalized child, and/or health care providers.

The Parents’, Hospitalized Child’s, and Health Care Providers’ Perceptions and Experiences of Family-Centered Care Within a Pediatric Critical Care Setting: A Synthesis of Quantitative Research

Twenty-five nurses were interviewed and asked to describe their perceptions of parent and nurse roles in caring for hospitalized children. Data were analyzed using content analysis. Six types of roles were identified: providing nonmedical care; providing technical and medical care; being a gatekeeper; being an advocate; providing psychosocial care; and providing general care. It seemed that often the nurses' need for control influenced the psychoemotional care they provided for parents.

Nurses' perceptions of parent and nurse roles in caring for hospitalized children.

Complementary and alternative therapies: survey of knowledge and attitudes of health professionals at a tertiary pediatric/women's care facility.

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Nurses' perceptions of parent and nurse roles in caring for hospitalized children.

Complementary and alternative therapies: survey of knowledge and attitudes of health professionals at a tertiary pediatric/women's care facility.