Family-centred care; an aspiration or reality?

The next EBN TWITTER journal chat will take place on Wednesday 11th June 8-9pm and focus on family-centred care. In order to participate in the EBN twitter chat, if you do not already have one, you require a Twitter account, you can create an account at www.twitter.com. Once you have an account contributing is straightforward; you can follow the discussion by searching for links to #ebnjc@EBNursingBMJ, or better still, create a tweet (tweets are text messages limited to 140 characters) to ENB the journal @EBNursingBMJ and add #ebnjc (the EBN chat hashtag)at the end of your tweet, this allows everyone taking part to view your tweets.

Family-centred care is often viewed as a core principle in the care of children and a means of working in partnership with children, young people and families. This approach to healthcare delivery, where there is a mutually beneficial collaboration between patients and health professionals, is widely advocated within children’s nursing and the healthcare literature. Family-centred care has been described as both a method of care delivery and a philosophy that values the vital role of the family in ensuring the health and wellbeing of the child, and involves planning and delivering care around the whole family (Shields et al. 2012). The Institute for Patient and Family-Centred Care (2010, p1) defines family-centred care as, ‘an approach to the planning, delivery and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families’. Despite considerable research, family-centred care is a ubiquitous nebular concept, having differing meaning within and across professional and patients groups. In addition, the evidence-base relating to the impact of family-centred care on care delivery and parental satisfaction is weak, and outcomes are difficult to measure (Shields et al. 2012).Lack of clarity and a common understanding of family-centred care have resulted in questions being asked about the extent to which these concepts are applied in practice (Coyne, 2013).

Challenges in embedding family-centred care into practice include:

  • Individual health professions attitudes towards, values and perceptions of family-centred care;
  • Unclear roles and boundaries between parents and health professionals, entrenched professional practices with health professionals retaining the role of decision maker, care prescriber and care giver;
  • Lack of knowledge and skills in relation to implementing family-centred care, which often operates without effective sharing of information and negotiation of care with families;
  • Lack of specific guidelines or policies, resulting in variability in embracing family-centred care and family-centred care becoming part of everyday practice.

References

Coyne, I. (2013a) Families and health-care professionals’ perspectives and expirations of family-centred-care: hidden expectations and unclear roles. Health Expectations; early on-line doi: 10.111/hex12104.

Institute for Patient and Family-Centred Care (IPFCC) (2010). Frequently asked questions. http://www.ipfcc.org/faq.html (accessed May 2014).

Shields, L., Zhou, H., Pratt, J., Taylor, M., Hunter, J., & Pascoe, E. (2012) Family-centred care for hospitalised children aged 0-12 years. Cochrane Database Systematic Reviews. Issue 2.

Questions for consideration:

Is family-centred care predominantly aspirational and therefore not part of ever-day practice?

What does family-centred care mean to you?

What are the key components of family-centred care that are essential when working with children, young people and families?

What skills are required by nurses working with families to ensure care is family-centred?

Jo Smith, Senior Lecturer Children’s Nursing, University of Huddersfield, Associate Editor EBN.   Join in the blog discussion @EBNursingBMJ  Tweet me @josmith175

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