2002 literature review Essay

Family Centred Care: A Parents perspective

Family centred care can be defined as the professional support of a child and their family, within a health setting that allows their care to be individualised so as to provide for the family as a whole, and not just the individual child (Jolley & Shields, 2009). Four key concepts should be met when planning and acting upon family centred care, these are dignity and respect, information sharing, participation and, collaboration (Davies, 2013). Over the last century, family centred care has evolved from being almost non-existent to an approach that involves a continuous change in practice, focussing on implementing a child friendly and loving environment, that allows families to be an integral part of care (Jolley & Shields, 2009).
The purpose of this literature review is to gain a better understanding of the parent’s perspective of the care that their child receives during their time in an acute care setting, whilst identifying and exploring common themes of (i) being present and involved, and (ii) a willingness to listen and learn, and (iii) an individual journey, through the use of qualitative journal articles.

(i) Being Present and Involved
In a study undertaken by Ames, Rennick & Baillargeon (2011), parents described how being present for their child allowed them to provide some normal parental comfort measures, for example holding their child’s hand and participating in normal routines such as daily bathing and providing explanations and reassurance. Families also sought to be involved in the decision making process by listening to recommendations made by staff and evaluating all options with an open mind, so individualised care could be put into practice (Goldfarb et al. 2010)

“He’s my boy, and I am the mother. I know he sees that I will be there for him.” (Ames et al. 2001, p.146)

Importantly, parents acted as an advocate when their child was unable to speak for themselves. This was highlighted as the ability to provide the protective parent role, where parents worked hard to express their child’s feelings and emotions (Taylor, 2006). Parents felt that a lack of patient understanding from the nursing and medical teams was partly due to minimalized input from the parents, who were sometimes made to feel disconnected and helpless, which in turn, had obvious implications at the bedside. Some parents however, were aware that not all staff were able to fully understand their child’s emotions due to frequently changing nursing staff, some questioning if staff had sufficient time to get to know the patients, and if each shift communicated with the next to identify key aspects of each patient (Merk & Merk, 2013).
All parents noted that they were the best source of information and knowledge of their child, and emphasised that sharing their expertise would allow a holistic approach to their child’s care, as well as highlighting how this was an important part of their parental role, especially when some care had to be relinquished by the primary carer (Ames et al., 2011). Parental expertise was elicited by staff through the use of direct enquiring to establish parameters and identify what was normal for the child being treated, to involving the parent during physical assessments, to assist in soothing the concerned and distraught child (Ames at al., 2011).
“[The physician] sometimes asked for my opinion, because he knows it’s my child…I know what the problem is with my child…I know what’s happening with my child because I am with him [all the] time.” (Ames et al. 2011, p.146)
Whilst parents expressed their need to be present for their child, it was evident that many parents felt it was sometimes difficult to interact with their child, for fear of disrupting the equipment or many access lines, leaving parents feeling unsure of how they were able to comfort their child and made them feel apprehensive in asking for help from already busy nursing staff (Gale, Franck, Kools & Lynch,

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