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    Family Centerd Care Final

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    Bhawna Pandhu
    Family-centered care is an approach that views the family as a child's primary source of support. It recognizes families as partners in a child's care who provide important information to healthcare professionals. Research has shown benefits for children when families are included in care, such as less crying, less need for medication, and earlier discharge from the hospital. The core concepts of family-centered care include supporting family strengths, sharing information, respecting family choices, and empowering families in their child's care.

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    Family Centerd Care Final

    Uploaded by

    Bhawna Pandhu
    355 views7 pages
    Family-centered care is an approach that views the family as a child's primary source of support. It recognizes families as partners in a child's care who provide important information to healthcare professionals. Research has shown benefits for children when families are included in care, such as less crying, less need for medication, and earlier discharge from the hospital. The core concepts of family-centered care include supporting family strengths, sharing information, respecting family choices, and empowering families in their child's care.

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    Family-centered care is an approach that views the family as a child's primary source of support. It recognizes families as partners in a child's care who provide important information to healthcare professionals. Research has shown benefits for children when families are included in care, such as less crying, less need for medication, and earlier discharge from the hospital. The core concepts of family-centered care include supporting family strengths, sharing information, respecting family choices, and empowering families in their child's care.

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    355 views7 pages

    Family Centerd Care Final

    Uploaded by

    Bhawna Pandhu
    Family-centered care is an approach that views the family as a child's primary source of support. It recognizes families as partners in a child's care who provide important information to healthcare professionals. Research has shown benefits for children when families are included in care, such as less crying, less need for medication, and earlier discharge from the hospital. The core concepts of family-centered care include supporting family strengths, sharing information, respecting family choices, and empowering families in their child's care.

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    Family-Centred Care for children

    Families are not visiting, they are“Family-ing”

    FAMILY:

    Family is a fundamental social group in society typically consisting of one or two parents and their
    children or Two or more people who share goals and values, have long-term commitments to one another,
    and reside usually in the same dwelling place. Families are big, small, extended, nuclear, multi-
    generational, with one parent, two parents, and grandparents. A family can be as temporary as a few
    weeks, as permanent as forever. One become part of a family by birth, adoption, marriage, or from a
    desire for mutual support... A family is a culture unto itself with different values and unique ways of
    realizing its dreams. Together, families become the source of rich cultural heritage and spiritual diversity.
    families create neighbourhoods, communities, states, and nations.

    INTRODUCTION OF FAMILY CENTERED CARE :


    The illness of a child can have a traumatic effect on both family and a child. Paediatric care
    has adopted the philosophy of a family centred care approach in order to maximize the wellbeing of
    paediatric patient. Parents are experts in the child’s care and know more about their child then we can
    learn through assessments and charts. . the family is also the child ‘s main source of support providing
    stability in what can be an otherwise traumatic period in child’s life. the presence of the family during
    health related procedures can significantly reduce both the child’s and parent’s anxiety . Decreasesd
    anxiety from the patient and family decrease the stress on the healthcare workers , positively affecting
    ability to provide treatment..
    Family-centred care is an approach to children’s health care that respects the central role
    of the family in a child’s life. It upholds the importance of the family as a partner on the health care team.
    One research study conducted by Neff in ohio USA in 2003 showed that children suffer less when the
    family is included in the care. In this study Children were found to have cried less, require less medicine ,
    less restless , and ever experience earlier discharge when the family was present during more aspects of
    care.

    HISTORY OF FAMILY CENTERED CARE:


    • Family-Centred care was first defined in 1987 as part of former Surgeon General Koop’s
    initiative for family-centred, community-based, coordinated care for children with special health
    care needs and their families. The Key Elements of Family-Centred Care were further refined in
    1994 by the ACCH (Association for the Care of Children’s Health). These key elements are widely
    accepted by families and professionals alike as they embody both the spirit and heart of Family-
    Centred Care. Family Centered Care challenges the traditional approaches that:
    – Focus on patient and family deficits
    – Disempower patients and families
    – Rely heavily on technology and biomedical science
    – Undervalue the importance of human interactions in the health care experience
    – Are driven by the needs of the healthcare professionals and the system

    PHILOSPHY OF FAMILY CENTERED CARE:


    According to wong and Hockenbery, the philosophy of family centred care recognizes the family as the
    constant in a child’s life , health care professionals enable and empower families to continue their care
    giving role. Families are supported in their natural care giving and decision making roles by building on
    their unique strengths as individuals and families. This philosophy also acknowledges diversity among
    family structures and backgrounds , family goals, dreams, strategies for coping and actions to deal with
    problems and family support such as relatives and friends., family-centred care is built on partnerships
    between families and professionals.
    Although family-centred care was first intended for children with special needs, it can also
    be relevant in all settings and can be applied to persons of all ages.’ It is a continual pursuit of being
    responsive to the priorities and choices of families.There is no single approach that is right for all families.
    Family-centred professionals acknowledge and respect family diversity Family-centred care is an
    approach to health care that shapes health care policies, programs, facility design, and day-to-day
    interactions among patients, families, physicians, and other health care professionals. Health care
    professionals who practice family-centred care recognize the vital role that families play in ensuring the
    health and well-being of children* and family members of all ages. These practitioners acknowledge that
    emotional, social, and developmental support are integral components of health care. They respect each
    child and family’s innate strengths and view the health care experience as an opportunity to build on these
    strengths and support families in their caregiving and decision-making roles.
    Family-centred approaches lead to better health outcomes and wiser allocation of resources
    as well as greater patient and family satisfaction. Family-centred care in paediatrics’ is based on the
    understanding that the family is the child’s primary source of strength and support and that the child’s and
    family’s perspectives and information are important in clinical decision making. Family-centred
    practitioners are keenly aware that health care experiences can enhance parents’ confidence in their roles
    and, over time, increase the competence of children and young adults to take responsibility for their own
    health care, particularly in anticipation of the transition to adult service systems.

    CORE CONCEPTS OF FAMILY CENTERED CARE

    Family-centred care core concepts include:

    Family Strengths:
    The family is the constant in the child's life. Support and empower family members as partners and
    decision-makers in their child's care and help them cope more confidently with their child's illness.

    Respect:
    Family-centred care requires trust and respect, including respect for each family's values, beliefs, and
    religious and cultural background.  Value families' knowledge of their children, acknowledging their
    authority as decision-makers and respect their choices.
    Choice:
    Provide the information families need to make educated choices about treatment and support the
    choices they make.  When families understand their options, they feel less powerless about their child's
    hospital experience.

    Information Sharing
    Professional staff provides medical information to families and values the personal information
    families provide about their children.  This information exchange builds trust and contributes to the
    partnership between families and caregivers.

    Support
    Support families by respecting their decisions; offering comfort as they cope with the child's illness;
    meeting the social, developmental and emotional needs of the child; and fostering family members'
    confidence in their ability to care for their child.

    Flexibility
    Families bring different personalities, life experiences, values, beliefs, education, and religious and
    cultural backgrounds to the hospital setting.  Family-centred care emphasizes that caregivers must be
    flexible so they can meet the needs and preferences of all families.

    Collaboration
    As partners in care, professional staff and family members work together as collaborators in the best
    interest of the child.

    Empowerment
    Families have the right and the authority to care for their children.  The core concepts of family-centred
    care empower families in the care of their children.

    ELEMENTS OF FAMILY-CENTERED CARE


     Recognize that the family is the constant in the child's life, while the service systems and personnel
    within those systems fluctuate.

     Share complete and unbiased information with parents about their child's condition on an ongoing
    basis. Do so in an appropriate and supportive manner.

     Recognize family strengths and individuality. Respect different methods of coping.

     Encourage and make referrals to parent-to-parent support.

     Facilitate parent/professional collaboration at all levels of health care -- care of an individual child,
    program development, implementation, and evaluation policy formation.

     Assure that the design of health care delivery systems is flexible, accessible and responsive to
    families.

     Implement appropriate policies and programs that provide emotional and financial support to
    families.

     Understand and incorporate the developmental needs of children and families into health care
    delivery systems.
     Recognizing that the family is the constant in a child's life, while the service systems and personnel
    within those systems fluctuate.

     Facilitating child/family/professional collaboration at all levels of service.

     Sharing with the family, on a continuing basis and in a supportive manner, the best information
    regarding their child's health care.

     Understanding and incorporating the developmental needs of infants, children, adolescents, and
    their families in health care delivery.

     Recognizing family strengths and individuality and respecting different methods of coping.

     Recognizing and honouring diversity, strengths and individuality within and across all families,
    including racial, spiritual, social, economic, educational and geographical diversity.

     Encouraging and facilitating family-to-family support and networking.

     Implementing comprehensive policies and programs that provide support to meet the diverse
    health care needs of families.

     Designing accessible service systems that are flexible, sensitive, and responsive to family-
    identified health care needs

    BENEFITS OF FAMILY CENTERED CARE:


     A stronger alliance with the family helps in promoting each child’s health and development
     Improved clinical decision making on the basis of better information and collaborative processes
     Improved follow-through when the plan of care is developed collaboratively with families
     Greater understanding of the family’s strengths and caregiving capacities
     More efficient and effective use of professional time and health care resources (eg, more care
    managed at home, decrease in unnecessary hospitalizations and emergency department visits, more
    effective use of preventive care)
     Improved communication among members of the health care team
     A more competitive position in the health care marketplace
     A practice environment that enhances professional satisfaction
     Greater child and family satisfaction with their health care
     Family-Centered Care improves and enhances clinical outcomes for children with special needs
    and provides more support for their families as they deal with the challenges and joys of raising a
    child with special needs Greater child and family satisfaction with their health care

    BARRIERS TO PARENT PARTICIPATION IN FAMILY-CENTERED CARE

    Role stress: All roles that a person adopts are subject to role stress during certain periods of his or her
    life. Role stress is a "subjective experience that is associated with lack of role clarity, role overload, role
    conflict, or temporary role pressures" . It can affect the communication process by causing the person to
    focus solely on the source of the stress rather than on the underlying issues. Parenting roles can be
    subjected to role stress from an ill child as well as from the different and greater demands placed on the
    parent as a result of the child's illness. During both hospitalization and home care, the parent's role
    changes from parenting the healthy child to parenting an acutely ill child. With such a shift in relations,
    stress will occur naturally .

    Negotiation failure. Negotiation "implies discussion resulting in mutual agreement" Negotiation in


    family-centered care involves an open relationship between the nurse, child, and parents whereby caring
    roles are established. Positive negotiation between the parents and nurse result in reaching an agreement
    with the parents concerning their roles in providing care without imposing any of their own erroneous
    expectations on one another Failed negotiations in care arrangements and poor nurse-family relationships
    can interfere with the health care experiences for the child and parents, as well as the parents' desire to
    care for their ill child.

    NURSES,S RESPONSIBILITIES IN PROVIDING FAMILY CENTERD CARE:

    Nurses play very important role in providing family centered care. As nurses act as collaborator
    between the physician and family so she plays a leading role in providing family centered care to
    children
     The nurse recognize the family as an essential part of the child's care and illness experience but
    also acknowledges and respects the expertise of the family in caring for the child both within and
    outside of the hospital environment.
     The nurse may suggest parenting classes to increase their knowledge base and promote
    empowerment
     In the absence of the child's family during hospitalization, the nurse should attempt to maintain
    routines established by the family
     The nurse involves encouraging family-to-family support and networking
     The nurse can also facilitate change and alleviate role stress effectively by aiding the family in
    realizing their own strengths, coping strategies, and support networks.
     The acronym LEARN dictates the following directives for nurses:
    L - Listen empathetically and with understanding to the family's perception of the
    situation.
    E - Explain your perception of the situation.
    A - Acknowledge and discuss the similarities as well as differences between the two
    perceptions.
    R - Recommend interventions.
    N - Negotiate an agreement on the interventions.
     the pediatric nurse involves helping the parents develop advocacy skills for their child to further
    empower their role during hospitalization and home care visits.

    RESEARCH EVIDENCES RELATED TO FAMILY CENTERED CARE

     A short-term longitudinal descriptive evaluation of current levels of parents' participation in the


    care of a child hospitalized with leukemia was conducted to identify varying levels of parent
    participation and their relationship to the child's behavior during hospitalization. A positive
    relationship between the number of activities a parent participates in and the child's behavior
    during hospitalization was revealed( Dolores C Jones)
     Family-centered care (FCC) has been implemented in many NICUs throughout the U.S. It is
    valuable in helping families whose infants require hospitalization cope with the stress, fear, and
    altered parenting roles that may accompany their child's condition and hospitalization. To employ
    such a significant philosophy of care, nurses must understand what the FCC concept signifies. A
    concept analysis can often aid understanding of abstract ideas such as FCC. This article utilizes a
    1995 framework for concept analysis to clarify the meaning of FCC for the neonatal nurse.
    Incorporating FCC into daily professional practice can enable nurses to improve the emotional and
    physical well- being of each family they encounter.( Maluski K Sheila)

    BIBLIOGRAPHY
     Hockenberry,Wilson .Wong’s nursing care of infants and children. 2 nd ed.New delhi: elsiever India
    PVT ltd; 2007.p. 17 -18

     Ball Jane, Bindle Buth. Pediatric nursing. 2 nd ed . Connecticut; Appleton and lange
    publishers;1995.p. 14

     Ahmann, E. (1994). Family-centered care: Shifting orientation. Pediatric Nursing, 20(2), 113-117.

     Arnold, E., & Boggs, K. (1995). Interpersonal relationships (2nd ed.). Toronto: W.B. Saunders
    Company.[Seriaonline]2009Aug[cited2010JAN];9(4):187.
    Availablefrom:URL:http//www.nursingcenter.com/library/journal/article.asp?Article_ID=930266

     Berlin, E.A., & Fowkes, W.C. (1983). A teaching framework for cross-cultural health care. The
    Western Journal of Medicine, 139(6), 934-938. [ serial online]2009 jul/sep[cited 2010 JAN
    19];23(3):213-216. Availablefrom:URL:http//www.nursingcenter.com/library/journal/article.asp?
    Article_ID=93160

     Brown, J., & Ritchie, J. (1990). Nurses' perceptions of parents and nurse roles in caring for
    hospitalized children. Children's Health Care, 19, 28-36. [ serial online] 2005 Aug[cited 2010
    jan19]; 35(8):57-59. Available from: URL:http//www.ncbi.nlm.nih.gov

     Callery, P. (1997). Caring for parents of hospitalized children: A hidden area of nursing work.
    Journal of Advanced Nursing, 26, 992-998. [serial online] 2008 May [cited 2010jan19] ; 45(5) :376-
    78.Available from: URL:http//www.ncbi.nlm.nih.gov/pubmed
    M. M. COLLEGE OF NURSING
    MULLANA, AMBALA

    IN- SERVICE EDUCATION PROGRAMME

    TOPIC: FAMILY- CENTERED CARE FOR CHILDREN

    SUBMITTED TO: SUBMITTED BY:


    Mrs. Prem Bhaskar Balwinder kaur
    Nursing Supdt. Janet Chaudhary
    Jaspreet kaur
    P. J. Subhashini
    Sandeep Kaur
    Kiran Khasa

    ( M. Sc Nursing 1st year


    2009- 2010)

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