Questioning family-centred care

Abstract

Aims: This article poses topics for discussion around family-centred care as a model of care delivery to children and families in health services.

Background: Family-centred care developed over three decades following awakening awareness that excluding parents during a child's hospital admission was detrimental to the child's mental health. Using resources from both past and current literature and existing research, I argue that it is time for a revision of practices and policies that espouse family-centred care as the optimum model of care in paediatrics. Once the historical development of family-centred care is discussed, current research shows a dearth of evidence about family-centred care, its use, implementation and applicability across cultures and nations.

Design: Discursive.

Methods: Five questions are discussed: is family-centred care relevant now? is it relevant only in Western countries?, what does it mean to implement family-centred care?, is family-centred care implemented effectively?, does it make a difference? Exemplars of good family-centred care practice are provided.

Results: At this stage, it is difficult to know whether using family-centred care makes a difference to a child's and family's health outcomes, as there is no rigorous evidence to answer the question 'does it work?'

Conclusions: Nurses must undertake studies so we can either support the successful implementation of family-centred care, or abandon it in the best interests of children, families and health services.

Relevance to clinical practice: Practitioners must be aware that family-centred care is a wonderful ideal that is almost impossible to implement and so new ways of delivering care to children may be needed.