Article Text

CONTAINING ACUTE CHILDHOOD ILLNESS WITHIN FAMILY LIFE: A GROUNDED THEORY
  1. I T Coyne1
  1. 1School of Nursing and Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland

Abstract

Objective and Method Family-centred care (FCC) has been promoted as the ideal way to structure the nursing care of sick children and their families and is seen as a key principle in children’s healthcare provision globally. Using data from two separate empirical studies, this paper will: explain how parents and nurses “work out” their roles and relationships within the hospital setting; describe the conditions, effects and management of FCC; illustrate how parents and nurses struggle to “find a balance” in the delivery of FCC; suggest ways in which FCC may be implemented to provide a firmer basis for the development and evaluation of practice.

Results The data indicate that a collaborative/partnership relationship rarely exists. Nurses are very reliant on parents’ contribution in the organisation of work. FCC is an important philosophy of care but as it is currently practised by nurses it is the devolution of responsibility to parents. The covert and overt expectations held by nurses may threaten the stability and functioning of the family. The FCC philosophy fails to recognise changing family structures, dual earners and the loss of extended family support.

Conclusions The implications for clinical practice, education and management will be clearly discussed. To improve the current situation on children’s units requires a fundamental change in how the FCC policy is implemented. It requires a critical perspective of systems objectives and revisioning the barriers to FCC from an interdisciplinary focus.

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