AN ASSESSMENT OF FAMILY CENTERED CARE IN ACUTE CARE PEDIATRIC HEALTH FACILITIES (HOSPITALIZATION)

The overall purpose of this study was to assess family centered care in acute care pediatric health facilities in the United States. This purpose was accomplished by completing three discrete but interrelated substudies. First, the study identified a set of interventions, services and policies that support the philosophy of family centered care and determined the points on the developmental continuum when those interventions were critically important. Second, based on those age dependent critical interventions, the study proposed a model for optimum support at and across the first five developmental levels. Finally, the study surveyed all acute care pediatric health facilities nationally in order to determine the extent to which family centered care services and policies existed in those institutions. Questionnaires were sent to the Director of Nursing in 301 hospitals in the United States. Responses were received from 264 (86%) of them. Analyses of the frequency and patterns with which family centered care services existed in those institutions determined the current availability of services and provided a measure of the degree of commitment to a philosophy of family centered care in those hospitals. The frequency with which certain family centered care services were reported by the sample has increased dramatically in the last 30 years and indicates a growing awareness of the efficacy of psychosocial support services in the treatment of hospitalized children. However, in spite of reported policy changes there is evidence that the attitudinal changes necessary to insure full implementation of psychosocial support for children and their families have not occurred. Three findings--the limited frequency of quality services, the low incidence of comprehensive practices and the disparity between patient needs and services provided--support the conclusion that hospitals that serve children in the United States today have not typically adopted a philosophy of family centered care in the treatment of their patients. Specific policies that address the emotional and developmental needs of children and families have been established, but the findings indicate that those policies exist on a random basis and not as part of an overall philosophy of care.