Family-centered care in an academic hospital in Gauteng: perceptions and practices of nurses working in the paediatric wards

Abstract

Changes in health care to take account of human rights, especially the rights of children, have occurred because of recognition that family is important in the care of sick and hospitalised child patients. As a result, family-centered care (FCC) is considered the acceptable standard of nursing care to support and facilitate the psychosocial care of the child–parent dyad in paediatric care. However, in South Africa, although advances have been made with regards to the management of childhood conditions, evidence suggests that the emotional and psychological well-being of the child and family are not always considered while in care. The inconsistencies observed in FCC-related care practices can be partially attributed to the various definitions, and therefore differing interpretations and perceptions of FCC by nurses. Hence, the purpose of this study was to describe the perceptions and practices of professional nurses concerning FCC in paediatric care at a tertiary academic hospital in Gauteng. A quantitative descriptive survey and cross-sectional design was used. Data was collected by means of self-administered questionnaires, the amended FCCQ-R, from the targeted population of 92 (N = 92) professional nurses working in the paediatric wards. Seventy-two (n = 72) questionnaires were distributed to the convenient sample over a three (3) month period. The overall response rate was 51.1% with forty-seven (n = 47) questionnaires adequate for data analysis. Data was captured on Microsoft Excel and entered in the STATA 14 software for descriptive and comparative statistical tests. The findings revealed that nurses perceived the following elements: recognising family individuality, emotional and financial support for families and emotional support for staff as necessary to practise FCC. Whereas they reported being able to recognise family individuality and provide emotional and financial support to the families as elements they practised daily. No association was found between the nurse’s perceptions and current practices evidenced by no statistical significance (p-value > 0.05). Meaning, their perceptions did not have an influence on their practice. Recommendations from the study are that there should be ongoing in-service training provided for nurses on how FCC should be implemented. In addition, nurse educators should be knowledgeable of current policies regarding child health in the work pace to be able to better equip students on how they can put their theoretical knowledge of FCC into practice. In conclusion the cohort of nurses were found to have a good understanding and knowledge of FCC evidenced by their perceptions but practised FCC inconsistently when rendering care daily. Key words: family-centered care, paediatrics, nurses