Family Centered Care

Answer

Family Centered Care

Family-centered is an approach that shapes health care programs, facility design, and health care policies together with day-to-day interactions among families, physicians, patients and other care professionals. Nurses who practice family-centered care recognize the vital role of families and their role on ensuring the health of a baby and adolescents. The nurses acknowledge developmental, social and emotional support is integral components in health. The nurses has respect family and child strength and they view their experience in health as an opportunity in building the strength and they help families in decision making.  The approach leads to better health and wiser allocation of resources for family and patient satisfaction (Wong, Hockenberry, & Wilson, 2011).

Nurses understand the role of family in health care as a primary source of support and strength and they help them in decision making. The care has emerged the important concept in second half of 20^th century; it increases awareness in meeting the developmental and psychosocial needs of children and the role of families to promote well-being and health of children. It is grounded through collaboration among, physicians, families, nurses, patients and other professions in delivery, planning and evaluation of health care professionals. The nurses have a responsibility in respecting the child and their family. They build and recognize the strengths of the child and the family even in hard situations (Bell, 2015).

Evidence based practice is explicit, conscientious and judicious usage of current evidence by making useful decision to the care of patient. It combines available research evidence by giving clinical judgement and consumer preferences. Health systems have undergone reforms while trying to enhance integration of care and have facilitated connected service provision with health care providers. They work through a mandate for health professionals and increase involvement in health promotion activities and early increase early intervention that slow progression of chronic disease like chronic illness. To arrive in the achievement, there is emphasis on building strong primary care system that provides both on-going chronic disease and preventative health care (James, Nelson, & Ashwill, 2014).

Organizing delivery of health care through patients’ needs may seem like simple and obvious approach. Patient centered care first emerged due to return of holistic roots of health care and it was dismissed by all but mostly philosophical providers as superficial, unrealistic or trivial. It defined characteristics of partnering with families and patients through encouraging, involving and welcoming and it personalized the care to preserve patients’ normal routine as much as possible (Bell, 2015). For decades, provisions of consumer-focused health care opportunities and information for loved ones’ that were involved in patient care, food, spirituality, healing physical environment have been considered expandable while compared to the critical and more pressing demand of clients’ quality and safety. The result is that today the patient centered care is conscious to almost every health care leader (Lawn, 2011).

Growth is quantitative changes in physical size of the body and its parts and the increases include tissues, cells, systems and structures. These physical growth examples include; weight, height, dental structures and none density. Development refers to behavioral changes both functional skills and abilities and they are qualitative and thus not easily measured. Maturation is the process of being developed and fully grown and involves behavioral and physiological aspects of an individual. It depends on functional growth, biological growth and learning (Biley, 2004).

All individuals have specific abilities and talents that develop to unique entities and there are no absolute rules that predict an individual development. However, general principles relate to growth and development on all individuals. Development occurs in cephalocaudal (head-to-toe) and proximodistal manner where infants have to move hands before lifting objects. It also occurs in orderly manner from simple to complex portrayed by infants crawling before walking. All individuals grow through similar developmental processes with every stage having specific characteristics (Johnson, & Keogh, 2010).

Growth and developmental occurs in six stages, one is developmental task of childhood and infancy. The developmental stages in this stage include; learning to talk, learning to talk, taking solid foods, sex differences and getting ready to read. The next stage is middle childhood where a child trains on physical skills, forming and building on attitude, achieving personal independence and get along with age-mates. At this age they develop conscience scale of value and morality and develop everyday concept. They also learn appropriate feminine and masculine roles and nurses caring for them have to help them in the stages ("Patient- and Family-Centered Care and the Pediatrician's Role", 2012).

During adolescence some developmental changes occur when the group starts achieving and desiring social responsible behavior and they are in age of preparation family and marriage for an economic career. It is a stage that care-givers help parents to bond with their children due to rebellious ways. The teens act like adults but they are not yet adults and their guardians have to be consulted before any treatment. They achieve more and new mature relations with age mates of both sexes.  During adolescent the care givers helps in preparing parents and the teens on what to expect on every stage of life (Taylor, 2011).

Nurses and care givers dealing with children and their relatives should understand the factors that contribute to different growth rate between children of same age. Hereditary that is influenced by genetic information transmitted from parents to children determines physical characteristic such as, body structure, posture, facial features, skin color and predisposal to diseases. It is a genetic blue print that determines a person’s growth and development and it determines the rate of mental and physical growth of a person. Nurses should understand the health status of wellness of a child as it contributes to the progressive growth of an individual. Disability and some chronic illness may deter achievements of developmental milestones (Johnson, & Keogh, 2010).

Life experiences also influence the rate of growth and development, a child exposed to poverty with lack or inadequate food may grow differently with one with adequate food. Cultural expectation may influence growth of a child where the society expects people to master specific skills for each milestone stage. For example, a man may be discouraged to show tenderness and gentleness and may result to dysfunctional psychosocial development (Taylor, 2011). Women may be forced by society to use their intellectual abilities thus altering their cognitive developments. Children growing from economically deprived homes may receive inadequate food, intellectual stimulation, shelter and emotional nurturing that may result to psychosocial, physical and cognitive development impairments (Wong, Hockenberry, & Wilson, 2011).

It is basic concept for professional nurses to provide care to the whole person thus growth and development knowledge is important to as interventions are appropriate according to the development stage. The nursing holistic perspective recognizes individual progressive development across the life span. Presence or absence of progressive of development affects the all the dimensions of life. The nursing holistic framework includes physiological, spiritual, cognitive, psychosocial and moral factors. Development and growth theories are used in nurses’ assessments and any alteration of the pattern is seen as an early indicator (Biley, 2004).

Patient and Family-centered care (PFCC) is an approach to the delivery, planning and evaluation of health care that is grounded in mutual benefit of among families, patients and health care giver. Providing this care to children in an emergency department has opportunities and challenges both to the care giver and the patient. The unique aspect of an emergency department is represented by an acute visit to a place that is unfamiliar without on-going patient-provider relationship. Lack of previous relationship between the nurse, patient and family limits the ability to create effective relationship. Societal and cultural influences on different family structures provide difficulty in identifying with certainty is the specific child’s guardian (Rozenblum, 2013).

Families and patient may not have ideas their roles as partners and the care givers visit may bring challenges to the family.  The families may also be unfamiliar with the care givers taking care of them. Reluctance of some health care professionals may to allow members to witness some procedure especially invasive procedures may limit family access that may be beneficial to family, patient and health care alike. Despite the challenges, PFCC excellence may be achieved through embracing its philosophy across disciplines and would patient safety, satisfaction and comfort.  There should be good communication between the patient, health care and family to enhance support of PFCC and improve care coordination and continuity during integration ("Patient- and Family-Centered Care and the Pediatrician's Role", 2012).

Family centered pediatric nursing care earliest description was provided by Florence Blake in a comprehensive proposal on ways of improving health care services that are delivered to children and families (1954). This proposal focused in addressing physical as well as psychosocial family and children needs and it included the relationship between families and children. Blake laid an emphasize on nurses’ deliberate efforts that establish relationship with parents which fostered understanding of children as well as that of parents concerning ways to adapt to an illness or hospitalization. Her focus was on significant changes in practice and philosophy of educating pediatric nurses but she recognized other aspects that needed to be addressed for successful adoption of the new philosophy. They included changing hospital practices so that parents stayed with their hospitalized child while taking care of them, home care services were provided to sick children who would be safely cared at home and educating health personnel’s about the care(Westrup, 2014).

The families value and expect a partnership relationship with the health care givers. The nurses should support the family centered care (FCC) even after experiencing difficult in implementing the philosophy to the care practice. Families value and expect a relationship of partnership with health professionals. Nurses support the concept of FCC but experience difficulty in implementing this philosophy of care in practice. FCC is multi-faceted and requires a lot of approaches to adequately study both its implementation and effectiveness. (Levin, & Chalmers, 2014)

Conclusion

Family centered care should be totally adopted as a care philosophy in pediatric nursing. The concept has been evolving from allowing parents to visit hospitalized children to welcoming guardians and parents to be full participants in partnership with health professionals. Families have started valuing FCC and are supporting it by living in partnership and understanding their roles as partners. The care givers need to offer more training to impact knowledge to parents or families of sick children on their roles and responsibilities. More research and trainings should be carried to assist nurses to implement the basic philosophy in practice in all situations and settings in which children and adolescents receive care.