Questioning family-centred care


  • Linda Shields

    1. Author:Linda Shields, PhD, FRCNA, FRSM, Professor of Paediatric and Child Health Nursing, Curtin University and Child and Adolescent Health Service, Perth, WA; Honorary Professor, Department of Paediatrics and Child Health, The University of Queensland, Brisbane, Qld, Australia
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Linda Shields, Professor of Paediatric and Child Health Nursing, School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, WA 6845, Australia. Telephone: +61 401103675.


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.