Uniacke Suzanne, Browne Tamara Kayali, Shields Linda
1 School of Humanities and Social Sciences, Faculty of Arts and Education, Charles Sturt University, Canberra, Australia.
2 School of Medicine, Faculty of Health, Deakin University, Geelong, Australia.
J Child Health Care. 2018 Sep;22(3):460-469. doi: 10.1177/1367493517753083. Epub 2018 Jan 18.
What is family-centred care of a hospitalized child? A critical understanding of the concept of family-centred care is necessary if this widely preferred model is to be differentiated from other health care ideals and properly evaluated as appropriate to the care of hospitalized children. The article identifies distinguishable interpretations of family-centred care that can pull health professionals in different, sometimes conflicting directions. Some of these interpretations are not qualitatively different from robust interpretations of the ideals of parental participation, care-by-parent and partnership in care that are said to be the precursors of family-centred care. A prominent interpretation that regards the child and his or her family collectively as the 'unit of care' arguably arises from ambiguity and is significantly problematic as a model for the care of hospitalized children. Clinical practice driven by this interpretation can include courses of action that do not aim to do what will best promote a hospitalized child's welfare, and such cases will not be unusual. More broadly, this interpretation raises challenging questions about the responsibilities and authority of health professionals in relation to the interests of hospitalized children and their families.
什么是对住院儿童的以家庭为中心的护理?如果要将这种广受欢迎的护理模式与其他医疗保健理念区分开来,并根据住院儿童的护理需求进行适当评估,那么对以家庭为中心的护理概念进行批判性理解是必要的。本文指出了对以家庭为中心的护理的不同理解,这些理解可能会将医疗专业人员引向不同的、有时甚至相互冲突的方向。其中一些理解与对家长参与、家长护理以及护理伙伴关系等理念的有力诠释在本质上并无不同,而这些理念据称是以家庭为中心的护理的前身。一种将儿童及其家庭视为一个“护理单元”的突出理解,可能源于概念的模糊性,并且作为住院儿童护理模式存在重大问题。受这种理解驱动的临床实践可能包括一些并非旨在促进住院儿童最佳福祉的行动方案,而且这种情况并不罕见。更广泛地说,这种理解引发了关于医疗专业人员在住院儿童及其家庭利益方面的责任和权力的具有挑战性的问题。