Foster Mandie, Whitehead Lisa
1 Centre for Postgraduate Nursing Studies, University of Otago, Christchurch, New Zealand.
2 Edith Cowan University, Western Australia, Australia.
J Child Health Care. 2019 Mar;23(1):102-117. doi: 10.1177/1367493518778389. Epub 2018 May 28.
Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.
以家庭和儿童为中心的护理是儿科学中使用的护理理念，其中家庭和/或儿童是医疗服务的核心。本研究探讨了新西兰一家儿科重症监护病房收治的学龄住院儿童的生活经历，以便从儿童的角度深入了解以儿童为中心的护理。采用了一种解释性主题方法，让儿童画一幅“医院里的一个人”的画，并通过访谈进一步探讨。访谈进行了录音，并逐字转录，运用以儿童为中心的护理框架完成了归纳主题分析。26名学龄儿童参与了研究。这些画作包括家人、医护人员、其他儿童和他们自己的画像。访谈产生的主题包括与自己、家人和医护人员的关系，以及心理社会、情感和身体支持。儿童将自己描述为自身医疗体验的共同创造者，这与以儿童为中心的护理一致，同时借鉴了以家庭为中心的护理原则。对“参与与保护”以及“儿童成长与儿童现状”概念的进一步探索，将有助于把以儿童为中心的护理和以家庭为中心的护理原则转化并融入实践、理论、研究和政策之中。
