School of Child and Youth Care, Faculty of Human and Social Development, 175083University of Victoria, Canada.
School of Nursing, 8166The University of British Columbia, Canada.
J Child Health Care. 2021 Sep;25(3):457-467. doi: 10.1177/1367493520953354. Epub 2020 Aug 27.
Child- and family-centered care (CFCC) is being increasingly adopted internationally as a fundamental philosophical approach to the design, delivery, and evaluation of children's services in diverse primary and acute health care contexts. CFCC has yet to be explored in the context of families and children whose health and health care is likely to be compromised by multifaceted social and structural factors, including racialization, material deprivation, and historically entrenched power imbalances. To date, an equity orientation for CFCC has not been examined or developed. This is a critical area of inquiry, given the increasing evidence that children in families who face such inequities have poor health outcomes. This article examines dominant discourses on CFCC in the context of families and children who are at greater risk of health inequities in wealthy countries, drawing on Canada as a useful example. It outlines an evidence-based approach to equity-oriented care that the authors contend has the potential to orient CFCC toward equity and provide greater clarity in the conceptualization, implementation, measurement, and evaluation of CFCC in ways that can benefit all families and children including those who have typically been excluded from research.
以家庭为中心和以儿童为中心的护理(CFCC)作为一种基本的哲学方法,在国际上越来越多地被采用,用于设计、提供和评估不同初级和急性保健环境中的儿童服务。CFCC 尚未在健康和医疗可能受到多方面社会和结构因素影响的家庭和儿童的背景下进行探讨,这些因素包括种族化、物质匮乏和历史上根深蒂固的权力失衡。迄今为止,CFCC 的公平取向尚未得到检验或发展。鉴于越来越多的证据表明,面临这些不平等的家庭中的儿童健康状况不佳,这是一个至关重要的研究领域。本文以加拿大为例,在面临更多健康不平等风险的家庭和儿童的背景下,探讨了 CFCC 方面的主导话语。它概述了一种基于证据的公平护理方法,作者认为这种方法有可能使 CFCC 面向公平,并在概念化、实施、衡量和评估 CFCC 方面提供更大的清晰度,从而使所有家庭和儿童受益,包括那些通常被排除在研究之外的家庭和儿童。