Franck Linda S, Mehra Renée, Johnson Beverley H, Abraham Marie, Rubin Nicole, Hoffmann Thomas J
Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA.
Institute for Patient- and Family-Centered Care, Bethesda, MD.
Med Care. 2025 Aug 12;63(10):749-57. doi: 10.1097/MLR.0000000000002203.
Family-centered care (FCC) contributes to improved health care delivery and outcomes in pediatrics.
To conduct a global survey of hospital leaders' views on FCC culture, policies, and practices in health care organizations serving children, including in the post-COVID-19 pandemic era.
A cross-sectional electronic survey.
Surveys were received from 256 leaders from 215 hospitals in 38 countries. Preliminary psychometric analysis yielded a 44-item instrument wherein a higher total score indicated leaders had more positive views of their hospital's FCC. A majority reported high levels of FCC culture at bedside and supportive policies for family presence and participation. Fewer leaders reported family partnership at the organizational level, health professional education on FCC, or organizational accountability for FCC. In multivariable analyses, having an active patient and family advisory council (PFAC) was associated with higher FCC scores. Free-text comments reflected respondents' commitment to family presence and participation in care and decision-making, factors that facilitated or impeded active PFACs, variability in FCC practices, and the COVID-19 pandemic's impact on FCC.
These findings suggest a commitment to FCC by leaders in hospitals providing pediatric care globally, and that an active PFAC is associated with higher ratings of hospital FCC culture, policies, and practices. Expanded adoption of PFACs, along with standardized measurement and quality improvement monitoring, may improve the family-centeredness of pediatric health care, and thereby contribute to quality and safety. Barriers such as a lack of organizational accountability for FCC must be addressed so that FCC can function optimally in pediatric settings.
以家庭为中心的护理（FCC）有助于改善儿科医疗服务的提供和效果。
对全球医院领导者关于在为儿童服务的医疗机构中，包括在新冠疫情后时代的FCC文化、政策和实践的观点进行调查。
一项横断面电子调查。
收到了来自38个国家215家医院的256位领导者的调查回复。初步的心理测量分析得出了一个包含44个条目的工具，其中总分越高表明领导者对其医院的FCC有更积极的看法。大多数人报告说床边有高水平的FCC文化以及对家属陪伴和参与的支持政策。较少的领导者报告了组织层面的家庭伙伴关系、关于FCC的卫生专业教育或医院对FCC的问责。在多变量分析中，拥有一个活跃的患者及家庭咨询委员会（PFAC）与更高的FCC得分相关。自由文本评论反映了受访者对家属陪伴和参与护理及决策的承诺、促进或阻碍活跃PFAC的因素、FCC实践的差异以及新冠疫情对FCC的影响。
这些发现表明全球提供儿科护理的医院领导者对FCC的承诺，并且一个活跃的PFAC与医院FCC文化、政策和实践的更高评级相关。扩大PFAC的采用，以及标准化测量和质量改进监测，可能会提高儿科医疗保健的以家庭为中心程度，从而有助于提高质量和安全性。必须解决诸如医院对FCC缺乏组织问责等障碍，以便FCC在儿科环境中能最佳运作。
