Exclusion and inclusion of parents of hospitalized children in Norway in the period 1877–2017

Abstract

Background Today, Norwegian parents have the right to stay with their children when they are in hospital. This right is relatively new. The purpose of this article is to examine the nursing profession’s ideas on how parents should be included/excluded when their children are in hospital, and to examine the social and ideological conditions that made the nursing profession’s ideas on inclusion/exclusion practices possible. Methods The analyses are done in the tradition of the French philosopher Michel Foucault’s writings on how different kinds of knowledge have been used to discipline citizens. Such studies include analyses of descriptive and normative material and analyses of the ideological and social conditions that made the practices possible. The analyses are based on Norwegian textbooks on nursing. Results Parents are rarely mentioned in Norwegian nursing textbooks from the period 1877–1940, and they are not present in photos from hospitals. The exclusion of parents may be due to the absence of welfare services and the fear of parents transmitting diseases from the hospitals to the general population. The first Norwegian nursing textbook that argued for the importance of letting parents visit their children in hospital was published in 1941. In 1968, nursing textbooks started to argue for parents’ participation in the care. Since 1987, nursing textbooks have advocated full parental participation. The inclusion of parents was in accordance with humanistic ideology. The inclusion of parents occurred in a period of great nursing shortage. In this situation, it would have been of interest to entrust as much as possible of the nurse’s work to the family. Conclusions Our conclusion is that ideas break through when they are in line with social conditions. From 1877 to 1940 social and economic conditions made it difficult for parents to be with their children in hospital, and hygiene ideology/theory contributed to legitimization of the exclusion of the parents in the care. During the period 1941–2017 it has been economically advantageous for the hospitals that parents care for their children. Ideas on the vulnerable child and self-help ideology have contributed to legitimization of the inclusion of the parents.

The Concept of Child-Centred Care in Healthcare: A Scoping Review

“…The theoretical origins of FCC came from the understanding of child attachment theories and recommendations from the Platt Report [10], which also had a significant influence on changes to care of children in hospitals. Where parents were largely excluded from children's hospital wards in the 19th and the first part of the 20th century, there have been incremental changes towards acceptance of parents, their presence and building partnerships [11][12][13].…”

Parents' perceptions of their child's pain assessment in hospital care: A cross-sectional study

“…Many hospitals implement the principles of family-centered care, which include parental involvement and shared responsibility for the child's care (Kokorelias et al, 2019). Parents can be involved in their child's care by preparing the child for medical procedures, sharing important information with the child and helping the child deal with the experiences of treatment and procedures (Sundal et al, 2019). It has been shown that the presence of parents in hospital reduces the anxiety of both the child and the parents (Çamur & Sarıkaya Karabudak, 2021), improves recovery, and shortens the time spent in hospital (Eichner et al, 2012;Franck & O'Brien, 2019).…”

The effect of parental participation in the care of hospitalized children on parent satisfaction and parent and child anxiety: Randomized controlled trial

“…Child hospitalization is a stressful experience for both children and their families. It is a situation that is traumatic at various levels depending on the age of the child and the cause of hospitalization (Aarthun, Øymar, & Akerjordet, 2019; Sundal, Petersen, & Boge, 2019; Weiss et al, 2017). Physical impairment, invasive interventions, surgery, death, pain and experiencing loss of control are among the reasons that children feel anxious in the hospital environment.…”

“…Because it lacks a precise definition in the literature, parental participation is referenced with several terms including ‘caregiver and decision‐maker’, ‘care partnership’, ‘shared participation’ and ‘caregiving by parents’; there is also a contradiction in the use of these terms (Romaniuk, O'Mara, & Akhtar‐Danesh, 2014; Vasli & Salsali, 2014). Parental participation reflects direct inclusion of parents in all caregiving activities (Hill, Knafl, & Santacroce, 2018; Romaniuk et al, 2014; Sundal et al, 2019).…”

“…People used to believe that nurses knew how to care for children better than mothers, and parents were expected to leave the responsibility of caregiving to healthcare personnel (Shields & Nixon, 2004). Studies conducted because have shown that long‐term separation could have negative outcomes for the child, maternal deprivation and separation anxiety hamper the child's recovery, and paediatric patients present negative behavioural changes after discharge (Sundal et al, 2019). Following these developments, the ‘Platt Report’ was published in England in 1959.…”