Problematising assumptions about ‘centredness’ in patient and family centred care research in acute care settings

Abstract

Over the last two decades significant efforts have been made to implement patient and family ‘centred’ care as both a practical and moral imperative for adult acute care delivery. Although many resources have been developed and adopted by institutions, research suggests persistent and diverse barriers to implementing and achieving patient and family ‘centred’ care in adult acute care practice settings. These issues in implementation suggest re‐examining the nature of ‘centredness’ in care may be useful. A structured problematisation method, as outlined by Alvesson and Sandberg, is utilised to identify and analyse assumptions about the central notions of ‘centring’ that inform patient and family centred care intervention research. From our analysis, we highlight three predominant areas within ‘centring’ intervention research that may benefit from rethinking: Vitruvian spatiality, democratising care, and ‘centring’ positioned as primarily a problem and accomplishment for nursing. As a challenge to these assumptions, we argue for the adoption of theoretical lenses that ‘de‐centre’ individual actors to better account for complex relations among multiple actors, both human and nonhuman, which work to involve patients and families in care practices.

Effectiveness and family experiences of interventions promoting partnerships between families and pediatric and neonatal intensive care units: a mixed methods systematic review

“…This was to accommodate the changes in FCC, including increased visiting times, that occurred around this time. 9 , 16 , 20…”

“…Publication year was limited from 2000 to current publications. This was to accommodate the changes in FCC, including increased visiting times, that occurred around this time 9,16,20 …”

“…It progressed to including families in the patient’s care and, in 2012, focusing on both patients and their families. 8 , 9 In addition, the Family Integrated Care model by Franck et al 7 focuses on enhancing information sharing, support, flexibility, and collaboration between health care providers and families, in addition to giving families choice and empowering families while respecting diversity. In order to recognize the diversity of definitions around family-centered or integrated care, this review will focus on partnerships between health care teams and families.…”

“…The focus on FCC has evolved from focusing only on the patient to more inclusivity, including allowing some family members to be present during health care of the child. It progressed to including families in the patient’s care and, in 2012, focusing on both patients and their families 8,9 . In addition, the Family Integrated Care model by Franck et al 7 focuses on enhancing information sharing, support, flexibility, and collaboration between health care providers and families, in addition to giving families choice and empowering families while respecting diversity.…”

“Just Throw It Behind You and Just Keep Going”: Emotional Labor when Ethnic Minority Healthcare Staff Encounter Racism in Healthcare

“…In spite of racial disparities mentioned above, medical professional practice values solidarity, equality, and scientific rationality highly. The insistence that healthcare is a rational practice of solidarity with the patient at the center ( Judge & Ceci, 2021 ) acts as a hindrance to discussing the occurrence of racism ( Hamed et al, 2020 ), and staff who express experiences of racism tend to have their concerns dismissed. This trivializing of racism can be seen as part of what Bain (2018) refers to as the practice of ignorance that, in turn, silences experiences of racism.…”