Health care today, is increasing conscious of the importance of family centered care. A health care service that leads to adverse family experiences, can inhibit the family from seeking health care for their need in the future. Ensuring patient satisfaction and family centered care, is the best way to promote the good will of health care in the community. For patients with high acuity illness, health care professionals often need to make rapid decisions that deny them sufficient time for interaction with the patient’s family. Sometimes, the needs of the family are too complex, and the nature of activities at the hospitals is uncontrollable. This can force clinicians to ignore family centered care. High volume of patient inflow and severe time constrain, act as barriers in offering family centered care. In addition, effective communication skills are required to understand patient and family needs, and to take a holistic approach to medicine. All these shortcomings are aggravated, when there is a shortage of competent staffs. (Barata, Benjamin, Mace, Herman, & Goldman, 2007)
As days pass by, the communities are becoming more multicultural. There is a difference in the risk and patient’s response to diseases in different cultures. In addition, lack of cultural sensitivity of the modern medicine, deters many from the minority populations in accessing the benefits provided by the healthcare. Language may act as a barrier in certain situations and this often impedes effective communication between the patient and nurse, who belong to different cultures. The health care system has an inherent responsibility to respond to different cultural needs of the community and restore the declining health of the population. There are still communities in our nation that have limited access to primary and specialty healthcare. (Caruso Brown, 2015)
The risk of failure in family centered care increases, when the patient and family members are denied an opportunity to communicate their complaints and concerns. A high quality health care is safe, patient centered, effective, efficient, timeless and treats every citizen in the community equally. Failure to incorporate patient and family needs, may lead to adverse consequences in emergency care. Some of the consequences occur from miscommunication and lack of informed consent. Health care personnel’s like nurses have a responsibility to effectively communicate the correct information. Misleading the patient is against nurse’s ethics and law. (Caruso Brown, 2015)
Lack of effective communication, can prevent the patient and family from understanding the diagnosis and treatment options in an effective manner. This leads to lack of cooperation and increases dissatisfaction rate. Much of the morbidity and mortality that occur in the population, can be prevented through patient and family centered care. Ethnic disparity has been identified as a cause for nurse’s bias. This is unfortunate, because nursing professionals are obliged to prioritize patient care and welfare, above other determinants. (Caruso Brown, 2015)
Family can be an active part of the patient’s welfare team. The core principle of family centered care is to treat the family members with respect and dignity. Nurses can share the information about the patient in an unbiased manner. The participation of the family can provide the patient with a sense of control and independence over his situation. Likewise, family centered care seeks the collaboration of the family in the delivery of care, policy development, program development and in professional education. (Caruso Brown, 2015)
There are a number of barriers that prevent the effective transition of the concept of family centered care into a reality. Not all family decisions and activities provide strength and support to the effective healthcare of the patient. Family can have only a collaborative role in the patients’ health care. A controlling activity by the family can work against the patient’s health. According to the current model of family centered care, family is expected to work in partnership with healthcare providers, to help deliver high quality care. This partnership model, enables effective information sharing and positive support from both partners. A completely flexible or rigid model, may not serve in meeting the objectives of patient centered care. Hence, it is necessary to in-cooperate certain rigid, as well as certain flexible rules to ensure that the care is effectively delivered. The objective of patient centered care is to empower the patient and family in the health process, rather than families being helpless observers. (Caruso Brown, 2015)
An innovative approach that recognizes the integral role of families in healthcare is expected to provide a mutually beneficial collaboration among the patient, family and health professionals. Patient and family centered care is inspired by the vision that health care is a service and not a condition that patient or their families are entitled to follow. Family, culture, values and goals, helps to understand the patient better. Honoring the context from which the family views the patient’s condition, can help improve safety and satisfaction. There are some exceptions to family centered care like: patient or minor visiting the hospitals alone, need for urgent intervention and resuscitation, visit related to child abuse and neglect, cognitive capacity of the patient or family, unanticipated emergency and death. (Grol, Wensing, Eccles, & Davis, 2013)
Healthcare provides a number of opportunities where family can get involved. Family opinion can be considered during clinical decision making, when the patient arrives at the crossroad of medical options. Example, the decision can be sought in choosing a major surgery over lifelong medication. Each clinical path has its consequence, that needs to be explained. Informing the patient, the relative advantages and disadvantages of each clinical decision, can enable effective decision making. Family and patient opinion, can be sought for screening and diagnostic tests, if these tests have an indirect or direct influence on the patient’s life. Likewise, a stressful intervention will also require the patient and family consent. The presence of the family can be sought during invasive procedures, as it can help the patient feel confident. Likewise, patient and family can also be involved in discharge and follow up plan. There are clinical situations, where the patient will require the help of the family to translate information or communicate on his behalf. It is essentially that culture and language difficulties are considered, and support is provided when needed. For example, followers of Hindu religion, may want to strictly adhere to a vegetarian diet and want to follow certain daily rituals like praying. The hospital can provide opportunities for carrying out such activities. A patient who is less stressed, recovers faster. Considering the culture of the patient in the healing process, is part of a culturally effective care. Patient and family feedback can be useful in revising hospital policies for the better. Hospital policies can consider the patients believes and practices in the care process. (Leininger, & McFarland, 2006)
Studies suggest that registered nurses are more supportive of patient believes and practices than MD’s. Trainees are found to be less supportive of family concerns when compared to trainees. Health care providers were less supportive of patient concern, when the intensity and acuity of the procedure increased. Providers who oppose the family’s presence, claims that patients and family beliefs can delay or cause disruption in the process of care. However, most of these claims are made without trying it and those who do practice family centered care are fierce advocates of the same. Family and patient connectedness offer support in the grieving process. Involvement of the family, helps reduce fears and anxiety. It removes unnecessary doubts. Sharing information, helps the family understand that the best possible care is provided to the patient. Family is part of a spiritual experience in certain situations. They provide support and help the patient in a personal way, that cannot be offered by nurses or health professional. (Baider, Cooper, & Kaplan De-Nour, 2000). Family centered care helps healthcare providers make an improved clinical decision. It also enhances the work place environment and improves awareness in the community.
References
Baider, L., Cooper, C., & Kaplan De-Nour, A. (2000). Cancer and the family. Chichester: Wiley.
Barata, I., Benjamin, L., Mace, S., Herman, M., & Goldman, R. (2007). Pediatric Patient Safety in the Prehospital/Emergency Department Setting. Pediatric Emergency Care, 23(6), 412-418. http://dx.doi.org/10.1097/01.pec.0000278393.32752.9f
Caruso Brown, A. (2015). Family-Centered Care and Evidence-Based Medicine in Conflict: Lessons for Pediatricians. Hospital Pediatrics, 5(1), 52-54. http://dx.doi.org/10.1542/hpeds.2014-0082
Grol, R., Wensing, M., Eccles, M., & Davis, D. (2013). Improving patient care. Chichester, West Sussex: Wiley-Blackwell/BMJ Books.
Leininger, M., & McFarland, M. (2006). Culture care diversity and universality. Sudbury, MA: Jones and Bartlett.
