An office or a bedroom? Challenges for family-centered care in the pediatric intensive care unit.
Although the modern pediatric intensive care unit (PICU) has followed general pediatrics and adopted the family-centered care model, little is known about how families prospectively experience PICU care. The authors' goal was to better understand the experiences of families whose child was hospitalized in a PICU. They conducted a 12-month prospective ethnographic study in a PICU in a tertiary care hospital in a large North American urban center. Data were obtained via participant-observation and formal and informal interviews with 18 families and staff key informants. Findings revealed a disconnect between the espoused model of family-centered care and quotidian professional practices. This divergence emerged in the authors' analysis as a heuristic that contrasts a professional "office" to a sick child's "bedroom." PICU practices and protocols transformed the child into a patient and parents into visitors; issues such as noise, visitation, turf, and privacy could favor staff comfort and convenience over that of the child and family. The authors' discussion highlights suggestions to overcome this divergence in order to truly make the PICU family centered.
Division of Oral Health and Society, Faculty of Dentistry, McGill University, 3550 University Street, Suite 030, Montréal, QC H3A 2A7, Canada. mary.macdonald@mcgill.ca
Mary Ellen
ME
Macdonald
Stephen
S
Liben
Franco A
FA
Carnevale
S Robin
SR
Cohen
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003258:Consumer Behavior; D022143:Family Nursing; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D017146:Models, Organizational; D011446:Prospective Studies; D036301:Qualitative Research