title: Parental reflective functioning: analysis and promotion of the concept for paediatric nursing.
abstract: OBJECTIVE
  To identify the definitional elements of parental reflective functioning and develop a framework for nurses to apply this concept in their clinical work with families.
  
  
  BACKGROUND
  In recent years, researchers have concluded that parental reflective functioning is a key mechanism in the development of child attachment security leading to lifelong mental and physical health benefits. Despite its clinical relevance, little has been published in the nursing literature on this concept.
  
  
  METHODS
  Concept analysis.
  
  
  METHODS
  The Walker and Avant (2011, Strategies for theory construction in nursing. Prentice Hall, Upper Saddle River, NJ) method of concept analysis and the Whittemore and Knafl (Journal of Advanced Nursing, 52, 2005, 546) method of integrative review were used. A search of the literature published from 1989-2013 was conducted using edited texts and online databases - Scopus, CINAHL, PubMed and PsychInfo. Among the 85 sources, 31 empirical studies, 17 book chapters, 32 review papers and five case studies were identified concerning parental reflective functioning.
  
  
  RESULTS
  The concept of reflective functioning, defined as the capacity to envision the mental states of self and other, was first described in 1989 by Fonagy. Slade (Attachment and Human Development, 7, 2005, 269) expanded the concept specifically for parents (i.e. parental reflective functioning). Results of this concept analysis describe seven defining attributes and five antecedent conditions. Consequences of parental reflective functioning are related to a child's attachment early in life and behaviour later in life. A model case is provided to contextualise the concept. To date, there are three measures for parental reflective functioning.
  
  
  CONCLUSIONS
  While parental reflective functioning has been predominately featured in psychology and parenting interventions, the potential consequences of secure attachment and longer-term children's behavioural outcomes suggest that the concept has global implications for paediatric nurses and primary healthcare clinicians.
  
  
  CONCLUSIONS
  Parental reflective functioning offers exciting and promising opportunities for paediatric health and new approaches for those who provide paediatric health care.
authors.affiliation: Yale University School of Nursing, West Haven, CT, USA.
authors.forename: Monica R
authors.initials: MR
authors.lastname: Ordway
authors.forename: Lois S
authors.initials: LS
authors.lastname: Sadler
authors.forename: Jane
authors.initials: J
authors.lastname: Dixon
authors.forename: Arietta
authors.initials: A
authors.lastname: Slade
mesh_terms: D000328:Adult; D002648:Child; D006801:Humans; D007223:Infant; D008606:Mental Processes; D008960:Models, Psychological; D009736:Nursing Process; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D010371:Pediatric Nursing; D011594:Psychometrics
keywords: concept; nurse-patient relationship; parental guidance; parenting; reflection
references.citation: Attach Hum Dev. 2005 Sep;7(3):299-311
references.pmid: 16210241
references.citation: Dev Psychopathol. 1997 Fall;9(4):679-700
references.pmid: 9449001
references.citation: Nurs Sci Q. 2012 Jul;25(3):285-7
references.pmid: 22753580
references.citation: J Pediatr Nurs. 2014 Jan-Feb;29(1):3-13
references.pmid: 23685264
references.citation: Dev Psychol. 1999 May;35(3):611-9
references.pmid: 10380853
references.citation: J Adv Nurs. 2005 Dec;52(5):546-53
references.pmid: 16268861
references.citation: Infant Ment Health J. 2012;33(5):506-519
references.pmid: 23049148
references.citation: J Am Psychoanal Assoc. 2000;48(4):1129-46; discussion 1175-87
references.pmid: 11212185
references.citation: Dev Psychol. 1999 Jul;35(4):1038-47
references.pmid: 10442872
references.citation: J Nerv Ment Dis. 2010 Jul;198(7):501-7
references.pmid: 20611053
references.citation: Attach Hum Dev. 2005 Sep;7(3):313-31
references.pmid: 16210242
references.citation: Attach Hum Dev. 2005 Sep;7(3):269-81
references.pmid: 16210239
references.citation: Attach Hum Dev. 2005 Sep;7(3):283-98
references.pmid: 16210240
references.citation: Infant Ment Health J. 2013 Sep 1;34(5):391-405
references.pmid: 24049219
references.citation: Infant Ment Health J. 2012 Jan;33(1):70-81
references.pmid: 22899872
references.citation: Pediatrics. 2001 Jan;107(1):195-7
references.pmid: 11134461
references.citation: Infant Behav Dev. 2013 Dec;36(4):635-41
references.pmid: 23906942
references.citation: Attach Hum Dev. 2010 Sep;12(5):483-504
references.pmid: 20730641
references.citation: Pediatrics. 2012 Jan;129(1):e224-31
references.pmid: 22201148
references.citation: Attach Hum Dev. 2013;15(4):349-67
references.pmid: 23550526
references.citation: Infant Ment Health J. 2008 Jul;29(4):362-376
references.pmid: 28636158