title: Perceptions of family-centred services in a paediatric rehabilitation programme: strengths and complexities from multiple stakeholders.
abstract: BACKGROUND
  Family-centred services (FCS) are best practice in paediatric rehabilitation and describe philosophies and approaches to medical care that emphasize the partnership and involvement of parents. While evidence supports FCS, there are complexities to its successful implementation. This mixed-methods study aimed to measure the extent to which parents and the healthcare provider (HCP) perceive service provision as being family centred, and to describe barriers and facilitators to the delivery of FCS.
  
  
  METHODS
  Parents of children participating in a rehabilitation programme and HCPs providing services participated in this study. Parents completed the measure of processes of care-20 and participated in interviews, while HCPs completed the measure of processes of care-service providers and participated in a focus group.
  
  
  RESULTS
  Quantitative analysis revealed that parents were mostly satisfied with features of FCS, which included communication and support between parents and HCPs, respect of diversity and parental collaboration and participation. Parents identified communication methods and psychosocial needs as areas that facilitated but sometimes detracted from FCS. Institutional barriers led to the identification of areas for improvement identified by multiple stakeholders. HCPs identified more areas for improvement than parents.
  
  
  CONCLUSIONS
  When considering these barriers, it is evident that implementation is a complex process, impacted by institutional barriers. FCS needs to be investigated further, and systemic interventions should be used to facilitate its implementation.
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: G G
authors.initials: GG
authors.lastname: Arcuri
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: A E
authors.initials: AE
authors.lastname: McMullan
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.|Motor Developmental Disorders Program, MAB Mackay Rehabilitation Centre, Montreal, QC, Canada.
authors.forename: A E
authors.initials: AE
authors.lastname: Murray
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: L K
authors.initials: LK
authors.lastname: Silver
authors.affiliation: Motor Developmental Disorders Program, MAB Mackay Rehabilitation Centre, Montreal, QC, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Bergthorson
authors.affiliation: Shriners Hospital for Children, Montreal, QC, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Dahan-Oliel
authors.affiliation: School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.
authors.forename: F
authors.initials: F
authors.lastname: Coutinho
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000592:standards; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D019988:Children with Disabilities / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D017144:Focus Groups; D006302:Health Services Research; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011368:Professional-Family Relations
keywords: evaluation; family-centred service; multidisciplinary; patient-centred care; qualitative research methods; quantitative research methods