Paediatric nurses' perceptions and practices of family-centred care in Saudi hospitals: A mixed methods study.
BACKGROUND
Family-centred care is widely accepted as the underlying philosophy of paediatric nursing. Studies of family-centred care have mainly been conducted in western countries and little is known of its practice in other contexts. No studies have been undertaken in the Middle East.


OBJECTIVE
To explore family-centred care in the Saudi context from the perspectives of paediatric nurses.


METHODS
A mixed methodology was utilised with an explanatory sequential design. In the quantitative phase a convenience sample of 234 nurses from six hospitals in Jeddah, Saudi Arabia completed the Family Centred Care Questionnaire. The qualitative phase took place in one hospital and involved 140h of non-participant observation of paediatric nurses' practice. A convenience sample of 14 nurses was involved. Additionally, 10 face-to-face semi-structured interviews were conducted with key staff members. A purposeful sample of 10 nurses was involved. The findings from both phases were integrated in the final analysis.


RESULTS
The survey results indicated that participants identified most elements of family-centred care as necessary for its practice. They were less likely to incorporate them into their practice (p<0.001, paired t-tests, all subscales). These findings were supported by the observation data, which revealed that, while several elements of family-centred care were frequently practised, others were implemented either inconsistently or not at all. Findings from the interview data indicated that participants had limited and superficial understanding of what family-centred care means as a model of care; rather, they worked with the elements as a set of core tasks. In the current study, there were similarities between what has been found in the Saudi context and findings from other studies using the same tool in western contexts. There is general agreement regarding the differences between theory and practice. Nurses do believe and acknowledge the importance of family-centred care; however, they struggle with practising this model in their everyday work. In the current study, many factors contributed to this issue, including language barriers, communication issues, cultural issues and hospital policies.


CONCLUSIONS
Western concepts of family-centred care appear to be accepted by paediatric nurses in Saudi Arabia. However, full adoption of family-centred care in keeping with western values is likely not to be appropriate or successful in the Saudi context where both nurses and families have a non-western culture. The western model of family-centred care requires cultural modification and further development to fit Saudi and Middle Eastern cultures.
School of Nursing and Midwifery, Faculty of Medicine, Nursing & Health Sciences, Monash University, Australia; Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia. Electronic address: halabdulaziz@kau.edu.sa.
Hawa
H
Alabdulaziz
School of Nursing and Midwifery, Faculty of Medicine, Nursing & Health Sciences, Monash University, Australia. Electronic address: cheryle.moss@monash.edu.
Cheryle
C
Moss
School of Nursing and Midwifery, Faculty of Medicine, Nursing & Health Sciences, Monash University, Australia. Electronic address: beverley.copnell@monash.edu.
Beverley
B
Copnell
D001291:Attitude of Health Personnel; D005190:Family; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D009741:Nursing Staff, Hospital / Q000523:psychology*; D018802:Patient-Centered Care; D010371:Pediatric Nursing; D012529:Saudi Arabia
Family-Centred Care Questionnaire; Family-centred care; Mixed methods; Paediatric nursing; Saudi Arabia