UNIT 1 FAMILY CENTERED CARE

Question 1

What is family-centered care?

Answer 1

A partnership that develops between families and health care professionals

Focuses on the needs of all family members, not just the child’s needs

Question 2

Why family-centered care?

Answer 2

When parents stayed with their children
1. They were quieter, happier, and recovered sooner
2. They had decreased anxiety during procedures
3. Needed less pain medication following surgery
4. Coped better during hospitalization

Question 3

What are the 7 elements of family-centered care?

Answer 3

1. Family as the center
2. Collaboration
3. Sharing information
4. Respect for cultural diversity
5. Broad array of supports
6. Flexible systems of care
7. Appreciating families

Question 4

What are some benefits of having family as the center of care?

Answer 4

1. Families have important knowledge about their children
   
   • their child’s health condition
   • How their child responds to various actions/events/medications

Question 5

Who knows the child best?

Answer 5

The family– they know their child better than anyone– they are the “experts”

Question 6

True or false: Illness or injury affects all members of the family system even the siblings?

Answer 6

True– family system theory

Question 7

What are some examples of how we can uphold the element of family as the center?

Answer 7

1. Providing comfortable places for the family to stay at the hospital
2. Providing a place to stay away from the hospital for families who spend long hours at the hospital or travel long distances
   
   • Ronald McDonald house
3. Encourage parents to participate in care provision
4. Encourage them to be with their child during procedures & treatments

Question 8

What is collaboration in family-centered care?

Answer 8

Seeking a “partnership role

Question 9

How is collaboration characterized in family-centered care?

Answer 9

1.Communication
- Establishes rapport
- Respectful
- Avoids medical jargon/terminology
- Asks- open-ended questions
- Summarizes/reflects
- demonstrates empathy
- non-judgmental attitude
2. Active listening- Talking is good but we need to make sure we take time to actually hear what our patients are telling us
3. Negotiation- adapting our schedule to meet their needs but to also accomplish our tasks

Question 10

What are some examples of collaboration in family centered care?

Answer 10

1. When communicating, remember to
   
   • understand the patient/family perspective. “why is her lasix pink today, it is usually yellow…. anytime a patient questions double check yourself regardless if you are 100% sure
2. Ask the question “how does your child look today”
   
   • we can only assess what we see on the days that we are hear… that is why its helpful to ask parents since they are with the patient almost always
3. Include parents in decision making process
   
   • multidisciplinary meetings or care conferences
   • bedside shift report/intradisciplinary rounds
4. Evaluating care and health care professionals involved in their care
5. Family advisory councils.

Question 11

What is sharing information in family-centered care?

Answer 11

1. Sharing complete and unbiased information to the family (including siblings at a developmentally appropriate level)

Question 12

What is Empowerment in family-centered care?

Answer 12

1. The interaction of professionals with families in a way that the family maintains or acquires a sense of control of their family lives
2. Once we assess the parents extent of knowledge of skills we can start to Acknowledge positive changes from fostering their strengths, abilities and actions.

Question 13

What are some examples of sharing information?

Answer 13

Sharing information about
1. Diagnosis- Doctors need to share initial diagnostic information but we can educate further when topics are not understood

2. Equipment- for example explaining what a pulse ox is for and what it monitors and what too look for and expect when the machines noise
3. Lab Results- as long as it not diagnostic we can share lab values and let them know that the doctor should reach back out with a plan if needed
4. Medication- remember to keep things simple when teaching children
5. routines (e.g., mealtimes, activities)
   
   • snack time is important
6. Eliciting vital information about their child’s response to
   
   • pain
   • medication- ask about past medications sometimes we have to adjust medication based on information given
   • illness

Question 14

What is respect for cultural diversity in family-centerd care?

Answer 14

Understanding cultural and religious beliefs- respect and sensitivity and understanding coping differences

Question 15

What does Texas nurse association rule 217.11 state?

Answer 15

Standards specific to registered nurse:
“provide, without discrimination, nursing services regardless of age, disability, economic status, gender, national origin, race, religion, health problems, or sexual orientation of the client served”

Question 16

What are some examples of respecting cultural diversity in family-centered care?

Answer 16

1. Providing translators/interpreters
   
   • written information should e in the families primary language
2. Learning about a family’s cultural healing practices & religious beliefs
3. Explaining terminology

Question 17

What is broad array of supports for family centered care?

Answer 17

Families need an adequate support system and appropriate resources

Question 18

What are some examples of utilizing broad array of supports in family-centered care?

Answer 18

1. Parent-to-parent or family-to-family support
   
   • parents have baby with congenital defect paired with a family that has went through similar events with a child with the same congenital defect
2. Mentors/navigators for chronic conditions
   
   • assigned at discharge… watch patients as they discharge to ensure that they have everything they need… meds, rides, resources to help manage health conditions… asthma and diabetic navigators are super common in the PEDI world.
3. Group support (for parents or child/adolescent)
   
   • anger management groups
   • parent support groups
   • sibling support groups
   • asthma camps, diabetic camps and other diagnosis-based camps (may have a scholarship available)

Question 19

What is flexible systems of care in family-centered care?

Answer 19

1. Choice- maintain routines established by the family
2. Flexibility- remember need for respite

Question 20

What are some examples of using flexible systems of care in family-centered care?

Answer 20

1. flexible scheduling of clinic visits (after 5PM and on Saturdays)
2. Alternatives such as satellite clinics at school that have a NP or PA that can see the child right away

Question 21

What is appreciating families in family-centered care?

Answer 21

1. Facilitate “normalization”
2. This refers to the efforts family members make to create a normal family life
   
   • schoolwork
   • hobbies & recreational activities
   • independence

Question 22

What are some examples of appreciating families in family-centered care?

Answer 22

1. Introducing ourselves
2. Never “assume” who the parents are
3. Asking parents their names and how they wish to be addressed
   
   • avoid terms such as honey, sweetie, mom
   • include siblings
4. Being sensitive to terminology

Question 23

Family is defined as

Answer 23

Whatever the patient considers it too be

Question 24

What is family systems theory?

Answer 24

The family is a system that continually interacts with its members and the environment

Emphasis is on interaction between members

Problems do not lie in any one member but in the type of interactions used by the family

Question 25

Family systems theory makes the ____ the “patient” and focus of care?

Answer 25

Family

Question 26

True or False: family units do not have a high level of adaptability?

Answer 26

False– they have a high level of adaptability

Question 27

What are the major influences on adaptability?

Answer 27

The major influences on adaptability are the imaginary lines that exist between the family and the environment, or the boundaries

Question 28

What is the overall major thing to know about the family systems theory?

Answer 28

Interactions between family members
&
if those family members have boundaries or boundaries outside of the family

Question 29

What is the family stress theory?

Answer 29

Families encounter stressors, both predictable and unpredictable

Question 30

Multiple stressors in a short period of time can cause what in the family?

Answer 30

Can overwhelm the families ability to cope, which can lead to crisis

Question 31

What does the nuclear family consist of?

Answer 31

Consists of a married couple and their biologic children

Question 32

What does the blended or reconstituted family consist of?

Answer 32

Includes at least one stepparent, stepsibling, or half sibling

Question 33

What does the extended family or household include?

Answer 33

Includes at least one parent, one or more children, and one or more members (related or unrelated) other than a parent or sibling
- for example, grandparents living with a child who is a young parent and their grandchildren

Question 34

What is a polygamous family?

Answer 34

Refers to multiple wives (polygyny) or rarely, multiple husbands (polyandry)

Question 35

What is a communal family?

Answer 35

• Share common ownership of property
• They provide security for children & share homemaking & childrearing function

Question 36

What are the 3 types of parenting styles?

Answer 36

1. Authoritarian or dictatorial
2. Permissive
3. Authoritative or democratic

Question 37

What is a authoritarian or dictatorial parenting style?

Answer 37

1. Control child’s behavior and attitudes through unquestioned rules and expectations
2. They expect the child to follow the rules rigidly and unquestioningly

“do it because I said so”

Question 38

Pros and cons of an authoritarian or dictatorial parenting style?

Answer 38

CON
1. can result in rigidly conforming behavior in the children who tend to be sensitive, shy, self-conscious, and submissive

PRO
1. More likely to be courteous, loyal, honest and dependable

Question 39

What is it important for a parent who uses the authoritarian/dictatorial parenting style to remember to prevent possible behavior issues later on

Answer 39

Make sure you still show affection to your child… they still need to have their emotional needs met.

Question 40

For Authoritarian parenting style to work what must happen

Answer 40

Takes close supervision and affection
- if not, it can lead to defiant and antisocial behavior

Question 41

What is permissive parenting style?

Answer 41

Parents exert little or no control over their children’s actions

allow children to regulate their own activity as much as possible

Parents aren’t ‘role-models’ but rather a resource

VERY FEW RULES, ALMOST NO PUNISHMENT

Question 42

What is the authoritative parenting style?

Answer 42

Combine practices of both authoritarian and permissive

Direct children’s behavior and attitude by explaining the reason for the rules and negatively reinforcing deviation

firm but fair and consistent

Question 43

What are the pros and cons of authoritative parenting style?

Answer 43

PRO
1. Kids feel encouragement, understanding, and security from parents (security is very important)
2. Control is focused on the issue, not on withdrawal of love or fear of punishment