Running head: FCC INTEGRATIVE REVIEW 1

Integrative Review: Family-Centered Care

Kaitlin Evans

Bon Secours Memorial College of Nursing

November 21, 2016

Nursing Research-4122

I Pledge
FCC INTEGRATIVE REVIEW

Abstract

The objective of this integrative review is to evaluate literature regarding family-centered

care (FCC)/family-centered rounding (FCR) and the effects it has on pediatric health outcomes.

Involving families in the care of the child and establishing trusting relationships with the patient

and family can have instrumental effects in caring for children. Implementing, understanding,

and educating staff and families on FCC/FCR is vital for the benefits of this type of care to be

fully utilized. Two databases were used to locate applicable research articles. There were

limitations to this review due to the writers lack of experience with integrative reviews and the

deficiency of articles relating to the subject. Overall, the five articles chosen for the review

depicted positive health outcomes for both the family and children using FCC/FCR. Future

research is needed to address FCC/FCR improvements in quality of care and actual pediatric

patient outcomes.
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Introduction & Background

Family-centered care (FCC) is the involvement of family members in the care of their

loved one. The health care team works together with the family to develop health care plans,

incorporate family feedback, involve the family in care, provide education, and build a trusting

relationship with the family and the patient. FCC has been defined as a collaborative approach

to health care delivery that regards the family perspective as central to health care decision-

making; a strong family-provider relationship is the foundation of FCC, with key principles

including respect, trust, information sharing, collaboration, and willingness to negotiate (Kuo,

Bird, & Tilford, 2011, p.794-795). The aim of this integrative review was to gather pertinent

evidenced based practice (EBP) literature related to the writers PICOT question; does the use of

FCC for acutely ill pediatric inpatients reduce the risk of hospital readmission compared to those

without FCC? The researcher had great difficulty in finding EBP literature from within five

years to assist with the study. Family-centered rounds (FCR) are another approach to care

involving the patient/family in plan of health care. This method involves the family and their

opinion during medical rounds, at the bedside, and with the medical team. Due to the lack of

information, the researcher altered the PICOT question to; does the use of FCC/FCR for inpatient

pediatrics provide increased health care satisfaction as compared to not using FCC/FCR? The

aim for the integrative review was to bring awareness to the positive effects FCC/FCR can have

on pediatric health outcomes.

Design & Search Methods

Five evidence-based practice research articles were utilized for this integrative review.

EBSCO Discovery Services for Bon Secours Health System and PubMed, were the two

databases utilized for finding the articles. The writer used specific set criteria to locate articles
FCC INTEGRATIVE REVIEW

related to the topic. Key terms used in the search included, family-centered care, family-

centered rounds, patient-centered care, pediatric, nursing, health care outcomes, parental

role, qualitative study, quantitative study, and physician/patient relationship. EBSCO

Discovery Service yielded 10,194 articles and PubMed yielded 60 articles.

To further narrow the search on the articles, a time frame was set for articles from 2011 to

2016. The author also selected for the search to only include academic journals. Most research

related to the PICOT question was presented in literature and integrative reviews, making it

challenging for the writer to find quality research articles related to the PICOT question, within

the time frame, and with actual clinical queries. After trying various search terms and criteria the

author was able to locate five articles. This review includes three qualitative and two

quantitative research studies related directly to the PICOT question.

Findings & Results

The results and findings of the research identified room for improvement, an increase in

research, and positive perspectives relating to FCC (Ames, Rennick, & Baillargeon, 2011;

Coyne, 2015; Kuo et al., 2011; Kuo, Sisterhen, Sigrest, Biazo, Aitken, & Smith, 2012; Rostami,

Hassan, Yaghmai, Ismaeil, & Suandi, 2015). Tables 1-5 include a summary of all the research

obtained in the five articles. The review was structured based on the categories:

parent/child/nurse perspectives and FCC versus non-FCC.

Parent/Child/Nurse Perspectives

Two of the qualitative studies looked to gain insight on the parent, child, and nurse

perspectives of FCC/FCR. Only one article identified using the grounded theory design to

conduct the research gained from the parent participants. Ames et al. (2011) explored parents

perception of their role in the pediatric intensive care unit (PICU). During the interpretive study
FCC INTEGRATIVE REVIEW

seven parents of children in the PICU were interviewed using in-depth semi structured

interviews. Three roles were identified by parents who had children in the PICU: being present

and participating in childs care, forming a trusting partnership with the PICU team, and being

informed of childs treatment plan and progress (Ames et al., 2011, p.143). The results

indicated parents believed participation in their childs health care was beneficial to providing

the individual care they needed. By obtaining this information more effective and supportive

ways to incorporate FCC into pediatrics can be implemented. Parents were able offer more of a

personal insight than medical staff would have knowledge of; this led seven parents who

participated in the study to note it was of fundamental importance to participate in their

critically ill childs care (Ames, 2011, p.148).

Coyne (2013) used grounded theory to explore parents perspectives on how FCC was

endorsed in a pediatric ward. Using open-ended questions and a computerized qualitative data

analysis program, QSR NVivo8, transcription of the personal interview information was

obtained. Results were indicative of four key themes: expectations; relying on parents help;

working out roles; and barriers to FCC (Coyne, 2013, p.796). This article identified the amount

of care and work parents contribute to their childs care and their concern for neglect of care if

they were not present. This indicated to the writer how parents view of FCC is not always

focused on contentment, but also on the critical and imperative aspects included in FCC. This is

important to note in order to make advances in health care for children. Parent, children, and

nurse participants identified barriers to receiving effective FCC, stating over-reliance of parents

and lack of communication were the two main barriers to effective FCC (Coyne, 2013, p.803).

Nurses also identified proper education, staffing, and managerial support were critical in

providing sufficient FCC.

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FCC vs. Non-FCC

Kuo et al. (2011), used Anderson/Aday health service utilization model to examine the

impact of FCC on specific health care service outcomes for children with special needs. A

National Survey of Children with Special Health Care Needs (NS-CSHCN) was used to help

with obtaining a large sample size of 38,915 participants, to acquire data regarding their personal

experience with FCC. Kuo et al. (2011), used an index of FCC to construct five questions

concerning how well the medical providers met family concerns: enough time spent with the

child, listening to their concerns, understanding the familys values, valuable information being

relayed to the family, and including parents as partners of care. Results indicated fewer

problems when FCC was implemented. FCC allowed for less family burden, financial strains,

caregiver burden, emergency room visits, and an increase in coordination of care, frequency of

doctor appointments, and unwavering health status of the child (Kuo et al., 2011). Therefore, it

is imperative to incorporate FCC in pediatrics to reduce family burden and maintain the childs

health. Kuo et al. (2011) noted FCC needs to be included in health reform efforts, education on

the subject and implementation needs to be taught to all health care providers, and FCC needs to

be incorporated into health care policies.

Kuo, D. Z. et el. (2012), conducted a qualitative study examining the association of

family-centered rounds (FCR) with family experience and health services. A sample of 140

families was eligible for the study and divided into two teams, FCR and non-FCR. Using Stata

10 and sensitivity analysis, data regarding the families experience with or without FCR was

obtained. A few of the questions included in the family outcome surveys were: parent had

option to discuss care plan with team, consistent medical information, doctors made me feel like

partner, and parent participated in bedside meeting (Kuo, D. Z. et al. 2012, p.303). As a result,
FCC INTEGRATIVE REVIEW

Kuo, D. Z. et al. (2012) received positive outcomes associated with FCR. There was a positive

response from participants included in FCR, indicating improved family experience and

satisfaction with care as opposed to those without FCR. Having the option of discussing care

plans, being included in decisions, and constantly being made aware of medical information,

positively affected the familys opinion on FCR. Kuo, D. Z. et al. (2012), acknowledged

limitations in the sample and recognized future research needs to be conducted to appreciate the

exact role of families in FCR.

Rostami et al. (2015), conducted a quasi-experimental study to determine the effects of

FCC on the satisfaction of parents of children hospitalized in Chaloos, Iran. Seventy

hospitalized children were split into two equal groups; control group (routine care) and

experimental group (FCC). The Institute of FCC family satisfaction survey was used along with

the Likert scale to obtain answers to a 47-item questionnaire cataloging participatory support,

educational support, and psychological support. Paired sample t-test and Wilcoxon test were

employed to compare family satisfaction before and after interventions. Results were staggering.

FCC had a significantly higher satisfaction rating than those without FCC. The results after

implementation of FCC showed significant increases in satisfaction, thus indicating the vital

impact practicing FCC has on pediatric units. FCCs philosophy and incorporation of holistic

care for the patient and family members created an environment for optimal healing and trusting

relationships with medical staff. Rostami et al. (2015) pointed out it changes the concept of

conducting interventions on the child and family to performing intervention with the family

(p.1079). Providing and incorporating this plan of care can have substantial effects on the childs

medical outcome.

Discussion & Implications

FCC INTEGRATIVE REVIEW

The information obtained from this research suggests more focus on education to medical

staff, nursing students, and families. Families need to know about FCC/FCR, what it involves,

how it works, and its purpose in the medical setting. Ames et al. (2011) points out in order for

FCC/FCR to be utilized optimally, parents perspectives must be established to help direct

nursing interventions and understand their perspectives of what good care consists of. Coyne

(2013) noted the importance of proper training, resources, and support for nurses was needed in

order to best deliver FCC. Families felt less burden, more support, fewer unmet needs, and

inclusion of care plans when involved in their childs healthcare needs; further reiterating the

importance of FCC/FCR (Kuo et al., 2011 & Kuo D. Z. et al., 2012). Rostami et al. (2015)

stressed familys satisfaction with care was when parents were actively involved in the medical

decision-making.

The results of the research articles in the review undoubtedly recognized a positive effect

on pediatric patient outcomes related to FCC/FCR. Patients, families, and medical staff are

able to work together on a care plan and utilize each others expertise to create the best possible

outcome for the child. The research in this review supports the PICOT question identified by the

writer. While some articles related to: family perspectives, FCR, or the critically ill patient, all

connected to the involvement of family with medical staff in the care of the child. The evidence

behind using FCC/FCR is exponential to health care, however, limited. In obtaining further

research on particular benefits of FCC/FCR on pediatric health outcomes and/or the impact of

FCC/FCR on readmission rates could offer invaluable information for how health care could be

implemented in the future.

Limitation & Conclusion

FCC INTEGRATIVE REVIEW

In conducting this integrative review, many limitations needed to be addressed. FCC has

not been a pressing topic of research in the past five years, making it difficult to find information

relevant to the topic. The availability of studies directly related to FCC and pediatrics was

extremely limiting. It should also be noted that the author did not have any previous experience

in writing or conducting an integrative review.

Major limitations within the research were included in the articles and acknowledged by

the writer. Coyne (2011) identified small sample size, female gender, and only Irish middle class

participants, to be limitations in the study. According to Ames et al. (2011), limitations in the

study regarding parents perception of parental role in the PICU were not as thorough or ample

as it could have been. Ames et al. (2011), also recognized limitations with sample size,

admission status (1st or 2nd time admit to PICU), length of time in the PICU, observational

component, and suggested grounded theory methodology for future research on the topic. Kuo et

al. (2011), data was cross-sectional and therefore, could not fully establish bases or means of

optimal care. Family members reported the survey results, no particular physician were

examined and the family-centered index does not score particular actions taken by physicians,

depending instead on family-centeredness (Kuo et al., 2011).

This integrative review highlights the validity FCC has on the family/parent and the

pediatric inpatients health-care outcome. The research was fairly consistent across the studies,

indicating the application of FCC/FCR in pediatrics has a positive effect on the parents and the

patients outcome. Therefore, the use of FCC/FCR for inpatient pediatrics provides increased

health care satisfaction as compared to not using FCC/FCR. Education and training for medical

professionals on the benefits and practice of FCC/FCR is imperative to providing and achieving

optimal health care.

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References

Ames, K. E., Rennick, J. E., & Baillargeon, S. (2011). A qualitative interpretive study exploring

parents perception of the parental role in the paediatric intensive care unit. Intensive and

Critical Care Nursing, 27(3), 143-150. doi:10.1016/j.iccn.2011.03.004

Coyne, I. (2015). Families and health-care professionals perspectives and expectations of

family-centered care: hidden expectations and unclear roles. Health Expectations, 18(5),

796-808. doi:10.1111/hex.12104

Kuo, D., Bird, T., & Tilford, J. (2011). Associations of Family-Centered Care with Health Care

Outcomes for Children with Special Health Care Needs. Maternal & Child Health

Journal, 15(6), 794-805. doi:10.1007/s10995-010-0648-x

Kuo, D. Z., Sisterhen, L. L., Sigrest, T. E., Biazo, J. M., Aitken, M. E., & Smith, C. E. (2012).

Family Expereinces and Pediatric Health Services Use Associated with Family-Centered

Rounds. Pediatrics, 130(2), 299-305. doi:10.1542/peds.2011-2623

Rostami, F., Hassan, S. T., Yaghmai, F., Ismaeil, S. B., & Suandi, T. B. (2015). Effects of family-

centered care on the satisfaction of parents of children hospitalized in pediatric ward in

Chaloos in 2012. Electronic Physician, 7(2), 1078-1084. doi:10.14661/2015.1078-1084

 FCC INTEGRATIVE REVIEW
First Author
(Year)/Qualifications
Background/Problem
Statement
Conceptual/theoretical
Framework
Design/Method/
Philosophical
Underpinnings
Sample/ Setting/Ethical
Considerations
Major Variables Studied if
appropriate
Measurement Tool/Data
Collection Method
Data Analysis
Findings/Discussion
Appraisal/Worth to practice
11
Table 1- Qualitative and Quantitative Article Evaluation Table
Ames (2011)- Pediatric Intensive Care Unit, The Hospital for Sick Children, Toronto, Ontario, Canada
Explore parents perception of their role in the pediatric intensive care unit (PICU)
Not identified, however noted a grounded theoretical framework would have been beneficial
Qualitative interpretive study
Interviews of parents personal experiences in the PICU setting of their participation in care and its influence on childs wellbeing
7 parents of children (infant-17yrs.) in tertiary PICU care
Canadian university affiliated pediatric hospital
Parents whose child was about to be discharged from the PICU and spoke English were interviewed
EBR approved
Witten informed consent obtained by parents before structured interviews
Wide range of child diagnosis and age
Small sample size
In-depth semi structured interviews were conducted using a set of interview questions
This allowed parents personal views
Follow up questions and probes were used to explore significant issues raised by parents
Interviews were audio recorded and field notes were taken, interviews lasted between 25-60min.
Constant comparative method was used to analyze interviews
Interview audio tapes were transcribed verbatim
Open & axial coding was used for all textual data and grouped into themes by the research team
Three roles were identified by parents of children in PICU: (1) Being present and participating in childs care, (2) Forming a
trusting partnership with PICU team, and (3) Being informed of childs treatment plan and progress
Parental participation in the care of a child in the PICU is very beneficial in providing individualized care
Having parents participate in care and educating them on procedures, medications, etc. help the parents trust the medical staff and
build relationships that could optimally impact the patients care
Insight into the parents perception of providing care allows medical institutions to better facilitate using family-centered care and
how it can be incorporated into care for pediatric patients
Future research is still needed on the actual outcome of child related to parental involvement of care
Having parents included in care can help provide invaluable insight to the child
 FCC INTEGRATIVE REVIEW
First Author
(Year)/Qualifications
Background/Problem
Statement
Conceptual/theoretical
Framework
Design/
Method/Philosophical
Underpinnings
Sample/ Setting/Ethical
Considerations
Major Variables Studied
Measurement Tool/Data
Collection Method
Data Analysis
Findings/Discussion
Appraisal/Worth to practice
First Author
(Year)/Qualifications
12
Table 2- Qualitative and Quantitative Article Evaluation Table
Coyne (2013)- PhD, Professor, Head of Childrens Nursing & Research, School of Nursing & Midwifery, Trinity College Dublin,
Ireland
Implementation of family-centered care (FCC) has been a challenging worldwide
Investigate how family-centered care was endorsed from families and nurses perspectives
Grounded theory
Descriptive qualitative
Grounded theory method
Explore parents, children and nurses perspectives & experiences of family-centered care
Understand how roles are negotiated within the hospitals in pediatric units
18 children (7-16yrs.), their parents, & 18 nurses
2 Childrens Hospitals and 1 Childrens unit in a large general hospital in Ireland
ERB approved x3
Voluntary, informed written consent from participants
Expectations, participation in care, roles, preferences, relationships, & types of care provided by participants
Audio-recorded interviews
Computerized qualitative data analysis program QSR NVivo8 was used after transcribing personal interviews verbatim
Open-ended questions
Open coding, memo-writing, category development and constant comparison of data
Three data sets: children, parents, & nurses were analyzed together and then within the set for comparison
Once final themes were adopted, two members from research team checked for congruency & agreement
4 key themes: expectations, relying on parents help, working out roles, and barriers to FCC
Parents wanted to participate in the care for their child and stated concerns for their child if they were not present due to RNs busy
role on the unit
Children wanted their parents with them for support but distinguished between parental roles and those of the nurse
Nurses liked FCC and expected parents to be involved. They identified issues with documentation and no formal assessment aids.
It is essential to have communication, information, and expectations to successfully implement FCC
RNs recognized need to document parent involvement and RN managers need to set quality standards, including proper staffing so
FCC can be beneficial to child, parent, and nurses.
RNs need proper training, resources, and staff support to implement and deliver optimal FCC
More research is needed to obtain parent and child satisfaction/outcome related to FCC
Table 3- Qualitative and Quantitative Article Evaluation Table
Kuo (2011) MD, Centered for Applied Research and Evaluation, Department of Pediatrics, College of Medicine, University of
Arkansas for Medical Sciences, Little Rock, AR
 FCC INTEGRATIVE REVIEW
Background/Problem
Statement
Conceptual/theoretical
Framework
Design/Method/Philosophical
Underpinnings
Sample/ Setting/Ethical
Considerations
Major Variables Studied, if
appropriate
Measurement Tool/Data
Collection Method
Data Analysis
Findings/Discussion
Appraisal/Worth to practice
13
Examine the relations between family-centered care (FCC) and specific health care service outcomes for childrens with special
needs
Conceptual framework: using predisposing, enabling, and need characteristics from
Use of Anderson/Aday model-describes variance in health service use, health status, and family burden by multiple factors
No method is identified, however reader identifies article as quantitative due to study design and data
Cross-sectional survey of a nationally representative sample of Children with Special Health Care Needs (CSHCN)
National Survey of Children with Special Health Care Needs (NS-CSHCN) is a module of the National Immunization Surveythis
is conducted annually by National Center for Health Statistics and uses computer-assisted telephone interviews on a random
national population sample
Household sample randomly selected from telephone numbers from National Immunization Survey sampling: screened children
<18yrs. with special health care needs
Final sample 40,723 families, 38,915 had data on FCC
Child had to have 1 out of 5 qualifications to be included in survey and expect to last longer than 12months
Telephone interviews were conducted with informed guardian/parent consent
Data collected between April 5, 2005 and February 5, 2007
Institutional Review Board approved
In accordance to Anderson/Aday model: age, gender, race/ethnicity, census region, poverty level, educational level of household,
functional status of child, primary language of household, usual source of care, usual source of preventive care, and diagnosis
Index of FCC- constructed from 5 questions regarding how well health care providers met family concerns
Dependent variables were chosen from measures in the NS-CSHCN-all related to outcomes and were consistent with past reports
and categorized into three domains; family burden, child health, and health care resource use
Chi-square- used to describe the correlation between predisposing, enabling, and need characteristics with FCC
Logistic regression- explored the association of FCC with child health care, family burden, and health care resource use
Propensity scoring, this matched with regression analysis can better account for selection bias based on observed variables than an
unmatched regression analysis
Families with FCC reported fewer problems w/ referrals, direct caregiving hours, financial burdens, ER visits, and less chance of
needing special education. They also reported more help with care coordination, greater chance of receiving health care services,
increased MD visits, and positively associated FCC w/ stable child health status.
3 strengths: (1.) Conceptual index, more complete assessment of family experience w/ FCC, (2.) propensity matching to minimize
selection bias, (3.) large national sample of children with special healthcare needs
Limitations: survey results are reported by the parents without external validation, no corrections were applied for multiple
comparisons, due to the exploratory nature of the analysis
Primary care pediatricians reported less comfort with behavioral conditions, which could translate to less effective delivery of care
Imperative in outlining the importance of FCC in pediatrics to reduce family burden and stable child health
FCC needs to be included in health reform efforts, including provider education and healthcare policies to incorporate families at
all levels of healthcare
FCC may have greatest effects on behavioral and psychological needs
Table 4- Qualitative and Quantitative Article Evaluation Table
 FCC INTEGRATIVE REVIEW
First Author
(Year)/Qualifications
Background/Problem State.
Conceptual/theoretical
Framework
Design/Method/Philosophical
Underpinnings
Sample/ Setting/Ethical
Considerations
Major Variables Studied
(and their definition), if
appropriate
Measurement Tool/Data
Collection Method
Data Analysis
Findings/Discussion
Appraisal/Worth to practice
14
Kuo (2012) MD, Centered for Applied Research and Evaluation, Department of Pediatrics, College of Medicine, University of
Arkansas for Medical Sciences, Little Rock, AR
Examine the association of family-centered rounds (FCR) with family experiences and health service use
Not identified
Qualitative Study
Prospective cohort study comparing families with a child admitted to general pediatric inpatient services with and without FCR
training
Data was obtained by in-person interviews, follow-up phone interviews greater than 1 week post discharge, and medical record
review
FCR was implemented on a general pediatric unit at Arkansas Childrens Hospital
Inclusion criteria: families of patients 10yrs. Or older, admit from ED or outpatient clinic, expected stay longer than 24hrs. and less
than 30 days, expected home discharge, primary care-giver of child present, and speak English
FCR team: 99 families eligible, 70 enrolled, and 49 follow-up phone survey
Non-FCR team: 104 eligible, 70 enrolled, and 48 follow-up phone survey
Approved by University of Arkansas for Medical Institutional Review Board
Informed consent from eligible family member
$10 gift card mailed to each family who completed the follow-up phone survey
FCR team had training and non-FCR team conducted rounds at their own discretion
Independent variable: assignment to an FCR team
Covariates: parent age, child age, parent relationship to child, parent race/ethnicity, parent-reported reason for admission, and
presence of special health care needs status
To distinguish between FCR and non-FCR teams, an index of FCR was developed through literature review and adapted from an
unpublished checklist created by one of the study authors
Propensity score-matched analytic model with length of stay covariates because of hospital charges
One-to-one matching without replacement was conducted with psmatch2 module in Stata 10 (Stata Corp, College Station, TX)
All analyses were performed with Stata 10
Sensitivity analyses examined association of FCR with study outcomes
90% of FCR respondents were eligible and 56% of non-FCR team respondents
Positive outcomes were reported with FCR, including; option of discussing the care plan, participation in decision making, and
constant medical information
Families with FCR felt physicians listened to them & their concerns, showing respect for them
FCR families also reported higher rates of clear terms & a sense of partnership
No significant difference was made between FCR & Non-FCR concerning time of discharge, medications used, or hospital charges
Limitation: findings only represented 1 general pediatric inpatient service in a large academic childrens hospital. This may not be a
fair representative of patients because of those excluded by criteria or refusal
Future investigation should be conducted to further understand the exact roles of families in FCR
FCR are associated with improved family experiences, particularly overall satisfaction with care & clear understanding of care
plan. This ties into Family-centered care and how the families are involved in the care of their children and the benefits to their
health outcomes.
 FCC INTEGRATIVE REVIEW
First Author
(Year)/Qualifications
Background/Problem
Statement
Conceptual/theoretical
Framework
Design/Method/Philosophical
Underpinnings
Sample/ Setting/Ethical
Considerations
Major Variables Studied, if
appropriate
Measurement Tool/Data
Collection Method
Data Analysis
Findings/Discussion
Appraisal/Worth to practice
15
Table 5- Qualitative and Quantitative Article Evaluation Table
Rostami (2015)- Ph.D. Candidate of Community Health, Community Health Unit, Department of Medicine, Faculty of Medicine &
Health Sciences, Department of Nursing, Faculty of Nursing & Midwifery, Islamic Azad University, Chaloos Branch, Chaloos, Iran
Determine effects of family-centered care (FCC) on the satisfaction of parents of children hospitalized in a the pediatric ward at
Razi Hospital in Chaloos, Iran in 2012
None identified
Quantitative Study
Quasi-experimental study done in 2012 pediatric ward at Razi Hospital in Chaloos, Iran
Convenience sampling method used
70 hospitalized children, ages 1-3, suffering from diarrhea, vomiting, or pneumonia
divided into 2 equal groups: control group (routine care) and experimental group (FCC)
informed permission was obtained from parents and process of study was explained
No IRB noted
used principle of homogeneity (same hospital, same ward, same facilities and situation, and same pediatrician) in the sampling of
variables to minimize biases
participatory support, educational support, and psychological support
Institute of FCC family satisfaction questionnaire was used--47 items that can be answered on a five-point Likert scale (ex.
0,1,2,3,4, and 5)
Rostami translated to Persian language, it was then sent to Iranian professional editor & translator for validity & accuracy
The Chronbachs alpha test: used to determine reliability of questionnaire
Each childs parent completed two-part questionnaire: 1st part: socio-demographic information and 2nd part: 30 questions related to
satisfaction of parent of care child received
Principle axis factor analysis with varimax rotation was calculated to assess the underlying structure of the 30 items in the FCC
questionnaire
Items were designed to index three constructs: participatory support(8 questions), educational support (10 questions), &
psychological support (12 questions)
SPSS Statistics 14 software used to analyze data, p<0.05 was considered significant
Descriptive statistics, means, standard deviations, and frequency tables were used to measure the extent of parents satisfaction
concerning the importance of FCC
Paired sample t-test: used to compare the means of family satisfaction before and after intervention
Wilcoxon test (non-parametric): used to compare each item before and after intervention
Scores related to paired sample t-test findings: Participatory satisfaction had a significant increase from 8.71 to 21.20, Educational
satisfaction increased significantly from 7.46 to 28.06, and psychological support increased significantly from 3.83 to 33.86
Results indicated using FCC parents were significantly more satisfied with the care provided
Family involvement is a critical component of intervention efforts as shown by the makings of participatory support, educational
support, and psychological support
Its notable that FCC may lead to increased quality of care and should be included in educational programs for nursing staff of
pediatric units
When family members established relationships with the medical team, were included in their childs plan of care, and part of the
decision making process; parents reported being more satisfied with their childs medical care
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