Negotiation of care for a hospitalised child: parental perspectives

The hospitalisation of a child impacts upon the family unit as a whole. Parents are expected to be with their hospitalised child and participate in care processes, but their role is ill-defined and the expectations of, and encouragement given, by staff are often inconsistent. Parental experiences relating to the negotiation of their child's care with nursing staff have not been previously investigated in an Australian tertiary paediatric setting. The purpose of this study was therefore to explore parental perceptions about their role in the care of their hospitalised child. A cross-sectional descriptive survey design was used to explore parent attitudes towards care practices while their child was an inpatient in a tertiary paediatric facility. Parental agreement was measured using a Likert scale across four categories relating to the establishment of communication, negotiation, care provision and attendance. Recurring issues and concerns identified through written narratives were grouped and analysed and the impact of demographic variables on parent responses evaluated. Participant responses supported the view that parents accept and value a family-centred approach to caring for their child. Open and effective communication, with the parent's inherent knowledge of their child being acknowledged and utilised, and with care provision expanded to include an extended family model, were highlighted. These study results have application throughout the spectrum of paediatric nursing care. They contribute to the literature, identifying gaps that may exist between nurse assumptions and parent attitudes and priorities.