Contemporary status of family-centred care in Saudi Arabian hospitals.

Background: Family-centred care (FCC) is a way of caring for children and their families within health services which ensures that care is planned around the whole family, not just the individual person, and in which all the family members are recognised as care recipients. In general, FCC emphasises the dynamic relationship between the family, the sick child and the health care providers to maintain the normality of the family’s life and to reduce the emotional stress for the sick child. Aims: studies that have examined nurses’ perceptions and practices of FCC have been mainly conducted in western countries. Little is known about perceptions and practices of FCC of paediatric nurses working in non-westernised countries. Thus this study is undertaken to explore FCC in the Saudi context from the perspectives of paediatric nurses and families. Design: a mixed methodology was utilised using explanatory sequential design. In the quantitative phase a convenience sample of 234 nurses and 101 family members were recruited and closed-ended questionnaires were administered. Participants were recruited from six hospitals in Jeddah city in Saudi Arabia. The qualitative phase involved 140 hours of non-participant observation for paediatric nurses in their practice and 10 face-to-face semi-structured interviews with them in one hospital. Results: the results of the quantitative phase showed that paediatric nurses generally believed that the identified elements of FCC are necessary to practise FCC. Nurses believed that they were implementing FCC elements in their current practice; however, there were statistically significant differences between their practices and perceptions of FCC elements. These results contrasted with families’ results that showed families were not satisfied with their current experience of the implementation of FCC. The qualitative results of observation data supported what has been identified in the quantitative phase. It agreed that the practice of FCC by paediatric nurses was limited. Indeed, the practice of nurses revealed that several elements of FCC were not consistently implemented. The results of the interviews showed that paediatric nurses had limited and superficial understanding of what FCC means as a model of care. This illuminates how their limited understanding of FCC reflected on their practice. However, they were in common agreement on the importance of families during hospitalisation and the significant role they play. Conclusion: paediatric nurses based in Saudi generally had a limited knowledge of the theoretical concepts underpinning FCC and they did not consistently implement FCC elements in their everyday practice. Saudi based families’ responses indicated awareness about the importance of FCC; however, they were less than satisfied with FCC provision, and indicated there is considerable scope for improvement. This study was seen as significant in filling the gap in literature by identifying the contemporary status of FCC in Saudi Arabia. Secondly, it provides the necessary insights into how paediatric nurses understand and practise FCC in the Saudi context. Its original contribution is two- fold. This research illuminates the application of FCC in a non-western country, a first at this level of depth; while the particular design application of mixed methods will be of interest to the research community