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Overview of Family-Centered Care

Family-centered care is a service delivery philosophy and approach that respects the rights, roles, and abilities of family members. Services are provided through a collaboration with the family and child to support their goals and promote their well-being and quality of life. Physical therapists have identified the need for professional and postprofessional education to foster competency in collaborating with families (Iversen, Shimmel, Ciacera, & Prabhakar, 2003). Although professionals value family-centered care, there can be challenges when implementing this approach (Bruce et al., 2002; Espe-Sherwindt, 2008).

The purpose of this chapter is to provide a foundation for family-centered care and an introduction to contextual issues regarding family ecology to support physical therapists in their interactions and provision of services with children and families. Family-centered care, though developed most prominently in pediatrics, is not restricted to the pediatric specialty area; it is a life span approach (Kokorelias, Gignac, Naglie, & Cameron, 2019). In addition, family-centered care is not restricted to one practice setting. Family-centered care is a standard of practice for both hospital and community-based services (Kuo et al., 2012). Family-centered care provides an opportunity for a preventive and supportive approach to wellness across the life span and along the entire continuum of care.

Theories and Frameworks

The foundation for family-centered care is based on the synthesis of many theoretical frameworks. Table 4.1 provides a summary of the key suppositions of the theories and examples of how the theories may be applied to family-centered care. The fundamental premise of family-centered care is that a person does not exist in isolation but functions within a family, as well as within larger and more complex social systems. Social systems, including the family unit, influence the function of that person, and that person subsequently influences the function of the systems to which he or she belongs. This proposition is central to systems theory. The family systems theory views individual and family functioning as an interactional dynamic process (Johnson & Ray, 2016). The transactional model of development emphasizes the reciprocal relationship between the child and caregiving environment and stresses the importance of an appropriate match between the child and the environment. A supportive environment may minimize the effects of biological risks (Sameroff & Chandler, 1975; Sameroff & MacKenzie, 2003). The child’s characteristics and the environment together influence functional outcomes. The ecological model of human development discusses the role that larger social systems have on the function of the family unit (Bronfenbrenner, 1977). Support from social networks and the political and economic culture can influence how a family interacts with and cares for their child. Family-centered care in pediatrics is based on the philosophy that the family plays the central role in the life of a child and the needs of children can best be met by ...

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