Academic journal article Journal of Cultural Diversity

Parents Experiences of Their Child's Care during Hospitalization

Academic journal article Journal of Cultural Diversity

Parents Experiences of Their Child's Care during Hospitalization

Article excerpt

Abstract: Driven by the institutionalization of healthcare, and the attendant financial and regulatory issues, health caregivers now need to objectively define and assess the quality of care that is delivered to patients. Measures of quality care for children lag behind the measures that are utilized for adults. To date, little is understood about how quality care for children is identified and measured. Pediatric literature acknowledges, but has poorly studied, the relationship between health care providers and parents in providing and evaluating quality care for children. This paper applies qualitative descriptive theory that is informed by grounded theory to explore parents' experiences of the care they received for their hospitalized children. From a convenience sample of six parent participants, this study finds that parents experience childcare in a hospitalized setting in terms of four interconnecting, circular processes: (a) facing boundaries, (b) attempting to understand, (c) coping with uncertainty and (d) seeking reassurance from caregivers. The experiences shared by the parent participants in this study convey new meaning to the interactional nature of the parent-caregiver relationship. In particular, the researcher finds that parents use the parent-caregiver relationship to help cope with their child's condition, and this in turn influences the parents' sense that their and their child's needs are being met.

Key Words: Qualitative descriptive theory, grounded theory, child care, pediatric care, child hospitalization

Driven by the institutionalization of healthcare, and the attendant financial and regulatory issues, health caregivers now need to objectively define and assess the quality of care that is delivered to patients. Improving the quality of children's care is a goal for pediatric nurses, yet nurses lack understanding and consensus on how quality care for children should be identified and measured. Indicators of quality for pediatric care - distinct from those of adults - pose additional challenges, due to a child's dependency on his parents for access to care, as well as demographics, differences in developmental factors, differential epidemiology (unique patterns of health, illness and disability) and the unique goals of child health care versus adult care (Forrest, Simpson, & Clancy, 1997; Seid, Varni & Kurtin, 2000).

Most studies of quality care in nursing practice are oriented toward adult patients, and are conducted from a quantitative perspective. In the adult acute-care setting, quality of care has been conceptualized and measured primarily in the form of outcome data. Researchers typically quantify the outcome in the form of adverse patient outcomes; however, it would be inappropriate to generalize such data to children. In any case, adverse outcomes as a measurement variable may not be the best approach for studying quality care in children.

Caregivers have not developed the tools and methods to measure processes and outcomes of pediatric care as well as those for adult care (Beal et al., 2004; Forrest et al., 1997). The field suffers from a lack of public awareness, political support and research funding. Consequently, a significant disparity exists between adult and pediatric quality care measures, with measures for children lagging far behind measures for adults (Dougherty & Simpson, 2004; Kuhlthau, Ferris & Iezzoni, 2004; Shaller, 2004).

If researchers can identify the essential components and processes of quality pediatric care in the hospital setting, caregivers can provide practice-based nursing assessments and interventions to monitor and maintain quality pediatric care. Conceptually, the pediatric literature acknowledges, but has poorly covered, the importance of health care providers in establishing partnerships with parents to plan and evaluate the quality of hospital care for children. This research posits that the partnership between parents and health care providers provides an essential component in quality child care. …

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