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Linda Shields


Family-centred care is a ubiquitous term in paediatric health facilities. It means that an admitted child can never be treated as a single individual patient, that the family is the unit of care, as the parents and family are central to the child’s wellbeing, especially during traumatic experiences. There is no rigorous evidence that family-centred care works, but qualitative research is drawing out some grave concerns with how it is implemented. Part of the problem is that there are many descriptions of family-centred care, but few definitions, and some of its component parts may be in place in some health services without the whole model being in place. This causes confusion amongst health professionals and parents and children, and makes it impossible to test in a randomised controlled trial. This paper discusses these problems and suggests that a new model, child-centred care, may be a better model of care for children.


family-centred care, children, parents

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Shields, L., Pratt, J., Davis, L.M. & Hunter, J. (2007). Family-centred care for children in hospital. Cochrane Database of Systematic Reviews Issue 1. Art. No.: CD004811.

Shields, L., Zhou, H., Pratt, J., Taylor, M., Hunter, J. & Pascoe, E. (2012). Family-centred care for hospitalised children aged 0-12 years. Cochrane Database of Systematic Reviews Issue 10. Art. No.: CD004811..

Trivette, C.M., Dunst, C.J., Allen, S. & Wall, L. (1993). Family-centeredness of the Children’s Health Care Journal. Children’s Health Care 22(4) 241-256.

Higgins, J.P.T. & Green, S. (eds.). (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Available from

Bolton, C.M. (2004). An evaluation of the quality of different forms of early postoperative care in children following tonsillectomy. Unpublished PhD thesis, University of Melbourne, Australia.

Shields, L., Zhou, H., Taylor, M., Hunter, J., Munns, A. & Watts, R. (2012).Family-centred care for hospitalised children aged 0-12 Years: A systematic review of quasi-experimental studies. JBI Library of Systematic Reviews JBL000423 10 (39) 2559-2592.

The Joanna Briggs Institute. (2011). The Joanna Briggs Institute Reviewers Manual 2011 Edition. Adelaide: The Joanna Briggs Institute.

King, S., Rosenbaum, P.L. & King, G. (1995). The measures of processes of care (MPOC): a means to assess family-centred behaviours of health care providers. Ontario, Canada: Neurodevelopmental Clinical Research Unit, McMaster University.

Watts, R., Zhou, H., Shields, L., Taylor, M., Munns, A. & Ngune, I. (2014). Family-centred care for hospitalised children aged 0-12 Years: A systematic review of qualitative studies. JBI Library of Systematic Reviews 12 (7) 204-283.

Burlingham, D. & Freud, A. (1942). Young Children in War-Time. London: Allen & Unwin.

Shields, L. & Mohay, H. (2001). John Bowlby and James Robertson: theorists, scientists and crusaders for improvements in the care of children in hospital. Journal of Advanced Nursing 35 (1) 50-58.

Spitz, R.A. (1945). Hospitalism: an inquiry into the genesis of psychiatric conditions in early childhood. Psychoanalytic Study of the Child 1,53-74.

Platt, H. (1959). The welfare of children in hospital: report of the committee. London: Ministry of Health.

Citizens' Committee on Children of New York City. (1955). Liberal visiting policies for children in hospitals. Journal of Pediatrics 46,710-716.

Institute for Patient-and-Family-Centered Care. (2015). What is patient and family-centered care? Available at: (last accessed 10 January 2015)

Darbyshire, P. (1994). Living with a sick child in hospital: the experiences of parents and nurses. London: Chapman and Hall.

Shields, L., Pratt, J. & Hunter, J. (2006). Family-centred care: a review of qualitative studies. Journal of Clinical Nursing 15 (10)1317-1323.

Mikkelsen, G. & Frederiksen, K. (2011). Family-centred care of children in hospital - a concept analysis. Journal of Advanced Nursing 67 (5) 1152-1162.

Tse, Y (2013). Children thrive on companionship, not single rooms. British Medical Journal (Clinical Research Edition) 347, f6335.

Shields, L. & Tanner, A. (2004). Costs of meals and parking for parents of hospitalised children in Australia. Paediatric Nursing 16 (6)14-18.

Siffleet, J., Munns, A. & Shields, L. (2010). Costs of meals and parking for parents of hospitalised children in an Australian paediatric hospital. Neonatal, Paediatric and Child Health Nursing 13 (3) 7-11.

Shields, L. (2002). The Parent-Staff Interaction Model of Pediatric Care. Journal of Pediatric Nursing 17 (6) 442-449.

Shields, L. (2010). Questioning family-centred care. Journal of Clinical Nursing 19 (17-18)2629-2638.

Smith, J., Swallow, V .& Coyne, I. (2015). Involving parents in managing their child's long-term condition-a concept synthesis of family-centered care and partnership-in-care. Journal of Pediatric Nursing 30 (1) 143-159.

Aggarwal, S., Chadha, P., Kalia, S., Richardson, S., Winterbottom, L. & Shields, L (2009). Perceptions of family-centred care: a UK pilot study of the Shields and Tanner questionnaires. Neonatal, Paediatric & Child Health Nursing 12 (2) 25-29

Shields, L., Mamun, A., Pereira, S., O’Nions, P. & Chaney, G. (2011). Measuring family centred care: working with children and their parents in a tertiary hospital. International Journal of Person Centered Medicine 1 (1) 155-160.

Gill, F., Pascoe, E., Monterosso, L., Young, J., Burr, C., Tanner, A. & Shields, L. (2013). Parent and staff perceptions of family-centred care in two Australian children’s hospitals. European Journal for Person-Centered Healthcare 1 (2) 317-325.

Shields, L., Mamun, A., Flood, K. & Combs, S. (2014). Measuring family-centred care: working with children and their parents in two second level hospitals in Australia. European Journal for Person Centered Healthcare 2 (2) 206-211.

Shields, L., Kristensson-Hallström, I., Kristjánsdóttir, G. & Hunter, J. (2003). Who owns the child admitted to hospital: a preliminary discussion? Journal of Advanced Nursing 41 (3) 213-222.

Zappia, T., Chapman, R., Blackwood, D., Watkins, R., Wardrop, J. & Shields, L. (2012). Lesbian, gay, transgender and bisexual parents seeking health care for their children: a systematic review of the literature. World Views in Evidence Based Nursing 9 (4) 200-209.

Carter, B., Bray, L., Dickinson, A., Edwards, M. & Ford, K. (2014). Child-centred nursing: promoting critical thinking. Thousand Oaks, CA: SAGE Publications Ltd.



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