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Kim Chenery, RGON, RSCN, MA (Applied) Clinical Nurse Educator, Child Health Cluster, Christchurch Hospital.
Chenery, K. (2004). Family-centred care: Understanding our past. Nursing Praxis in New Zealand, 20(3), 4-12.
Today the concept of family-centred care is broadly accepted throughout the New Zealand child health sector. Commitment to the ethos of family-centred care is reflected in the philosophies of care delivery in paediatric wards and is a stated principle in the Ministry of Health’s (1998) Child Health Strategy. Despite this almost universal endorsement of family-centred care, its application to practice in the context of the paediatric ward, often remains paradoxical and problematic. Drawing on findings from my recent historical research study this paper argues that current practice paradoxes are historically ingrained.
Key Words: Family-centered care, New Zealand child health nursing, historical trends
The care of the hospitalised child and the development of family-centred care cannot be viewed in contextual isolation. They can be understood only in relation to predominant societal beliefs about children and sick children at any given time period. This paper does not provide a complete account of all the changes which historically have shaped the hospital care of children. It focuses instead on the significant influence that Dr. John Bowlby’s theory of maternal deprivation had on how the hospitalised child was viewed and presents aspects of a wider historical research study conducted in 2001.1 The study examined the development of family-centred care in New Zealand as part of an international movement advanced by professionals in the 1950s concerned with the effects of mother -child separation. The progression towards family-centred care was positioned within the broader context of ideas and beliefs about mothering and children that emerged in New Zealand society between 1960 and 1980 as a response to these new concerns for children’s emotional health. This paper argues that although the concept of family-centred care today is broadly accepted throughout the New Zealand child health sector, its application to practice in the context of the hospital children’s ward, often remains paradoxical and problematic. I contend that these current practice paradoxes are historically ingrained and draw on some oral history accounts from the aforementioned study to illustrate this.