Family-Centred Care: Understanding Our Past       

Abstract
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.       

Keywords
Family-centered care, New Zealand child health nursing, historical trends       

Introduction
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.