Psychometric Evaluation of the Family-Centered Care Scale for Pediatric Acute Care Nursing
Martha A. Q. Curley, PhD, RN, FAAN, is Ellen and Robert Kapito Professor in Nursing Science, School of Nursing, Anesthesia and Critical Care Medicine, University of Pennsylvania, Philadelphia. Mabel Hunsberger, PhD, RN, is Associate Professor, School of Nursing, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning & Discovery, McMaster University, Hamilton, Ontario, Canada. Sion Kim Harris, PhD, CPH, is Assistant Professor of Pediatrics, Harvard Medical School, Department of Medicine, Boston Children's Hospital, Massachusetts.Nursing research (Impact Factor: 1.36). 05/2013; 62(3):160-168. DOI: 10.1097/NNR.0b013e318286d64b
BACKGROUND:: Caring for families is fundamental to pediatric nursing. However, existing measures do not capture parents' experiences with family-centered nursing care. OBJECTIVE:: The aim of this study was to describe the development and initial psychometric testing of the Family-Centered Care Scale, a seven-item instrument designed to measure a parent's experience of nursing care that embodies core principles of family-centered care. METHODS:: In Phase 1, 18 items describing what nurses do to engage parents of hospitalized children were derived from the literature describing mutuality. After establishing face validity, pretesting, and revision for clarity, the scale was administered to a convenience sample of 91 parents of hospitalized patients. In Phase 2, two items on parents' perceptions of being well-cared-for were added. The 20-item scale was administered to 564 parents of children recruited from all inpatient units in a children's hospital. In Phase 3, the scale was shortened to seven items and retested for validity among 454 additional parents. RESULTS:: Internal consistency reliability was high across all versions and testing phases. Confirmatory factor analysis with data from a subsequent sample supported the final factor structure, regardless of patient type and race. There was a linear association between the scale consistency scores and overall quality of care ratings, supporting predictive validity of the scale. DISCUSSION:: The Family-Centered Care Scale showed initial evidence of reliability and validity among parents with hospitalized children.
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ABSTRACT: The focus of emergency departments on resolving immediate threats to patient survival and wellbeing distinguishes their services from those provided by all other hospital departments. The high-pressure environment in the emergency department is a source of significant stress for patients and their families, with some experiencing serious physical and mental impacts that result in high tension, acute stress, anxiety, and other mental and physical reactions. The concepts of family-centered care and transition theory have been shown to help promote a sense of wellbeing and adjustment to unfamiliar experiences. Therefore, these concepts may be applied to help facilitate the successful transition of patients and their families to the emergency department and thus help maintain normal family functions during the transition from the emergency department to other departments.
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ABSTRACT: Abstract Background: A children’s hospital within a hospital (CHWH) in the Midwest region of the United States established a strategic goal to become the preferred provider for children in the region. Outcomes in patient and family experience had fallen short of established organizational expectations. Recognizing that parent advisors are an essential component of patient and family centered care, the strategic plan called for integrating parents into formal, advisory roles. Purpose: The purpose of this practice improvement project was to perform an assessment of organizational readiness to incorporate parents into formal advisory roles at this CHWH. Methods: A cross-sectional survey design was used to measure indicators of organizational readiness: 1) an analysis of the current state of patient and family centered care (PFCC) 2) an analysis of stakeholder attitudes and beliefs about incorporating parents as advisors. Results: A score of five for each question on the PFCC Organizational Self-Assessment Tool indicates an organization’s culture is consistent with best practice organizations. Assessment of the current state of PFCC in this CHWH resulted in only five of eleven domains on the PFCC Self-Assessment Tool having a mean score >3. However, 83.7% of all stakeholders responded in support of integrating parents into formal advisory roles. These results suggest that the CHWH is in the contemplative stage of organizational readiness (Prochaska, Norcross, & Diclimente, 1994). Conclusion: Stakeholders in this CHWH recognize knowledge gaps regarding PFCC culture in their organization. They are confident their individual clinical practices are supportive of PFCC, yet recognize that integrating parents into formal advisory roles will require adoption of complex organizational changes in this CHWH. Keywords: Patient and Family Centered Care; Family Centered Care; Parent Advisors; Patient and family advisors; Readiness assessment; IPFCC survey instrument
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ABSTRACT: The objective of this study was to create a psychometrically sound measure of family-centered care, the Family-Centered Care Assessment (FCCA), developed through a process led by families in collaboration with maternal and child health leaders. The items for the FCCA scale were initially developed by families of children and youth with special needs in partnership with pediatric providers and researchers. Using an Institutional Review Board-approved research protocol, the questions were revised based on input from focus groups of diverse parents in three states. Parental responses (N = 790) to the revised 59-item survey were collected online from families in 49 states. Item distributions uniformly showed excellent spread. A principal axes factor analysis confirmed the existence of a single factor. Rasch modeling item analyses identified a reduced subset of 24 items that demonstrated excellent psychometric properties. All items met the criteria for a linear Rasch scale. Empirical evidence in support of the construct validity of the 24-item measure was derived: all items had a positive and substantial item-total correlation; person alpha scale reliability was >0.80 and the item reliability was >0.90; both separation indices were >2.0; infit and outfit statistics were within 0.5-1.5; and item difficulties ranged between -2 and +2 logits. Strong rank-ordered associations and large effect sizes were observed for six indicators of quality of care. This study's family-led process produced a tool, the FCCA, to measure families' experience of care with excellent psychometric properties.
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