Evaluation of the Knowledge on Importance of Family Presence and Participation during Pediatric Hospitalization and Treatments among Parents/Guardians in Thika Level Five Hospital

CHAPTER ONE:  INTRODUCTION

1.0.Background Information

Family is a source of emotional and psychological support and comfort to its every member.  Children continuously require the support and comfort for wholesome development (Watson et al. 2007). Therefore, separation of a child may cause a lot of discomfort that may affect his or her physical health. The separation may occur when the child is sick and is hospitalized. Therefore, for continuation of provision of support and comfort, family members should be present when the child is hospitalized.  Febbraio (2010) noted that the presence and participation of the family members during patient’s hospitalization is very important, because they are able to provide emotional and psychological support patient during treatment and care.  Moreover, this is very essential even to children who are hospitalized and undergoing some medical procedures and treatment. 

Having this knowledge is therefore very important to the parents and guardian whose children are hospitalized. This is because, it will enable them to be present and actively participate in the treatment and care of their children. However, most family members including parents and guardians are not aware of their importance in participating and being present during their children hospitalization and treatment. During my clinical placement for four weeks at Thika Level Five District Hospital in pediatric ward in 2010, I realized that many parents whose children were admitted were afraid to be present when their children were undergoing some medical procedures such as drug administration, injections, specimen collection, surgical procedures, ventilation and resuscitations. Those who were present did not completely participate in the care of their children. 

Again, Kenya Pediatric Association (KPA) (2006) recognized that many parent, approximately 64% do not actively participate in their children care including during hospitalization, home care or home visit (KPA, 2006).  Evidently, this may indicate that these parents are not aware of the importance of their involvement on their children’s treatment and care, and if they are aware, they may not have the adequate knowledge on how to participate actively during the child’s hospitalization and care.

Therefore, this research has been organized to evaluate knowledge on the importance of family presence during a child’s hospitalization among parents and guardians who have their children admitted in Thika Level Five District Hospital. Knowing whether these parents and guardians are aware that it is very important for them to be present during their children’s hospitalization is very essential since it will assist the health care provider to empower parent to be present when their children are undergoing medical procedures.

1.1. Research Question

Since most of the parents in Kenya have been reported not to adequately participate in their children treatment and care whether at home or in the hospital, it is an indication that they may not be aware or have knowledge of their importance in their children hospitalization. This consequently, descends to individual parents in various hospitals whose children are admitted and are undergoing treatment and care management. Therefore, the research aims at answering a challenging question; are parents or guardians whose children are admitted in Thika Level Five District Hospital aware that their presence and active participation in the treatment and care of their children important? By answering the question, the research will be able to evaluate the knowledge level of patient centered care among parent and guardians in Thika Hospital, and provide appropriate recommendations.

1.2. Research Aims and Objectives

The research aims at both achieving the following objectives

1.2.1. Broad objectives

To establish the level of knowledge and awareness of importance of family presence and participation among parents in Thika Hospital To identify some of the factors that hinders effective family presence and participation

1.2.2. Minor Objectives

To identify how parents utilize their awareness in participating in their children treatment and care during hospitalization. To determine factors that hinders the awareness of family presence and participation during pediatric hospitalization. To identify various approaches of improving and promoting awareness of family presence and participation during pediatric hospitalization To recommend some of the ways in which family presence and participation can be enhanced and improved

1.3. Propelling Issues

Various issues have encouraged the research to be conducted especially in in pediatric word, and among parents. First, it is recommended that parents should actively participate in their children treatment and care during hospitalization, since they are the fundamental source of the child’s emotional and psychological comfort, particularly when the child is ill or sick. Therefore, they should be aware of this. To establish their awareness, the research should be done to investigate their knowledge and awareness. Secondly, since, family presence and participation is a component of patient centered care approach (Iordanou et al. 2009), the knowledge and awareness of the parents and guardian have on the child (patient) centered care should be assessed, to provide an opportunity of enhancing and promoting patient centered care.

1.4. Research concept

The research is based on one main nursing care approach theory, the Family Centered Care. According to American Academy of Pediatrics, Family Centered Care is based on the understanding that the primary source of the child’s strength and support is the family, and the information provided by the family is very essential in the child health care (Damboise and Cardin, 2003). It is therefore involves healthcare policies, facility design, programs, daily interaction among patient (child), families and health care providers. This is mainly to provide emotional, social and developmental support to the child during treatment and care.

One of the core principles of Family Centered Care is that it involved collaboration with families at all levelsof health care, inthe care of the individual child and in professionaleducation,policymaking, and program development (Kyritsi et all. 2008). The main outcome of Family Centered Care is that family presence during health care procedures decreases anxietyfor the child and the parents (Damboise and Cardin, 2003). Research indicates that whenparents are prepared, they do not prolong the procedure or makethe provider more anxious. Therefore, it is very essential to determine whether the family, particularly the child’s parents or guardian, are aware or have knowledge of the importance of their presence and participation during the child treatment or hospitalization. Establishing this is very crucial in encouraging and improving family participation during the child’s hospitalization.

1.5. Relevancy to the Course

Nursing is very vital in patient’s care in the hospital including children. However, since the child is very dependent on their family, particularly on the parents or guardian, nurses therefore have to integrate family participation into the child’s treatment and care to ensure achievement of holistic care (Kyritsi et all. 2008). Therefore, it is the role of a nurse is to ensure that the family member (parents and guardians) of the children are aware of their vital role in the child’s care, to provide effective interventions such as through educating them. This can be achieved through assessing and evaluating the knowledge of the awareness among parents. This therefore requires a nurse to participate into a research of establishing such awareness among parents and guardian. This research is therefore, very relevant to the nursing profession course.  

1.6. Scope of the study

The main scope of the study is determining whether parents are aware that family presence and participation during a child’s hospitalization is important and necessary. The research will be restricted to parent, guardians and other relevant family members of children admitted in pediatric ward at Thika level Five District Hospital.  However, the research will also determine some of the activities that this parent engaged in while their children are admitted, and the extent of the engagement.