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unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author Manuscript J Pediatr Nurs. Author manuscript; available in PMC 2011 October 1. Published in final edited form as: J Pediatr Nurs. 2010 October ; 25(5): 335–343. doi:10.1016/j.pedn.2009.01.006. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript The earliest description of the multiple components of family centered pediatric nursing care was provided by Florence Blake in her comprehensive proposal for improving health care services delivered to children and families (1954). The proposal focused on addressing the psychosocial, as well as physical, needs of children and families and included attending to the relationship of children with their families. Blake emphasized that nurses must make a deliberate effort to establish a relationship with parents that fostered understanding of parents’ as well as children’s needs concerning adapting to illness and hospitalization. Blake’s focus was on significant changes in the philosophy and practice of educating pediatric nurses, but recognized other aspects of health care that would need to be addressed for successful adoption of this new philosophy. These included changes in hospital practices so parents could stay with and care for their hospitalized child, provision of home care services for sick children who could safely be cared for at home, and education of staff nurses and other hospital personnel. The components of care described in Blake’s proposal included many of the components currently associated with FCC, such as caring for the child in the context of family, facilitating parent participation in care, identifying and supporting family strengths, caring for children within the context of their development, providing information to children and families, recognizing that each family is unique, and designing health care that is flexible and responsive to families. These components of family centered pediatric care were examined by nurse leaders from a large metropolitan children’s hospital in several articles providing a comprehensive overview of the practice of FCC and its clinical application (Beatty, 1972). Of special importance was the discussion of implementation of this philosophy of care in a large institution (Luciano, 1972). This relatively early work demonstrates the leadership of pediatric nursing in valuing, committing to, and working toward implementation of this philosophy of nursing practice. A formal, multidisciplinary definition of FCC for children and families came in response to professional and parental concerns about the approach to health care for children with special health care needs, a population that was rapidly growing as a consequence of improved medical and technological care (Shelton, Jeppson, & Johnson, 1987). Discontent with traditional approaches to health care delivery prompted the formation of a multidisciplinary task force composed of professionals and parents and charged with the task of defining FCC. The seminal definition of FCC produced by this task force was published by the Association for the Care of Children’s Health (ACCH) in 1987 (Shelton et al.) and has been further examined and clarified (Shelton & Stepanek, 1994). The eight elements of FCC according to this definition are: 1. Incorporating into policy and practice the recognition that the family is the constant in a child’s life, while the service systems and support personnel within those systems fluctuate. 2. Facilitating family/professional collaboration at all levels of hospital, home and community care: care of an individual child; program development, implementation, evaluation, and evolution; and policy formation. 3. Exchanging complete and unbiased information between families and professionals in a supportive manner at all times. 4. Incorporating into policy and practice the recognition and honoring of cultural diversity, strengths, and individuality within and across all families, including ethnic, racial, spiritual, social, economic, educational, and geographic diversity. 5. Recognizing and respecting different methods of coping and implementing comprehensive policies and programs that provide developmental, educational, Harrison Page 2 J Pediatr Nurs. Author manuscript; available in PMC 2011 October 1. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript emotional, environmental, and financial supports to meet the diverse needs of families. 6. Encouraging and facilitating family-to-family support and networking. 7. Ensuring that hospital, home, and community service and support systems for children needing specialized health and developmental care and their families are flexible, accessible, and comprehensive in responding to diverse family-identified needs. 8. Appreciating families as families and children as children, recognizing that they possess a wide range of strengths, concerns, emotions, and aspirations beyond their need for specialized health and
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