Dominance of paternalism on family-centered care in the Pediatric Intensive Care Unit (PICU): An ethnographic study

Abstract

This article examines the culture of family-centered care (FCC) in the pediatric intensive care unit (PICU) using focused ethnography. Data collection strategy was participant observation, fieldwork, and interviews with main actors of the PICU, namely supervisors, nurses, and parents. This study took place in one PICU in a hospital in Tehran, Iran. The results were in the main named as paternalism and were presented as five themes: “non-possessed environment,” “separation of the children from their parents,” non-interactive communication,” “limited participation,” and “affection and sympathy combined with superiority.” In conclusion, the prevailing atmosphere in care was paternalistic as there was a huge gap between conceptually or theoretically accepted application of FCC in PICU and what is practically administrated. Bridging such a gap between theory and practice can be helpful in improving social, environment, and organizational culture for the children, their parents, and health care providers as well as their performance in the context of PICU.

• Ethnography
• family-centered care
• PICU

ACKNOWLEDGMENTS

The authors would like to thank all participants including the parents and the staff who took the time to contribute to our understanding of their lived experience and culture.

DECLARATION OF INTEREST

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.