Family-Centered Care and Psychosocial Support
Core concepts
Family-centered care recognizes the family as the child's constant and the unit of care. Core principles include dignity and respect, information sharing, participation, and collaboration. Candidates must understand developmental stages of children's understanding of illness: preschoolers may use magical thinking and fear bodily injury, school-age children understand more concretely and fear loss of control, and adolescents value privacy and peer acceptance. Preparation should be developmentally tailored, using honest, simple language and play-based teaching. Parental presence during induction is a debated but supported practice when it benefits the child and is structured. Anxiety-reduction strategies include child life specialists, distraction, comfort positioning, and premedication. Separation anxiety peaks in toddlers and preschoolers. Cultural and language needs must be addressed with interpreters, not family members, for clinical communication. Ethical concepts such as assent (child's agreement when developmentally able) and consent (parental permission) apply. Debriefing after distressing events supports families and staff.
Traps in questions
A common trap uses adult explanations for a preschooler or assumes a child who is quiet is not anxious. Another trap relies on a child to interpret for the family rather than using a professional interpreter.
Rule of thumb
Match preparation to development: use play and simple honest words for young children, offer choices to school-age children to restore control, and protect adolescent privacy.