Family-Centered Care: An Evolutionary Concept Analysis

Document Type : Content Analysis


Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran


Introduction: The inappropriate development of nursing concepts is one of the most important obstacles to the progress of nursing knowledge. Family-centered care is one concept that is not well-defined, even though it is widely used in many areas of nursing and caregiving. This study aimed to analyze the concept of family-centered care using Rodgers’ evolutionary model.
Methods: The 8 steps of Rodgers’ evolutionary model were followed. After concept selection, the Pubmed, Medline, Scopus, Science Direct, OVID, and SID databases were seached for the terms “family-centered care”, “parental involvement”, “family participation”, and “care by families”.
Results: The results of this study, including the dimensions, antecedents, barriers, and consequences, are reported based on Rodgers’ model. Family-centered care is described as a holistic point of view, a philosophy that helps families in their caring role, the basic principles of child care, care given by parents, parents and professionals working together, and the chance for parents to protect their children under the supervision of professionals. In this study the antecedents of family-centered care were categorized as being political-conceptual, economical, and motivational. Some results of family-centered care are improved patient and family satisfaction, increased efficacy and improved quality of life, improved flow of information, and better interaction between the family and the professional team.
Conclusions: Data from the present study showed that even though family-centered care is an appropriate framework for the provision of health services, more study is needed for better implementation.


  1. Rodgers BL, Knafl KA. Concept Development in Nursing: Foundations, Technqiues, and Applications. 2nd ed. Philadelphia: Saunders; 2000.
  2. Rodgers BL. Concept analysis: an evolutionary view. In: Rodgers BL, Knafl KA, eds. Concept Development in Nursing: Foundations, Technqiues, and Applications. Philadelphia: Saunders; 1993.
  3. Bradley SF. Processes in the creation and diffusion of nursing knowledge: an examination of the developing concept of family-centred care. J Adv Nurs. 1996;23(4):722-727. doi:10.1111/j.1365-2648.1996.tb00043.x.
  4. Walker LO, Avant KC. Strategies for theory construction in nursing. 3rd ed. Norwalk: Appleton & Lange; 1995.
  5. Briar-Lawson K, Lawson HA. Family-centered Policies and Practices: International Implications. Columbia University Press; 2010.
  6. Wexler DA, Rice LN. Innovations in client-centered therapy. Oxford, England: John Wiley & Sons; 1974.
  7. Rosenbaum P, King S, Law M, King G, Evans J. Family-centred service: A conceptual framework and research review. Phys Occup Ther Pediatr. 1998;18(1):1-20. doi:10.1080/J006v18n01_01.
  8. Dyke P, Buttigieg P, Blackmore AM, Ghose A. Use of the measure of process of care for families (MPOC-56) and service providers (MPOC-SP) to evaluate family-centred services in a paediatric disability setting. Child Care Health Dev. 2006;32(2):167-176. doi:10.1111/j.1365-2214.2006.00604.x.
  9. Leiter V. Dilemmas in sharing care: maternal provision of professionally driven therapy for children with disabilities. Soc Sci Med. 2004;58(4):837-849. doi:10.1016/S0277-9536(03)00258-2.
  10. Bamm EL, Rosenbaum P. Family-centered theory: origins, development, barriers, and supports to implementation in rehabilitation medicine. Arch Phys Med Rehabil. 2008;89(8):1618- 1624. doi:10.1016/j.apmr.2007.12.034.
  11. Janzen W. Long-term care for older adults. The role of the family. J Gerontol Nurs. 2001;27(2):36-43; quiz 54-35. doi:10.3928/0098-9134-20010201-13.
  12. Johnson BH. Family-centered care: Four decades of progress. Fam Syst Health. 2000;18(2):137-156. doi:10.1037/h0091843.
  13. King RB, Semik PE. Stroke caregiving: difficult times, resource use, and needs during the first 2 years. J Gerontol Nurs. 2006;32(4):37- 44.
  14. Schoot T, Proot I, ter Meulen R, de Witte L. Recognition of client values as a basis for tailored care: the view of Dutch expert patients and family caregivers. Scand J Caring Sci. 2005;19(2):169-176. doi:10.1111/j.1471-6712.2005.00327.x.
  15. MacKean GL, Thurston WE, Scott CM. Bridging the divide between families and health professionals’ perspectives on family-centred care. Health Expect. 2005;8(1):74-85. doi:10.1111/j.1369-7625.2005.00319.x.
  16. Foster M, Whitehead L, Maybee P. Parents’ and health professionals’ perceptions of family centred care for children in hospital, in developed and developing countries: a review of the literature. Int J Nurs Stud. 2010;47(9):1184-1193. doi:10.1016/j.ijnurstu.2010.05.005.
  17. Rodgers BL. Philosophical foundations of concept development. In: Concept Development in Nursing: Foundations, Technqiues, and Applications. 2nd ed. Philadelphia: Saunders; 2000.
  18. Mitchell ML, Chaboyer W. Family Centred Care--a way to connect patients, families and nurses in critical care: a qualitative study using telephone interviews. Intensive Crit Care Nurs. 2010;26(3):154-160. doi:10.1016/j.iccn.2010.03.003.
  19. Shelton TL, Stepanek JS. Excerpts from family-centered care for children needing specialized health and developmental services. Pediatr Nurs. 1995;21(4):362-364.
  20. Hutchfield K. Family-centred care: a concept analysis. J Adv Nurs. 1999;29(5):1178-1187. doi:10.1046/j.1365-2648.1999.00987.x.
  21. Mitchell M, Chaboyer W, Burmeister E, Foster M. Positive effects of a nursing intervention on family-centered care in adult critical care. Am J Crit Care. 2009;18(6):543-552; quiz 553. doi:10.4037/ajcc2009226.
  22. Dowling J, Vender J, Guilianelli S, Wang B. A model of family-centered care and satisfaction predictors: the Critical Care Family Assistance Program. Chest. 2005;128(3 Suppl):81s-92s. doi:10.1378/chest.128.3_suppl.81S.
  23. Masoodi R, Alhani F, Rabiei L, et al. The effect of family-centered empowerment model on quality of life and self efficacy of multiple sclerosis patients family care givers. Iranian Journal of Nursing Research. 2012;7(27):32-43.
  24. Vahedian Azimi A, Alhani F, Ahmadi F, Kazemnejad A. The effect of family-centered empowerment model on the life style of myocardial infarction patients. Iranian Journal of Critical Care Nursing. 2010;2(4):127-32.
  25. Zeinali J, Mirhaghjou SN, Mirzaei M, Alhani F, Kazemnezhad E, Dehghani M. The effect of family centered care on meeting parental information needs of hospitalized children. J Holist Nurs Midwifery. 2012;22(1):30-37.
  26. Eldredge D. Helping at the bedside: Spouses’ preferences for helping critically ill patients. Res Nurs Health. 2004;27(5):307-321. doi:10.1002/nur.20033.
  27. Lolaty HA, Bagheri-Nesami M, Shorofi SA, Golzarodi T, Charati JY. The effects of family-friend visits on anxiety, physiological indices and well-being of MI patients admitted to a coronary care unit. Complement Ther Clin pract. 2014;20(3):147-151. doi:10.1016/j.ctcp.2014.03.002.
  28. Peyrot M, Burns KK, Davies M, et al. Diabetes Attitudes Wishes and Needs 2 (DAWN2): a multinational, multi-stakeholder study of psychosocial issues in diabetes and person-centred diabetes care. Diabetes Res Clin Pract. 2013;99(2):174-184. doi:10.1016/j.diabres.2012.11.016.
  29. Safaeepour L, Mokhtari Nouri J, Moradian ST, Saied Ghazis SM. The Effect of Family-Centered Care on the Duration of Weaning from Mechanical Ventilation in Coronary Artery Bypass Surgery Patients: A Clinical Trial Study. Iranian Journal of Critical Care Nursing. 2017;10(2):e10655. doi:10.5812/ccn.10655.
  30. Arockiasamy V, Holsti L, Albersheim S. Fathers’ experiences in the neonatal intensive care unit: a search for control. Pediatrics. 2008;121(2):e215-222. doi:10.1542/peds.2007-1005.
  31. Geller G, Bernhardt BA, Carrese J, Rushton CH, Kolodner K. What do clinicians derive from partnering with their patients? A reliable and valid measure of “personal meaning in patient care”. Patient Educ Couns. 2008;72(2):293-300. doi:10.1016/j.pec.2008.03.025.
  32. Johnson BH, Abraham MR, Shelton TL. Patient- and family-centered care: partnerships for quality and safety. N C Med J. 2009;70(2):125-130.
  33. Epstein RM. Making communication research matter: what do patients notice, what do patients want, and what do patients need? Patient Educ Couns. 2006;60(3):272-278. doi:10.1016/j.pec.2005.11.003.
  34. Pryzby BJ. Effects of nurse caring behaviours on family stress responses in critical care. Intensive Crit Care Nurs. 2005;21(1):16-23. doi:10.1016/j.iccn.2004.06.008.
  35. Azoulay E, Pochard F, Kentish-Barnes N, et al. Risk of post-traumatic stress symptoms in family members of intensive care unit patients. Am J Respir Crit Care Med. 2005;171(9):987-994. doi:10.1164/rccm.200409-1295OC.
  36. Chaboyer W, Kendall E, Kendall M, Foster M. Transfer out of intensive care: a qualitative exploration of patient and family perceptions. Aust Crit Care. 2005;18(4):138-141, 143-135. doi:10.1016/S1036-7314(05)80026-8.
  37. Mitchell ML, Courtney M, Coyer F. Understanding uncertainty and minimizing families’ anxiety at the time of transfer from intensive care. Nurs Health Sci. 2003;5(3):207-217. doi:10.1046/j.1442-2018.2003.00155.x.
  38. Nethercott S. A concept for all the family. Family centred care: a concept analysis. Prof Nurse. 1993;8(12):794-797.
  39. Litchfield R, MacDougall C. Professional issues for physiotherapists in family-centred and community-based settings. Aust J Physiother. 2002;48(2):105-112. doi:10.1016/S0004-9514(14)60204-X.
  40. Morris R, Payne O, Lambert A. Patient, carer and staff experience of a hospital-based stroke service. Int J Qual Health Care. 2007;19(2):105-112. doi:10.1093/intqhc/mzl073.