Two Concepts of Care
Family-focused care also known as family-centered care (FCC) can be defined as a collaborative approach to making decisions related to health care (Kuo et al., 2011). FCC is a philosophy of care that has been recognized and held in high esteem by numerous medical societies, legislative bodies on both state and federal levels, the Institute of Medicine, and Health People 2020 (Kuo et al., 2011). However, the term FCC could be used to interpret a wide variety of health care concepts that are often accompanied by principles of information sharing, partnership, negotiation, and respect (Kuo et al., 2011).
Those principles have been developed by the Maternal and Child Health Bureau (MCHB), the American Academy of Pediatrics (AAP), and the Institute for Patient and Family-Centered Care (Kuo et al., 2011). They allowed to recognize care in the context of a family as the standard of health delivery and divide its implementation into the following categories: inpatient setting that is associated with family-centered rounds (FCR) and ambulatory setting represented by the concept of Medical Home (Kuo et al., 2011). Family-oriented nursing care promotes the philosophy of the FFC approach to health delivery.
According to a recent report by the American Academy of Pediatrics (AAP), family-oriented care allows a practitioner to extend their responsibilities to include an assessment of the emotional and social status of a child’ parents (Pettoello-Mantovani, Campanozzi, Maiuri, & Giardino, 2011). Family-oriented care differs from FCC in its approach to the unit of medical care. Unlike FCC, family-oriented care does not categorize a family as the primary unit of care thereby escaping conceptual confusion that stems from the differentiation of two entities: family and individual. Rather, it focuses on a family as a source of important health beliefs and behaviors to recognize patterns that might help treat a patient (Pettoello-Mantovani et al., 2011).
Community-based nursing care can be described as the provision of health care services with the focus on “specific individuals and families within a community” (Hunt, 2010, p. 16). There is an ample evidence base suggesting that community-based service systems target needs of families thereby demonstrating the characteristics of improved access to health care services for different groups. (Garland et al., 2012). However, there is still a wide range of problems associated with such services due to the fragmentation in their delivery which is associated with the “floating” type of health delivery (Garland et al., 2012; Hunt, 2010, p. 16).
Community-based care is inextricably related to the context of the family systems as well as social systems within which it is being provided. The focus on prevention of disease and injury in community-based care allows conferring health protection on individuals within community and family units. Three main preventive dimensions concentrate on the promotion of family health: primary prevention, secondary prevention, and tertiary prevention (Hunt, 2010).
While considering the role of prevention in the health care delivery process, it is necessary to remember that unique characteristics of families inside a particular locality add to the complexity of the medical needs of the whole community (Hunt, 2010). In addition to being cost-effective, preventive interventions significantly increase the level of patient satisfaction as well as facilitate faster recovery. It should be mentioned that community-based care has been introduced in a variety of settings such as home care, school care, emergency preparedness, and chronic care thereby significantly contributing to the promotion of family health (Hunt, 2010).
Garland, A., Haine-Schlagel, R., Brookman-Frazee, L., Baker-Ericzen, M., Trask, E., & Fawley-King, K. (2012). Improving community-based mental health care for children: translating knowledge into action. Administration and Policy in Mental Health and Mental Health Services Research, 40(1), 6-22.
Hunt, R. (2010). Introduction to community-based nursing. Philadelphia, PA: Lippincott Williams & Wilkins.
Kuo, D., Houtrow, A., Arango, P., Kuhlthau, K., Simmons, J., & Neff, J. (2011). Family-centered care: current applications and future directions in pediatric health Care. Maternal and Child Health Journal, 16(2), 297-305.
Pettoello-Mantovani, M., Campanozzi, A., Maiuri, L., & Giardino, I. (2011). Family-oriented and family-centered care in pediatrics. Italian Journal of Pediatrics, 35(1), 12-23.