Language barriers, cultural differences, and parents’ expectations of family-centered care in pediatric home health therapy

Background: While many definitions of family-centered care (FCC) exist, overall, the concept is to include families and patients in all aspects of the plan of care. To date, no studies have investigated how often FCC is utilized in the pediatric home health therapy setting. No studies have examined incorporation of FCC in this setting when cultural or language differences exist. The purposes of this study were to determine how many of the FCC concepts are being incorporated by therapists in the pediatric home health setting, to investigate the differences in incorporating FCC concepts among families with different cultures and different languages, and to explore parents’ expectations of FCC within the home health pediatric setting. Participants: A total of 76 parents/caregivers of children with special needs receiving physical, occupational and/or speech therapy from two pediatric home health agencies across Texas, USA completed data collection (16.9% return rate). Methods: A quasi-mixed methods design was used. The Measure of Processes of Care-20 items set (MPOC-20) determined perceived FCC utilization. Participants completed the MPOC-20 to provide quantitative data on how often FCC concepts were incorporated and explore incorporation of FCC when language/cultural differences exist. A 7-question open-ended survey was created and used to obtain qualitative data on parent expectations of incorporating FCC in this setting. Results: MPOC-20 results showed FCC concepts were incorporated to “a great extent” or higher in this setting. Statistical analysis indicated no differences between English- and Spanish-speaking respondents, nor among cultures/ethnicities in regard to incorporating FCC concepts in home health pediatric therapies. Qualitative analysis revealed participants did not fully understand the FCC model. Nevertheless, parents expected a collaborative relationship with the therapists ensuring the child receives individualized and optimal care in order to make the best progress in his or her home health therapies. Discussion and Conclusions: Findings from this study showed therapists incorporated FCC concepts in this setting regardless of language or cultural differences. Families expect to build relationships with therapists, receive information appropriate to preferred mode of interaction and level of involvement, and for therapists to be accepting of differences regardless of personal cultural or non-cultural beliefs.