Joumal of Advanced Nursing, 1995,21, 716-722 Parental participation in care: a critical review of the literature Imelda T Coyne BSc DipN RSCN RGN RNT Lecturer, Department of Nursing Studies, King's College London, Comwall House Annex, Waterloo Road, London SEl 8TX, England Accepted for publication 23 June 1994 COYNE I T (1995) Joumal of Advanced Nursmg 21, 716-722 Parental participation in care, a cntical review of the hterature The literature reviewed demonstrates that parental participation is a complex issue which has been viewed mainly m a fragmented manner which does not recogmze the integrated holistic nature of parent-nurse partnership There is a dearth of research which focuses upon parents' perspectives and expectations of participation Furthermore, there is an assumption that parental participation IS unproblematic which precludes the identification of social and environmental constraints The current level of knowledge about nurses' attitudes regarding parental participation is limited There is an absence of clear indicators of how parental participation may be facilitated and supported in the institutional setting It is proposed that further research is required which determines the extent of parental participation and which considers the lived expenences of both the parents and nurses of parental participation Improved care for children and families could result from efforts directed to those endeavours BACKGROUND There is a wealth of evidence which highlights the adverse effects of hospitalization for both children and their parents (Spence 1947, Bowlby 1951, Robertson 1958a,b, Rutter 1972, Quinton & Rutter 1976) Refiecting this, par- ental involvement m the hospitalized child's care has been advocated smce the publication in tbe UK of the Platt Report (Ministry of Health 1959) Since then the Children Act (1989) and recent govemment policy have reaffirmed that hospital care of children should be provided in part- nership with parents and famihes (Department of Health 1991) The Children Act (1989) stressed the importance of developmg a workmg partnership with the child's parents and promoting the role of families m the care of their children Today parents should have access to their hospitalized children 24 hours a day, and be encouraged to participate m their care However, the extent to which parental par- bcipation has actually been incorporated m practice is uncertain Thomes (1983) surveyed parental access and family facilities m children's wards and found limited accommodation and restricted visiting in over half the wards Interestmgly, madequate facilities and lack of pro- vision for parents contmues to be reported, as evidenced by tbe most recent Audit Commission (1993) report This report reiterated the importance of supportmg parental participation m care Assumption This partnership with parents is based upon the assump- tion that all parents are willing to participate m their sick child's care However, it is uncertain whether all parents are willing and prepared to participate m the care of their child (Knafl et al 1988) and the extent to which parents and nurses negotiate mutually satisfactory roles m hospital IS questionable (Callery 1988, Darbyshire 1992) With sick children bemg mcreasmgly cared for m the home by their parents because of early discharge and mcreased use of day surgery, there is now an expectation that parents will he extensively mvolved m the care of their hospitalized child To consider the issue of parental participation, this 716