Parental Power in the Health Care System

Abstract

This session will be the presentation of a 1990s Parenting the Hospitalized Child, Stage Theory (which has, until now, never been presented or published) and a review of the research on parent/child centered care over the past 15 years. The original research is symbolic interaction as described through the grounded theory approach of Glazer and Strauss. The main or core category was found to be a basic social process, the relinquishment and regaining of responsibility for parenting the hospitalized child. The first stage occurs prior to the actual hospitalization, when the parent notices a change in his or her child's behavior. If the parents attempt to understand the changes are unsuccessful, then they become alarmed and seek outside confirmation that something, beyond their capacity is wrong with the child. This stage was labeled losing control because attending the physician begins the transfer of power. Relinquishment of responsibility is the second stage. Parents at the hospital staff assume the care of the child deeming them to be the experts. The parents stay with their children if they see a need to be there. For some parents the need is continual. While being there with their children and parents become aware of the inadequacies of the care in relation to their child's individual needs. They noticed that nurses are very busy. All parents mentioned anger at being ignored as a source of information and assistance. Some parents become frustrated and liberate themselves by recognizing their own potential to become more powerful and to resume responsibility. Other parents repress their frustrations, being resigned to the situation. The parents who feel liberated increase their resources by getting information, developing trusting relationships and assuming responsibility for care. The parents who repress their frustrations resume responsibility when their children are discharged. They express anger at themselves for not having taken more control during hospitalization and have more difficulties with post hospital care of their children. The theory is very much about “Governance of the Self” and understanding this social process will assist everyone involved in recognizing the power dynamics of one aspect our health care system.