Exploring Occupational Therapist’s Perceptive For Implementing Family Cantered Practice In Saudi Arabia: Qualitative Study

This qualitative study explores the occupational therapist’s perspective for implementing family-centered practice in Saudi Arabia. It discusses the relevance of family-centered practice, its importance to occupational therapists, barriers between therapists and families, and literature review on family-centered care.

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Task
“Exploring Occupational Therapist’s Perceptive For Implementing Family Cantered
Practice In Saudi Arabia : Qualitative Study
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Part one
Trends in Family Centred Practice
Family-centered practice is an effective process of enabling interactions between the
families and the children through predictive interactive avenues which improve development.
Family-centered practice is a process which the families formally and informally in various
systems provide enhanced capacity to offer care and protection of children.
The family-centered practice has been implemented in various contexts and results have
shown positive outcomes, research undertaken shows that parent’s involvement on education
perspective of their children is linked to an improved learning outcome, (Nzinga-Johnson et
al, 2009). Family-centered practice approach promotes adequate care for the children.
Professional understanding and respecting family relationships and cultures offer a higher
continuity of care and secured attachments.
In a study conducted in India assessing the effectiveness of the Family-centered
approach, showed that this tool improved perception and practice engagements of the
participants towards health care issues and over ally providing enduring and feasible
solutions for the families, (Shivalli, Majra, Akshaya, & Qadiri, 2014).
The family-centered practice has not been adopted and implemented as first as it could.
Evidence has shown that some of the practitioners are engaged in search of practical
guidelines on the implementation of the family-centered practice. Challenges observed have
been linked to a lack of administrative support from management, families, and challenge of
enabling families as experts and equals in their network teams, (Espe-Sherwindt, 2008).
The relevance of Family-Centred Practice for the Family
The key focus of FCP is on the safety of the children and needs in the context of the
underlying families and communities on building strengths so as to achieve optimal
outcomes. This process enhances family support and strengthens families while ensuring

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child safety process, (Bringing It All Back Home Study Center, 2002). Despite this
recognition of family-centered practice, there has been beliefs and principles which have
been formulated to guide this practices whoever still remain unclear.
The emphasis of the family-centered process in healthcare is geared towards the
improvement of improved outcomes among children and families involved,(Dempsey &
Keen, 2008). Key fundamental principles which have been laid down to enhance family
centred practice include closer collaboration within family units which enhances safety and
family members well being, strengthening family capacities for effectively functioning,
empowerment of families, establishing relationships, offering individualized care and linking
families with professional network teams such as occupational therapists, (National Child
Welfare Resource Centre for Family-Centered Practice 2002).
FCP has focused on the attention of the family as its primary aim through enhancing
strength, respect, and offering support, ( Fingerhut et al, 2013). Families and their respective
children are evaluated so as to build an inclusive program with the family rather than offering
a dictated program, this enhances the family and caregivers towards the maintenance of
authority and positive program results.
Importance of FCP to the Occupational Therapist role
Occupational therapy has been implemented in Occupational Therapy Framework
Domain and Processes as an avenue for a client-centered approach which its end result is
achieving and enhancing health participation throughout the life and occupation, (2nd ed.;
American Occupational Therapy Association [AOTA], 2008). Occupational therapy
professionals use a family-centered approach rather than client approach when dealing with
children, (Case-Smith, 2010).
Occupational therapy approach for the children creates a positive environment for the
children and family to offer support and contributing towards occupational therapy process

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through an equal partnership approach. Occupational therapy professionals in the previous
decades have been concerned with practices which are child-friendly being involved in the
daily occupational process so as to minimize and prevent harm and impairments, (Dunford,
Owen & Kelly, 2010).
Occupational therapy approaches among youth and children have often been complex
due to associated challenges and affordability of client-centered practices. Services have been
channelled through family-centered networks occurring within the networks of the family,
(Samadi, McConkey & Kelly, 2013). Children engagement in the therapeutic care process
enhances motivation by developing a sense of autonomy, building competence and
connecting with other significant personalities, (Poulsen, Rodger & Zivian, 2006).
Occupational centered practice identifies goals and objectives for the children and
families. It seeks to enhance change within the inert person, occupation and the surrounding
environment. When an occupational therapist undergoes this process of building a
collaborative process among children during goal setting, more benefits are achieved,
(Bourke-Tylor, 2017).
Barriers between the therapists and families
Various studies have been undertaken to investigate barriers and challenges facing
family-centered practice among the therapist practitioners. In an exploratory qualitative
design study on treatment barriers facing family focussed mental health services, results
indicate that barriers associated included; treatment access challenges, limited support and
poor involvement levels of the family level, (Baker-Ericzen, Jenkins & Haine-Schlagel,
2034). Similarly, a study assessing functional family therapy found out that families
engagement, organizational factors and structural and delivery challenges were noted,
(McPherson, Kerr, Casey & Marshall, 2017).
Occupational therapy practice and implementation protocol have broadly been based in

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Western values, however, replication of the same practice in Arabic, Middle East, and other
Islamic cultures have been investigated to have the difference and observed cultural
differences. Experiences of Occupational therapists in Oman and its environ have shown
significant differences. Applications of family therapeutic goals facilitating autonomy and
independence have been a challenge in a culture where family duty and care responsibility
are highly at stake. Home care services such as dressing and cooking care gender-related
issues display significant challenges. Occupational therapist key roles are to adopt this
differences which allow pragmatic problem-solving process and strategies without any
alterations of family philosophy, (Al Busaidy & Borthwick, 2012).
This scenario depicts families as highly influenced by culture and patterns of belief and
associated behaviors. It is evidence that in most Arab cultures, the roles of the family are
often placed above the individual personality needs, where honoring family values is often
linked to adaptations of life changes, (Awaad, 2003). In the Islamic cultures, it is the norm of
the immediate family to care for the ill family members, as this is regarded as a duty and
social, (Yang, Shek, Tsunaka & Lim, 2006) responsibility tasked with offering psychological
and physical support.
Part Two
Literature Review
Over the past decade, intervention programs have focussed on family-centered care
with the realization and need for child support and community taking a central role. In the
US, the Council for Exceptional Children has published recommendations which focus on
family-centered care, (Hemmeter, Joseph, Smith, & Sandall, 2001). These guidelines have
focussed on strengthening the participation and relationship of monitoring intervention of
children. Currently, family-centered care services dominate child care services in western
countries, (Klassen et al, 2008).

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In a qualitative study on FCP Model having family strengths, ideas and treatment
involvements engaged in the empowerment process for the families showed positive
experiences on service outcomes, (Roley et al, 2008).
In Saudi Arabia, assessment on perception and practices of nurses on family-centered
care revealed that the participants identified most key elements being necessary for family-
centered care. However, despite these findings, health care practitioners still face challenges
in implementing this model. Adoption of western values into the context of Saudi Arabia
proves to be a challenging as they have no western culture, (Alabdulaziz, Moss & Copnell,
2017).
Previous studies have shown the importance and relevance of family involvement in
pediatric care, there still exist challenges in the organizational context in countries such as
Iran. In a quasi-experimental study, undertaken in Razi Hospital, Iran on determining effects
of Family-centered care on parents satisfaction, showed that there was increased satisfaction
rate among parents, thus the implementation of FCC can increase care quality of families and
patients, (Rostami2015).
A meta-analysis study by Foster, Whiethead, Maybee & Cullens, (2013) on delivery
family-centered care in pediatric care on perceptions and experiences of parents and health
care practitioners showed that critical care units individual cultures was essential in creating
and reinforcing parental care needs coupled with communication and effective relationships
were key factors in maintaining negative perceptions and experiences in healthcare settings.
Quality of health care can be evaluated by assessing medical outcomes involved. Effect
of family-centered practice on maternal health care satisfaction and readmission process
showed that FCP was effective in improving the satisfaction of maternal women and reduced
the rates of neonatal admissions in health care organizations in Iran, (Bastin, Abadi &
Hgahani, 2015).

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The rise of family-centered care and its related involvement of health care decision has
increased relaxed policies on visitation schedules of family members to their patients at
bedsides. Assessment of health care practitioner’s attitudes on family care approaches in
Kingdom of Saudi Arabia showed a positive attitude towards the presence of family members
in offering care process for the patients, (Omran, Ali& Alshahrani, 2015).
Thus these studies have shown the relevance of family-centered care practice being
critically important in the care process. Involving family care plays a fundamental role in
illness recovery of patients. Challenges and barriers have been noted especially in Arab
countries touching on cultural issues. Assessing and exploring occupational therapist
perception plays a critical step in the implementation of family-centered practice in Saudi
Arabia.

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References
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