Parent Empowerment in Pediatric Healthcare Settings: A Systematic Review of Observational Studies

Abstract

Background: Parent empowerment is often an expressed goal in clinical pediatrics and in pediatric research, but the antecedents and consequences of parent empowerment are not well established.

Objective: The objective of this systematic review was to synthesize potential antecedents and consequences of parent empowerment in healthcare settings.

Eligibility criteria: The inclusion criteria were (1) studies with results about parent empowerment in the context of children's healthcare or healthcare providers; and (2) qualitative studies, observational studies, and systematic reviews of such studies.

Information sources: We searched the databases of PubMed, Web of Science, and Google Scholar (2006-2017) and reference lists.

Included studies: Forty-four articles met the inclusion criteria.

Synthesis of results: We identified six themes within consequences of empowerment: increased parent involvement in daily care, improved symptom management, enhanced informational needs and tools, increased involvement in care decisions, increased advocacy for child, and engagement in empowering others. Six themes summarizing antecedents of empowerment also emerged: parent-provider relationships, processes of care, experiences with medical care, experiences with community services, receiving informational/emotional support, and building personal capacity and narrative. We synthesized these findings into a conceptual model to guide future intervention development and evaluation.

Strengths and limitations of evidence: Non-English articles were excluded.

Interpretation: Parent empowerment may enhance parent involvement in daily care and care decisions, improve child symptoms, enhance informational needs and skills, and increase advocacy and altruistic behaviors. Parent empowerment may be promoted by the parent-provider relationship and care processes, finding the right fit of medical and community services, and attention to the cognitive and emotional needs of parents.

Clinical registration no: PROSPERO 2017:CRD42017059478.

Figure 1.

PRISMA Flow Diagram illustrating articles included and excluded in this systematic review and narrative synthesis.

Figure 2.

Conceptual model illustrating the relationship between antecedents and consequences of parent empowerment. Bold curved arrow highlights that prior health care experiences, including prior parent empowerment, become contextual factors influencing current health care experiences and current empowerment.