Balancing infection control practices and family-centred care in a cohort of paediatric suspected severe acute respiratory syndrome patients in Hong Kong

Objective: To identify key nursing issues for paediatric patients suspected of severe acute respiratory syndrome (SARS) in relation to the family-centred model of nursing care and to develop a data-based model of paediatric nursing care to be better applied in situations of suspected SARS or where outbreaks of other infectious diseases occur. Methods: This is a retrospective descriptive case series, which analysed the medical and nursing records of all highly-suspected/suspected SARS patients admitted to a major acute hospital in Hong Kong. Key nursing personnel were also interviewed. Results: The study included a total of 17 highly-suspected and 49 suspected SARS paediatric patients (age: 1-16). None of the paediatric patients was eventually diagnosed of SARS. Most cases presented fever (highly-suspected: 76.5%/ suspected: 100%), cough (64.7%/71.4%), nausea and vomiting (35.3%/28.6%). Nursing care was provided to the patients as necessary. Both the children and parents experienced fear of SARS, as well as separation anxiety arisen from hospitalization in a strict isolation setting. Conclusions: Infection control overshadowed the family-centred nursing practices in the management of SARS paediatric patients. A major nursing care issue for SARS paediatric patients was to achieve a careful balance between attending to patients' physical and psychological needs and adhering to the infection control guidelines, while at the same time offering psychological support to family members. The current philosophy and practice of family-centred nursing model neglect the special needs of children with infectious diseases and predominantly apply to children with non-infectious diseases that family visits are allowed and nursing care by parents are encouraged.