{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:48:05Z","timestamp":1793746085702,"version":"4.6.1"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Many children with complex health care needs face chronic health and developmental issues that may include functional impairments, neurodevelopmental disabilities, and lifelong dependence on medical technology. Providing the necessary care and services for this unique group of children and youth places substantial demands on the health care system. Much of the focus on improvements has been in acute care settings even though homecare accounts for the largest proportion of health care utilization among children with complex health care needs. While parents assume great responsibility for their child's care at home, they indicate that the balance of power between themselves and their health care providers does not change when care shifts from the hospital to home. Given the expanding role of paediatric homecare and parents' concerns of their role in decisions related to their child's care, it is imperative to explore these practices in this unique setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of this work is to explore mother\u2013nurse decision making practices for children with complex health care needs receiving health care services in their home.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A qualitative descriptive study design was used. Five mothers and five nurses participated. Twenty\u2010six home observations with accompanying analytical memos and 10 semistructured interviews were conducted with five mothers and five homecare nurses. Thematic analysis of study data, using an iterative process, identified major themes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Data revealed the complex and relational nature of mother\u2013nurse decision making practices within the home setting. Three major themes were identified: (1) core areas of decision making, (2) a dynamic and collaborative process, and (3) centrality of relationships.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Study findings enhanced our understanding of how decision making and relational care practices take place in the home for children with complex health care needs receiving homecare services, which has implications for child and family health.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cch.12966","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T07:58:11Z","timestamp":1642579091000},"page":"605-612","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Mother\u2013nurse decision making practices for children with complex health care needs receiving homecare services: A qualitative descriptive study"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9434-8205","authenticated-orcid":false,"given":"Karen","family":"LeGrow","sequence":"first","affiliation":[{"name":"Daphne Cockwell School of Nursing, Faculty of Community Services Ryerson University  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Cohen","sequence":"additional","affiliation":[{"name":"Complex Care Program, Hospital for Sick Children, Professor, Department of Pediatrics University of Toronto  Toronto Ontario Canada"},{"name":"Edward S. 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Leong Centre for Health Children, Department of Pediatrics University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry","family":"Espin","sequence":"additional","affiliation":[{"name":"Daphne Cockwell School of Nursing, Faculty of Community Services Ryerson University  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2015-004315"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2333393617742282"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-1885"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DBP.0000000000000167"},{"key":"e_1_2_10_6_1","volume-title":"Pan\u2010 Canadian scan: Home and community\u2010based services and supports\u2014Children with complex care needs","author":"Canadian Home Care Association","year":"2016"},{"key":"e_1_2_10_7_1","volume-title":"Children and youth with medical complexity in Canada","author":"Canadian Institute for Health Information","year":"2020"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0789"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1367493508088552"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthplace.2008.05.003"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedn.2010.04.008"},{"issue":"4","key":"e_1_2_10_12_1","first-page":"136","article-title":"Crossing lines: Parents' experiences with pediatric nurses in the home","volume":"4","author":"Coffman S.","year":"1995","journal-title":"Rehabilitation Nursing Research"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/019394599701900106"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-0910"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0175"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1945-1474.2008.tb01137.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.74"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/104973299129122144"},{"key":"e_1_2_10_19_1","volume-title":"Qualitative inquiry and research design","author":"Creswell J. 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