Felt or enacted criticism theory - a contribution to the understanding of parents' decision making in acute childhood illness at home

Aim: Parents' experience considerable anxiety concerning when to seek help for a sick child. This paper explores findings, from a doctoral research project, which contribute to the understanding of parents' decision making at these times. Method: This grounded theory study used 24 in-depth interviews in 4 rounds of data collection to explore psychosocial processes in 15 families when children are acutely ill at home. Analysis followed the tenets of Glaserian grounded theory methodology until theoretical saturation was reached. Results: Families strive to 'do the right thing' for their child, and to 'contain acute childhood illness within family life' - the core category of the grounded theory. Informal social rules regarding expected behaviour are learnt through 'felt or enacted criticism' during parent's encounters with others, when their children are ill. Consequently parents take action to avoid exposure to such negative scrutiny, sometimes resulting in late consultation for more serious illness. Conclusions: The findings indicate a need to develop professionals' skills in facilitating family care through positive learning experiences rather than felt or enacted criticism. Take home message: Health care professionals need to identify and reduce felt or enacted criticism experienced by families when seeking help for a sick child so that families help seeking behaviour can be positively enhanced