Peer-reviewed article
Stable Family Accompaniment as a Relational Right in Pediatric Care: A Delphi Study of Its Dimensions and Perceived Contribution to Child Well-being
Lucía García Expósito, María José Arroyo González ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study used expert consensus methods to define what stable family accompaniment means for hospitalized children and how it supports their well-being. Experts from healthcare, education, social care, law, and foster care agreed on five core dimensions of accompaniment, with strongest agreement on educational continuity, identity recognition, and emotional support. The research found that stable accompaniment is a relational right that requires coordinated protocols across different sectors to implement effectively.
Key points
- 37 of 45 items (82.2%) reached full consensus among experts on dimensions of stable family accompaniment in pediatric care
- Strongest agreement emerged around educational continuity, identity recognition, and existential-relational support for hospitalized children
- Stable accompaniment was defined as a multidimensional relational condition supporting the practical exercise of children's rights during hospitalization
- Tensions identified included concerns about volunteer substitution for family members and clarity around clinical decision-making roles
- Implementation requires intersectoral protocols, supervision mechanisms, and assignment of public responsibility
Limitations
The study establishes expert consensus on concepts and dimensions but does not measure outcomes for children themselves or test whether implementing these dimensions actually improves child well-being. The research is based on perceived contributions rather than empirical evidence of impact.
Abstract
Abstract Stable family accompaniment may support the well-being of hospitalized children, particularly when family presence is absent, fragmented, or mediated by public guardianship. This study aimed to establish expert consensus on the dimensions of stable accompaniment and its perceived contribution to emotional, educational, clinical, identity-related, institutional, and existential-relational well-being in pediatric care. A two-round mixed-methods Delphi study was conducted between June and September 2025 with 45 experts from health care, education, social care, law, public institutions, foster care, volunteering, and lived-experience backgrounds. Round 1 generated 843 narrative contributions, which were analyzed through inductive thematic coding. Round 2 used a 45-item Likert questionnaire completed by 42 experts. Consensus, content validity, ordinal agreement, and exploratory internal consistency were examined using medians, interquartile ranges, agreement percentages, I-CVI, S-CVI/Ave, Kendall’s W , and Cronbach’s α . The panel identified five core dimensions and one cross-cutting existential-relational axis. Thirty-seven items reached full consensus (82.2%), six reached partial consensus (13.3%), and two did not reach consensus (4.4%). The strongest agreement concerned educational continuity, identity recognition, and existential-relational support, whereas tensions emerged around volunteer substitution and clinical decision-making. Stable accompaniment was understood as a multidimensional relational condition that supports the practical exercise of children’s rights during hospitalization. Ensuring it requires intersectoral protocols, supervision, and public responsibility.