Globally, >2.1 billion children have chronic illnesses (Guariguata & Jeyaseelan, 2019), which are long-term conditions lasting from three months to a lifetime (Gallo et al., 2021). Each child with a chronic illness has particular healthcare needs to manage their conditions and prevent further complications and mortality (Curtis et al., 2016; World Health Organization, 2022). Their families face challenges, experience anxiety, and lack the knowledge and skills, leading to undesirable outcomes (Franck & O'Brien, 2019; Sivanandan et al., 2021). Thus, the family-centered care (FCC) model was developed and implemented in the Western context as the best practice for providing care to ill children (Al-Motlaq & Shields, 2017). An extension of this model and person-centered care is the child-and family-centered care (CFCC) model, which recognizes children and their families' perspectives and needs in the care process (Foster & Blamires, 2023). Both FCC and CFCC have similar core concepts and are used synonymously (Foster & Shields, 2018), but the CFCC specifically considers children's participation in decision-making (Foster et al., 2023). The existing evidence documented these models' benefits, such as earlier discharge from the hospital, minimizing readmission rates (Gómez-Cantarino et al., 2020; Park et al., 2018), and improving children's quality of life (Kuo et al., 2012; Park et al., 2018). However, there is still a lack of studies on pediatric patients examining the impact of partnership with families on the quality of care, which refers to the extent to which healthcare services achieve desired health outcomes (World Health Organization, 2023).

The literature highlights that not all nurses practice CFCC (Malepe et al., 2022; Mirlashari et al., 2020) with inconsistencies between their perceptions and practices (Dall'Oglio et al., 2022; Phiri et al., 2022; Prasopkittikun et al., 2020). Both qualitative (Malepe et al., 2022; Mirlashari et al., 2020;Toivonen et al., 2019; Wong et al., 2023) and quantitative studies (Abdel Razeq et al., 2021; Kutahyalioglu et al., 2022; Matziou et al., 2018) look at the factors that impact CFCC. These studies reported that nurses' characteristics, such as years of experience, knowledge, communication skills (Toivonen et al., 2019; Wong et al., 2023), and sharing information (Malepe et al., 2022; Mirlashari et al., 2020) might shape nurses ability in practicing CFCC. Also, organizational characteristics such as resources, integration of centered care into the mission statement, and physical design (Kutahyalioglu et al., 2022; Malepe et al., 2022; Wong et al., 2023) have been reported as important factors. Although these previous studies have provided insights into CFCC practice among nurses, qualitative studies are limited in providing knowledge related to the significant predictors of it. Quantitative studies mainly use bivariate associations without theoretical frameworks, leading to a lack of theory-driven knowledge. In addition, most previous studies have been conducted in Western countries, such as North America (Kutahyalioglu et al., 2022). The family-centered practice was initially developed in Western countries (Al-Motlaq & Shields, 2017). Thus, the factors that impact it in other parts of the world could be different, given that the healthcare system governs structures (McCarthy & Guerin, 2022) and cultural norms and values shape the practices (Srivastava, 2014).

In Saudi Arabia, only one study looked at the practice of a family-centered approach among nurses (Alabdulaziz et al., 2017), but this study did not examine the direct and indirect factors that influence it in different clinical settings. In addition, the influence of CFCC on the quality of care is still lacking in Saudi Arabia. This knowledge is required to tailor interventions for nurses and inform the implementation of healthcare policies. Thus, there is a need to examine the factors that impact CFCC practice and its impact on the quality of care.