Child and Family Nursing Practice: Nursing Care Plan for Zhang Family

This case study report applies the nursing process to the Zhang family, focusing on challenges faced due to Wei's health condition and the impact on Daiyu. The report identifies issues, plans nursing interventions based on evidence-based practice and family systems, and evaluates their effectiveness in reducing Daiyu's stress and improving family functioning. It further analyzes the influence of social and health policies on children and families, particularly regarding vaccination decisions, with a focus on the community nurse's role in providing evidence-based information and addressing parental concerns.

Child and Family Nursing
Practice
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Table of Contents
Part 1................................................................................................................................................2
Identification of problem or issue faced by the family................................................................2
Planning.......................................................................................................................................2
Implementation of nursing care interventions.............................................................................2
Evaluation of nursing care interventions.....................................................................................4
Part 2................................................................................................................................................5
References........................................................................................................................................7

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Part 1
Identification of problem or issue faced by the family
Within the case study, it has been observed that due to the critical health condition of Wei
(Daiyu's father-in-law), Daiyu has to face health-related problems. As Wei is not allowed to get
Medicare facility, Daiyu is being forced by Jin (her husband) to work full time to gain extra
money. Daiyu is also responsible for doing all household chores, along with cooking. After
returning from work, she does not get enough time to sleep as she has to breastfeed her daughter
Olivia who is six months old. As a result, all these factors create a negative impact on her health
condition as well as family function by increasing differences in their relationships (Kassam-
Adams et al., 2015).
Planning
Based on the issue of the poor and distressful health condition of Daiyu due to family-related
stress, there possess a common nursing goal. The nursing goal is to educate, guide and counsel
the family members to maintain the wholesome spiritual, psychological and physical
environment, practice safe cultural practice and enhance good personal health habits (Tallon,
Kendall & Snider, 2015). This goal is being chosen as it will help permit and encourage Wei to
make appropriate decisions related to his health management. This particular nursing goal aims
to take appropriate measures to identify relevant resources and teach client family techniques to
help Wei and his family to maintain self-sufficiency. This will help them to cope with difficult
situations and enhance well family functioning without facing challenges.
Implementation of nursing care interventions
The two nursing interventions that must be developed to support the family to achieve the goal
are evidence-based interventions and family systems interventions.
Evidence-based practice interventions
The evidence-based practise interventions will be implemented by the nurse to achieve the goal
of teaching the family members the importance and use of client family techniques and

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maintaining self-sufficiency. This intervention will help Daiyu and his family members to avoid
emotional and physical harm. The implementation of the intervention will help Daiyu to
minimize stress as it creates a negative impact on her wellbeing and health. Such type of
interventions helps family members to become more confident and competent (Foster et al.,
2016). As a result, it will help the nurse to provide effective and safe care to Wei that can reduce
Daiyu's stress by increasing the sense of control and certainty and minimize her load.
Comprehensive counselling sessions by the nurse will help the family members such as Ling,
Wei, Jin and Daiyu to handle their responsibilities systematically. Through this nursing
intervention provided by the nurse, the family members will realize that it is significant to
maintain self-sufficiency and put pressure on one individual. Therefore, this particular
intervention is known to be the problem-solving approach that is mostly applied by most of the
nurses to help family members cope with difficult situations.
Family systems interventions
In order to achieve the goal of maintaining self-sufficiency, the nurse will implement family
systems interventions. The intervention will be implemented directly to the individual family
members by understanding the problems faced by each of the family members. This intervention
has been developed to address the lack of systems-oriented support, and when families
experience distress (Svavarsdottir et al., 2015). The significant aim for implementing this
intervention is to create an environment of change by conducting meetings with the family
members. As a result, this intervention will help Daiyu to maintain a family relationship, avoid
psychological empowering and eliminating experiences of suffering. Through the
implementation of this intervention, the nurse will achieve the goal of teaching and guiding
Zhang family members to maintain a positive relationship and mutual understanding with each
other.
With the implementation of this intervention, a nurse aims to interact with each member of the
family to know what issues are faced by them that creates an impact on their family functioning
(Coyne, Hallström & Söderbäck, 2016). Furthermore, within the case study, the nurse will
communicate with Wei, Ling, Jin and Daiyu regarding the difficult circumstances faced by them
after Wei has been diagnosed to the fourth stage of bowel cancer. The nurse will implement this

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intervention by focusing on the theoretical implications based on the problems faced by the
family members. This will help in achieving the goal and reducing the significant amount of
stress faced by Daiyu.
Evaluation of nursing care interventions
The two nursing interventions, such as evidence-based practice and family systems interventions
by the nurse, will help Daiyu to cope with health-related stress and maintain a positive
relationship with her family members. It is seen that evidence-based practice interventions help
in making appropriate decisions by going through several pieces of evidence. It possesses the
ability to individualize and evolve care of patients, enhance the expertise and minimize the cost
of patient care. Similarly, family systems interventions also help in understanding the difficulties
faced by family members. Such type of interventions aims to motivate the ability of both families
and patients for illness management and problem-solving (Smith, Swallow & Coyne, 2015).
However, the nurse would evaluate the effectiveness of this intervention by monitoring the
behavior of the family members. The evaluation will be carried out by the nurse by visiting
Zhang's home subsequently. It will help the nurse to observe the similar parameters that have
been examined on the relating findings and initial home visits based on expected goals or
outcomes.
The nurse will also teach Daiyu's limits of evaluation that will Daiyu to acquire professional
interventions if required. Moreover, at every visit, the nurse will focus towards the
documentation of client's progress and care given towards goal accomplishment. On the other
hand, the community nurse will evaluate the effectiveness of the interventions through physical
examination of every member of the Zhang family to identify the physical state of health. This
will help the nurse to acknowledge patient along with the family environment (Yektatalab,
Seddigh Oskouee & Sodani, 2017).

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Part 2
As per nursing response, testing strategies help parents to make evidence-based decisions related
to vaccines. This involves financial incentives, patient and provider communication techniques,
recall or reminder systems and online decision aids (Dubé, 2017). According to recent studies
individually tailored approaches and strong provider recommendations might be efficient in
maximizing the acceptance of the vaccine. The community nurse states that implementing a
randomized intervention trial to analyze the effectiveness of web-based resource use interactive
social media technologies to involve parents affect their immunization behavior and alleviate
their concerns. Thus, the evidence-based information gained from online resources will help
Daiyu to gain appropriate information regarding vaccination that is to be given to Lucy. The
evidence-based information provided by government agencies will help Daiyu to increase the
intention to vaccinate Lucy that makes her eligible to get admission in Kindergarten.
Moreover, the community nurse also states that public policy initiatives also focus on engaging
with vaccine-hesitant parents so that 95% of children are fully vaccinated (Reno et al., 2018).
She ensures Daiyu that public policy impacts the decisions related to vaccinations by developing
legislative or policy measures to promote vaccination. The community nurse will use clear and
effective language to provide evidence for vaccine benefits and disease risks accurately and
fairly to Daiyu. Based on the nursing response, she will reinforce parental responsibility and the
importance of community protection. This will help in correcting misconceptions regarding
vaccination and validate parental concerns systematically (Kestenbaum & Feemster, 2015).
Therefore, she must use public policy along with its responses to gain information regarding the
benefits of vaccination.
The community nurse will guide Daiyu that if she avoids or delays vaccination, it will increase
the outbreak of vaccine-preventable diseases. This will help in building a trusting relationship
between Daiyu and community nurse. Moreover, the community nurse will use effective
communication strategies by telling stories related to vaccine-preventable disease cases that will
help in addressing the concern of Daiyu related to vaccination. The community nurse will also
compassion and care while responding to the concern of Daiyu. It is observed that healthcare
providers play a significant role in enhancing vaccine acceptance among vaccine-hesitant

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parents. The healthcare provider has to ensure that every child must receive routine vaccination
(Henrikson et al., 2015). As a result, she will listen to the concerns of Daiyu related to
vaccination and acknowledge her in a non-confrontational way. Enabling Daiyu to express her
concerns will encourage her to listen to the views of the community nurse. Moreover, the
community nurse will build a partnership with Daiyu in making a personalized decision
regarding immunization. It is the responsibility of the nurse to provide relevant information to
parents related to Vaccine Information Statement policy through reliable web-sites and
educational resources (Shen & Dubey, 2019). The community nurse must give more stress to the
number of lives saved due to vaccination instead of concentrating on the number of deaths
because of not immunizing. She will discuss appropriate state laws for taking admission in
school and the reason behind such laws. As a result, such nursing response will help Daiyu to
gain a better understanding of vaccination-related aspects.

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References
Coyne, I., Hallström, I., & Söderbäck, M. (2016). Reframing the focus from a family-centred to a
child-centred care approach for children’s healthcare. Journal of Child Health
Care, 20(4), 494-502.
Dubé, E. (2017). Addressing vaccine hesitancy: the crucial role of healthcare providers. Clinical
Microbiology and Infection, 23(5), 279-280.
Foster, K., Maybery, D., Reupert, A., Gladstone, B., Grant, A., Ruud, T., ... & Kowalenko, N.
(2016). Family-focused practice in mental health care: An integrative review. Child &
Youth Services, 37(2), 129-155.
Henrikson, N. B., Opel, D. J., Grothaus, L., Nelson, J., Scrol, A., Dunn, J., ... & Grossman, D. C.
(2015). Physician communication training and parental vaccine hesitancy: a randomized
trial. Pediatrics, 136(1), 70-79.
Kassam-Adams, N., Rzucidlo, S., Campbell, M., Good, G., Bonifacio, E., Slouf, K., ... &
Grather, D. (2015). Nurses' views and current practice of trauma-informed pediatric
nursing care. Journal of pediatric nursing, 30(3), 478-484.
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Shen, S. C., & Dubey, V. (2019). Addressing vaccine hesitancy: Clinical guidance for primary
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Smith, J., Swallow, V., & Coyne, I. (2015). Involving parents in managing their child's long-term
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