Case study - Canadian researcher
Please use 4-5 references Part 2: Case study analysis (40%) Objective: To apply FCC principles to a complex patient scenario and demonstrate critical thinking in assessing and planning family involvement. Instructions: Case study: A 10-year-old child, Liam, is admitted to the pediatric unit for a severe asthma exacerbation. He lives with his mother, Maria, and his 15-year-old sister, Chloe. Maria works two jobs and struggles to be present during the day. Chloe is very involved in Liam's care and often acts as a source of information for her mother. The family speaks English as a second language. Questions: 1. Family assessment: Perform a family assessment that goes beyond the immediate medical issue. What additional information would you need to gather to provide truly family-centered care? Consider cultural background, family dynamics, and resource availability. 2. Addressing the four principles: Describe specific, actionable nursing interventions that address each of the four core FCC principles within this case. For example, how would you ensure information is shared effectively with Maria, considering her work schedule? 3. Navigating challenges: What potential challenges might you face in this case (e.g., language barriers, limited parental presence, differing family opinions)? How would you approach these challenges to maintain a collaborative partnership?
Part 2: Case Study Analysis
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1. Family Assessment
An all-encompassing family assessment of Liam should not just confined to only acute asthma exacerbation but include aspects of culture, emotions, social, and resource-related problems with regard to family-centered care. To start with, it is necessary to acquire insights into the cultural background of the family, in particular, their thoughts regarding illness, asthma-provoking factors, drugs, and preferred communication style. Since they are a second language in English, it would be essential to determine their language of choice when discussing health, the level of their literacy skills, and the level of their comfort related to medical terms and words, to make sure that they understand everything and do not experience much anxiety.
It is also essential to examine the psychosocial background of the illness of Liam. It is evidenced that the anxiousness of children with asthma can be increased, and the psychological functioning of their parents that is characterized by anxiety of their mothers, can affect asthma control (Ferraro et al., 2024). Consequently, I would evaluate the stress level associated with hospitalization and emotional reaction to asthma attacks of Liam, and stress and potential anxiety of separation among Maria, since she was limited in her presence at the hospital. It is also crucial to know the emotional pressure on Chloe because teenage brothers and sisters tend to take up the role of a caregiver, which can affect their health.
The family dynamics also have to be analyzed. Maria works two jobs and is not always available throughout the day; therefore, Chloe is the closest she has to relay information. I would also determine the role allocation of the family, modes of communication, and decision-making. It is necessary to understand that they are willing to take part in asthma education and discharge teaching since initial and continuous education has proven to prevent further complications of asthma (Kennedy et al., 2022).
Lastly, there is a need to determine the availability of the resources. This will involve considering access to transport, insurance access, affordability of medication, access to a primary care physician, and past asthma education. A model of integrated care connecting families with follow-up services has been proven extremely helpful in reducing the number of emergency visits and hospital stays among pediatric asthma patients (Homaira et al., 2022). Care coordination, language services, or social work referrals will be identified during the early stages of the identification of gaps.
2. Addressing the Four Core Principles of FCC
A. Respect and Dignity
Cultural humility would allow me to promote dignity and respect towards the family and employ professional interpreters when necessary, and capture their worries regarding the symptoms and hospital stay of Liam. Recognizing the fact that Maria has limitations in her work and Chloe has a caring responsibility will aid in developing trust. It has been established that emotional stress is prevalent in parents of asthmatic children (Ferraro et al., 2024), and, therefore, it is important to be understanding of the emotional burden of a family.
B. Information Sharing
Maria cannot be available at all times, and thus, I would use flexible and multimodal modes of communication. This might involve regularly calling or video conferencing when she is taking a break and giving print materials in the language of her family, asking for visual aids to demonstrate the changes in medication. Its significance can be supported by evidence; timely and clear education, early corticosteroids, and proper follow-up administration are associated with better outcomes (Antonino et al., 2024). Also, the interactive type of education methods with the use of digital or VR-based instruments (asthma teaching methods) could enhance long-term adherence and asthma control (Wang et al., 2025). The tools might be presented at the time of hospitalization or even transferred back home as a tool.
C. Participation
To facilitate significant inclusion of the family into the care process, I would engage both Maria and Chloe in care consultation, where possible. I would seek permission and not overwork Chloe with making decisions that she should make, and make sure that she is not overworked as required of a sibling. Inhaler technique, humming about early symptom recognition and trigger management, joint discussions with the family help to increase involvement. The Teach-to-Goal technique in asthma discharge pathways focuses on the learning experience of mastery that can be positively related to better results and fewer asthma attacks in the future (Kennedy et al., 2022). I would also employ the same practical techniques so that Maria and Chloe can be sure that they are competent in administering drugs.
D. Collaboration
Collaboration entails the coordination of care between settings. I would collaborate with the interdisciplinary team to provide follow-up visits, language-related resource packets, and referrals to the family, which comprises the respiratory therapy, social work, and care coordinator. It has been observed that care coordinators have effectively minimized ED visits and admissions because they enable communication between primary care and hospital providers (Homaira et al., 2022). Cases of collaboration with school nurses can also help in continuing with the management of asthma.
3. Navigating Challenges
Several challenges may arise in this case.
Language barrier can also lead to confusion in understanding the treatment plans or the steps in asthma action plans. I would deal with this by having professional interpreters always use, asking the family to repeat important information, and giving them materials in their language.
Limited parental presence creates a problem in learning and making of decisions. In response, I would provide alternative teaching and distance learning services. When Maria posed the question: “What would you do if you cannot be present during the day?”, I would resort to the following answers: I would schedule the updates, request an electronic copy of plans of care, and insist all important information is shared with me in writing so that I would be able to observe it during working hours.
Siblings as informal caregiver presents a danger of role strain to Chloe. I would confirm her intervention, but put the main load on adults. Another thing I would evaluate with her is her level of comfort with asthma education materials so that the patient is not overwhelmed.
It is possible that emotional pressure and anxiety in the victims, Liam and Maria, can influence the control of asthma, which was reported in the literature (Ferraro et al., 2024). I would evaluate anxiety, promote coping skills, and give referrals to child-life specialists or mental health professionals.
The various settings of care and inconsistent follow-up can prove to be obstacles in the long-term management. In this regard, I would incorporate care coordination so that a primary care provider could follow up within the stipulated period. Integrated models and reminders of programs have also been reported to do a tremendous job of reducing ED visits (Homaira et al., 2022).
Treating every challenge with empathy, flexibility, and evidence-based interventions will allow me to have a collaborative partnership benefiting the whole family, as well as maximizing the outcomes of asthma in Liam.
References
Antonino, L., Goossens, E., van Olmen, J., Bael, A., Hellinckx, J., Van Ussel, I., ... & Van Hoorenbeeck, K. (2024). Managing Pediatric Asthma Exacerbations: The Role of Timely Systemic Corticosteroid Administration in Emergency Care Settings—A Multicentric Retrospective Study. Children, 11(2), 164. https://doi.org/10.3390/children11020164
Ferraro, V. A., Spaggiari, S., Zanconato, S., Traversaro, L., Carraro, S., & Di Riso, D. (2024). Psychological Well-Being of Children with Asthma and Their Parents. Journal of Clinical Medicine, 13(17), 5100. https://doi.org/10.3390/jcm13175100
Homaira, N., Dickins, E., Hodgson, S., Chan, M., Wales, S., Gray, M., ... & Woolfenden, S. (2022). Impact of integrated care coordination on pediatric asthma hospital presentations. Frontiers in pediatrics, 10, 929819. https://doi.org/10.3389/fped.2022.929819
Kennedy, L., Gallagher, G., Maxwell, B., Bartholme, B., Fitzsimons, A., Russell, C., ... & Shields, M. D. (2022). Implementation of a Children's Safe Asthma Discharge Care Pathway Reduces the Risk of Future Asthma Attacks in Children–A Retrospective Quality Improvement Report. Frontiers in pediatrics, 10, 865476. https://doi.org/10.3389/fped.2022.865476
Wang, H., Dong, Q., & Wang, X. (2025). The impact of asthma education grounded in virtual reality technology upon the quality of life of pediatric patients with bronchial asthma. Frontiers in Pediatrics, 13, 1588562. https://doi.org/10.3389/fped.2025.1588562
