child bering

8/20/2019 Child Bering

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2/22

1 million immigrants come to the U.S.each year (U.S. INS, 1991).

More than half are women of

childbearing age (U.S. INS, 1991). 1 in every 1 !ersons in the United

States is foreign"born (National #enter for#$lt$ral #om!etence, 1999).


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AfricanAmerican--12.1%

Hispanic--11.5%

Asian/PacificIslander--3.8%

AmericanIndian/AlaskaNative--0.7%

Nn-Hispanic

!"ite--71.#%(Population Estimates and

Projections, 2000)

American Indian/

Alaska Native

Asian/Pacific

Islander

Hispanic

African

American

NonHispanic

!"ite


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%roviding services, s$!!orts andassistance&

'hat are res!onsive to beliefs, inter!ersonal

styles, attit$des, lang$age and behaviors ofindivid$als with the greatest lielihood ofens$ring maim$m acce!tance and!artici!ation

'hat demonstrate res!ect for individ$al

dignity, !ersonal !reference and c$lt$raldi*erences

(#evelopmental #isa$ilities and %ill of &i'"ts Act of 2000)


5/22

U.S. demogra!hics are changing.

+ealth dis!arities eist between ethnicgro$!s in the United States.

eg$latory mandates re-$ireincreased, doc$mented c$lt$ralcom!etence.

#$lt$ral com!etence enriches!rofessional n$rsing !ractice.


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#$lt$re is a distinct way of life thatcharacteries a !artic$lar comm$nityof !eo!le.

#$lt$re incl$des shared !ractices,beliefs, val$es and c$stoms !assedthro$gh generations.

#$lt$re !rovides a sense of identity

(/I belong0).


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al$es

2orld view

3isease etiology

'ime orientation

%ersonal s!ace

4amily organiation

%ower str$ct$re


8/22

Integration into mainstream c$lt$re

5*ected by age at time of arrival in anew setting, reason for moving to a

new setting and residence in a!redominantly ethnic neighborhood

6enerally taes three generations inthe United States (S!ector, 7)


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8thnocentrism is the belief that onesown c$lt$re is best.

%roviders m$st be mindf$l of their own

ethnocentrism.


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8mic !ers!ective:;f an insider ormember of the c$lt$re

8tic !ers!ective:;f an o$tsider or

observer of the c$lt$re


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5 f$nctional tradition enhances anindivid$als health and well"being.

5 ne$tral tradition neither enhances

nor harms an individ$als health andwell"being.

5 non"f$nctional tradition is !otentiallyharmf$l to an individ$al.


12/22

Individ$al vs. gro$! identity

3ecision"maing

8ye contact


13/22

8vil s!irits

4athers !artici!ation at birth

Male health care !roviders

%regnancy as a healthy, nat$ral state


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From USDA & DHHS, 2002


15/22

5frican 5merican:Sicle cell disease

5mish:%=U, hemo!hilia <

6ree:'halassemia

>ewish:'ay"sachs, 6a$chers disease

Native 5merican:'y!e 7 diabetesmellit$s

Note: Conditions not limited to a single populationgroup.


16/22

#ommon !ractices 5voiding !eo!le from other c$lt$res

ef$sing to recognie c$lt$ral di*erences

ecogniing di*erences, b$t feeling ownway is s$!erior (ethnocentrism)


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2here were yo$born?

+ow long have yo$lived in the UnitedStates?

2ho are yo$r ma@ors$!!ort !eo!le?

2hat lang$ages do

yo$ s!ea and read?

2hat are yo$rreligio$s !ractices?

2hat are yo$r food

!references? 2hat is yo$r

economicsit$ation?


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2hat doeschildbearingre!resent to yo$?

+ow do yo$ viewchildbearing?

5re there anymaternal !reca$tionsor restrictions?

Is birth a !rivate orsocial e!erience?

+ow wo$ld yo$ lieto manage labor!ain?

2ho will !rovidelabor s$!!ort?

2ho will care forthe baby?

3o yo$ $secontrace!tion?


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Use a conversational a!!roach.

5s o!en"ended -$estions.

Integrate c$lt$ral and childbearing

assessments. Aisten with interest.

emain non@$dgmental.


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Inter!reters comm$nicate verbally. Sho$ld be female

Sho$ld not be a family member

'ranslators wor with written comm$nication.


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Maintain strict conBdentiality.

Inter!ret everything the woman sayswitho$t editorialiing or !ara!hrasing.

8ither !arty may interr$!t or seeadditional information.


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6ro$! needs vs. individ$al needs

ef$sal of treatment

Informed consent

'r$thf$lness

Morality

child bering

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