1A. Consider all birthplace options, recognizing that birth experiences are enhanced in home, birth center, or hospital settings that support parent's informed choices for the labor, birthing, and postpartum process.
References:
Abstract 1:
Premise: The cultural beliefs and traditions held by childbearing women may influence their perception and expression of pain and discomfort experienced during labor and postpartum periods.
Research Questions: What are some of the ethnic and cultural elements that may influence a woman’s pain experience. How does transcultural knowledge foster optimum management of pain and discomfort experienced by women during labor and postpartum periods?
Study Design: The study is based on a literature review of 20 references, including oral accounts, on cultural diversity’s importance in delivering quality nursing care. The literature reviewed noted both quantitative and qualitative design studies utilized (e.g., true experimental, quasi-experimental, comparative, phenomenological, ethnographic, grounded theory, and case studies).
Findings: Consistent documentation of empirical data validates that ethnicity and culture do play a role in how a woman perceives, expresses, and experiences pain during childbirth. Problems sometimes develop with care providers because 1) verbal communications related to cultural differences are impaired, 2) social dissonance or lack of common understanding leads to impaired social interaction or interpretation, and 3) differences in the mother’s value system about health beliefs may create conflict with care provider assumptions. In-depth cultural assessment can use tools such as the Leininger Assessment, the Tripp Reimer Assessment, or the Andrews Assessment. Emergency cultural assessments should include details about nationality, language, religion, and expectations about care. Nonverbal communication becomes increasingly important when verbal communication is impaired. This can consist of demonstrating warmth and respect, offering a soothing touch when accepted, and presenting simple idiom-free language. Care providers should study transcultural key concepts for cultures that they frequently encounter. Care providers should also demonstrate and make allowances for cultural differences. Interpretations and written materials should be available.
Research reviewed by Roxanne Zeto-Brennan, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.
Abstract 2:
Premise: Hispanic immigrants have a unique set of health beliefs that influence their breastfeeding decisions.
Variables: Prenatal care obtained, individual perception.
Study Design: A total of 140 women of Mexican-American descent were selected in four hospitals. The women were an average of 21 years old and primiparous. The women were interviewed at 24 hours postpartum and six weeks postpartum. All questions were read aloud to the subjects to eliminate any potential for error because of reading difficulty.
Findings: The Hispanic’s health-seeking behavior is different from the Anglo-American’s. While both groups may use the care provider, the information received is mediated differently. In the Hispanic culture, family members and friends are a strong influence on how the woman makes decisions about breastfeeding. The use of Pender’s modification of the Health Belief Model is useful in predicting motivational factors that affect breastfeeding. These include individual perceptions (prenatal care obtained and reason for selecting the feeding method), modifying factors (maternal age and head of household), and likelihood of action (timing of the breastfeeding decision and father's opinion). As families immigrate, they form a unique culture that is unlike that of Mexicans or Anglo-Americans. Health professionals need to understand these influences on their breastfeeding decisions.
Research reviewed by Roxanne Zeto-Brennan, RN, while a student at Virginia Commonwealth University, School of Nursing, in Richmond, VA.