Diversity and Maternal Child Nursing Chapter 2 Diversity and Maternal Child Nursing

Definitions Related to Providing Culturally Sensitive Nursing Care Culture: a view of the world and a set of traditions a specific social group uses and transmits to the next generation Transcultural nursing Cultural values Culture-specific versus culture universal values Ethnicity Race Diversity

Sexual Orientation/Gender Identity Heterosexual, homosexual, bisexual Gender identity Inner sense a person has of being male or female May be same or different from sex assigned at birth

2020 National Health Goals Related to Cultural Influences on Health Care Increase the proportion of pregnant women who receive early and adequate prenatal care from a baseline of 70.5% to a target of 77.6%. Increase the proportion of mothers who breastfeed their babies in the early postpartum period from a baseline of 43.5% to a target of 60.6%.

2020 National Health Goals Related to Cultural Influences on Health Care—(cont.) Increase the proportion of healthy full-term infants who are put down to sleep on their backs from a baseline of 69.0% to a target of 75.9%. Increase the proportion of young children who receive all vaccines that have been recommended for universal administration from a baseline of 68% to a target of 80%.

2020 National Health Goals Related to Cultural Influences on Health Care—(cont.) Reduce the rate of suicide from 11.3 per 100,000 to 10.2 per 100,000, a 10% decrease. Reduce the adolescent suicide attempt rate from 1.9 per 100 to 1.7 per 100, a 10% decrease. Increase the proportion of homeless people who suffer with mental illness who are able to receive mental health services from 37% to 41%.

Assessing for Cultural Values

Examples of Nursing Diagnoses Related to Cultural Diversity Impaired verbal communication related to limited English proficiency Anxiety related to a cultural preference for not wanting to bathe while ill Powerlessness related to expectations of care not being respected

Examples of Nursing Diagnoses and Outcomes Related to Cultural Diversity Nursing Diagnosis Outcome Impaired verbal communication related to limited English proficiency Family will be able to communicate their needs accurately to their health care provider. Anxiety related to a cultural preference for not wanting to bathe while ill Anxiety related to woman’s cultural preference will be decreased. Powerlessness related to expectations of care not being respected Feelings of powerlessness will be decreased.

Quality & Safety Education for Nurses (QSEN) Patient-Centered Care Teamwork & Collaboration Evidence-Based Practice Quality Improvement Safety Informatics

Possible Nursing and Therapeutic Interventions Interventions Related to Rendering Culturally Sensitive Maternal and Child Nursing Care Nursing Diagnosis Possible Nursing and Therapeutic Interventions Impaired verbal communication related to limited English proficiency Assure that a translator is readily available when communicating with the family. Anxiety related to a cultural preference for not wanting to bathe while ill Respectfully discuss the woman’s belief about not bathing while ill. Powerlessness related to expectations of care not being respected Respectfully explore the family’s expectations of their health care.

Evaluating Outcomes Related to Rendering Culturally Sensitive Maternal and Child Nursing Care Nursing Diagnosis Outcome Evaluation Impaired verbal communication related to limited English proficiency Family expresses that they feel that their needs were accurately expressed to their healthcare provider. Anxiety related to a cultural preference for not wanting to bathe while ill ? Powerlessness related to expectations of care not being respected

Question Which is an example of a culture-specific value or norm? The expectation that communication between the woman and the healthcare provider will be understood by both parties The expectation to have only the spouse present during the delivery The desire to have healthy family communication The desire for the family to have enough basic necessities in life

Answer B. The expectation to have only the spouse present during the delivery Rationale: The expectation of having only the spouse in the delivery room is only one of many cultural values related to expectations about labor and delivery and thus is not a universal one. In contrast, the expectations of clear communication with healthcare providers, having good family communication, and striving for enough resources for the family to flourish are almost universally embraced by all cultures.

Question In performing a family assessment, what is the best way to handle the situation of an English-speaking healthcare provider and parents who do not speak English? Assure that a translator from the healthcare organization is present. Enlist the help of a neighbor visiting the home who speaks English. Ask the oldest child in the family who has learned English to translate. Ask the family to bring a friend who speaks English with them for the next visit.

Answer Assure that a translator from the healthcare organization is present. Rationale: It is the healthcare organization’s responsibility to provide translation resources when the healthcare provider and the clients do not speak the same language. Asking a child in the family, a friend, or a neighbor is not appropriate (except in case of extreme emergency) because this could lead to the child needing to make age-inappropriate judgments or could easily result in a “third-party” health history from nonfamily members.

Question The nurse is assessing a laboring woman for pain. Which is most important for the nurse to remember? Pain threshold sensation can vary widely from one culture to another. Communication of pain is acceptable in all cultures, so she will readily tell you if she is in pain. Ways of expressing pain is fairly universal. Use of a 0 (no pain) to 10 (the most pain) scale is an objective way of assessing pain.

Answer D. Use of a 0 (no pain) to 10 (the most pain) scale is an objective way of assessing pain. Rationale: Use of a numeric pain rating scale is an evidence-based method of objectively assessing pain for most cultures. Although pain threshold and pain tolerance can vary widely across cultures, pain threshold sensation is fairly stable. Ways of expressing pain and the acceptability of expressing pain can also vary widely across cultures.