Potential for intergenerational conflict in Cuban and Haitian immigrant families

Potential for Intergenerational Conflict in Cuban and Haitian Immigrant Families

Lydia De Santis and Doris Noel Ugarriza

A descriptive survey of 30 Cuban and 30 Haitian immigrant mothers describes and differentiates the families within the two cultural groups on: (a) sociodemographic characteristics; (b) concepts of children; and (c) childreating beliefs and practices related to independence training, sex role development, and discipline patterns. Results indicate the two groups have similar sociodemographic char- actetistics but differ"bn qualities admired in boys and girls, career expectations held for their children, s~tcial autonomy allowed male and female children, and

x methods used to instill proper sex role behavior. Findings suggest the existing potential for intergenerational conflict in families within immigrant groups whose language and cultural beliefs differ from those of the culture into which they have entered and are acculturating. |mi~lications for care indicate a need for psychi- attic mental health nurse (PMH nurses) to use the principles of cultural brokerage for intervention in and prevention of intergenerational conflict. Emphasis is placed on the development of transcultural interventions designed to empower immigrant parents to address the real or perceived conflicting childreating beliefs and practices held between their original culture and the culture into which they are acculturating. Copyright © 1995 by W.B. Saunters Company

F qEW NATIONS in the world have a history of massive influxes of immigrants and refugees

like the United States. Numerous ethnic groups, such as the Vietnamese, Cubans, Haitians, Nica- raguans, Mexicans, Chinese, Afghans, and Arabs, have recently undergone or are undergoing the process of acculturation.

The majority of immigrant groups experience the phenomenon of intergenerational conflict during the acculturation process (Levinson, 1989; Or- leck, 1987; Szapocznik & Truss, 1978). The conflict evolves when parents, as the main socializing agents of children, tend to retain traditional values related to appropriate role behaviors and standards of conduct for their children. Children, on the

From the University of MiamL School of Nursing, Coral Gables, FL.

Address reprint requests to Lydia De Santis, PhD, Uni- versity of Miami School of Nursing, 5801 Red Road, Coral Gables, FL 33124.

Copyright © 1995 by W.B. Saunders Company 0083-9417/95/0906-000453.00/0

354

other hand, tend to adopt the norms and values of the new host culture more rapidly than parents because of their enrollment in school, greater language facility, and friendship with children who are members of the new culture (Bernal & Gutier- rez, 1988; Foner, 1987; Ruiz, 1982; Serafica & Rose, 1982; Spector, 1994; Szapocznik & Truss, 1978).

Research studies with pre-Castro Cuban immigrants in South Florida have shown that families with the greatest intergenerational gaps in acculturation had the most widespread adjustment problems (Szapocznik & Kurtines, 1980). Family dis- ruption and dysfunction linked to intergenerational problems has become a focus of concern among Haitian immigrants who were distressed and dis- appointed over their children's loss of discipline and respect for authority (Charles, 1986; Miller, 1994; Shannon, 1985; Staff, 1994; Taylor, Bi- afora, Warheit, Vega, & Zimmerman, 1992; Viglucci, 1994). Haitians attributed the loss of those highly prized values to the Americanization

Archives of Psychiatric Nursing, Vol. IX, No. 6 (December), 1995: pp. 354-364

INTERGENERATIONAL CONFLICT 355

of their children (Charles, 1986; Shannon, 1985; Staff, 1994; Viglucci, 1994).

The results of a research study of childrearing beliefs and practices with Cuban and Haitian immigrant mothers in South Florida shows the potential for intergenerational conflict and the need for a transcultural nursing approach to lessen the disorganizing effects of acculturation on family functioning. The study was undertaken because there was limited knowledge about childrearing beliefs and practices of these groups, and because they differed in their sociodemographic characteristics and immigration process from previous groups of Cuban and Haitian immigrants who entered South Florida before the 1980s.

The purpose of this article is to (a) compare and contrast the degree of encapsulation of Cuban and Haitian immigrant families in South Florida; (b) describe their cultural views of children; and (c) provide information for psychiatric mental health (PMH) nurses to use as a basis for constructing and implementing transcultural nursing interventions for potential problems arising from intergenerational conflict during the acculturation process.

Glossary of Terms

Acculturation may be considered as relearning culture to adapt to a new or changing environment. During the process, a person's cultural beliefs, practices, and values are generally modified or re- placed by those of another culture (DeSantis, 1986).

Encapsulation is the existence on a daily basis within a relatively enclosed and geographically bounded enclave of persons of the same socioeconomic and/or ethnic group. The enclave provides the majority of an individual's interpersonal rela- tionship network, goods and services needed for activities of daily living and family life, socioeconomic and political support, and entertainment and recreation activities (Hammerz, 1980; Nash & Schaw, 1962).

Transcultural nursing encompasses the integra- tion of the concept of culture into all aspects of nursing care. It is the ability of nurses to tempo- rarily suspend their own cultural values, beliefs, and practices to appraise the situation as those of another culture do. It requires the use of appropriate aspects of each health-culture orientation under consideration to develop mutually derived and cul- turally acceptable health care interventions (De- Santis, 1994).

Culture brokerage is the process of linking, bridging, negotiating, or translating between the health care orientations of the provider and the client. It involves the interpretation of messages, instructions, and beliefs and practices from one person or group to another (DeSantis, 1994; Tripp- Reimer & Brink, 1985).

METHOD

The study is a descriptive survey using a semistructured interviewing format. No field observa- tions were performed during data collection.

Sample

The sample consisted of 30 Cuban and 30 Hai- tian immigrant mothers in the Miami-Dade County Metropolitan area of South Florida. The participants met the following inclusion criteria: (a) born and reared in their country of origin, (b) lived in the United States for 4 years or less, (c) reared children in the United States and/or their country of origin, and (d) had children in the infancy to adolescent age range.

Sampling Procedure

A purposive, volunteer sample was obtained from congregations of churches serving the Cuban and Haitian communities and through the Dade County Health Department. Permission from the institutions was granted to telephone and/or network with the mothers to ascertain their willingness to take part in the study. On gaining permission, interviewers visited the participants in their homes and obtained their informed consents.

Instrument

A 110-item Child-Rearing Beliefs and Practices questionnaire was developed for the study by the principle investigators. Four areas were surveyed: (a) sociodemographic characteristics; (b) household structure and function; (c) concepts of child health and illness; and (d) childrearing beliefs and practices related to discipline, expression of emo- tion, independence training, feeding and weaning, social autonomy, and sex role development.

The majority of questions were semistructured, but the interviewees were encouraged to elaborate on their answers. Content validity was established by asking a panel of experts on Cuban and Haitian cultures to review the questionnaire for content,

356 DESANTIS AND UGARRIZA

clarity, and appropriateness. The questionnaire was pilot tested for usability. Changes made in the questionnaire due to pilot testing were mainly editorial in nature.

Data Collection

The interviews were conducted by Spanish or Haitian Creole speaking health care providers trained in open-ended interviewing and questionnaire administration. The interviewers were de- briefed by the researchers to ensure the complete- ness of the recorded responses and to enhance the accuracy of data interpretation. Interviewees were recontacted as necessary to clarify their responses or to obtain missing data.

Data Analysis

Sociodemographic characteristics were summa- rized using frequencies, percentages, and aver- ages. Content analysis at the level of phrases or sentences was performed on answers to the childrearing questions, to generate categories of responses. The responses were compared using frequencies and percentages to show intergroup and intragroup variations.

Validity and Reliability of Findings

Multiple method validation was performed to assure the findings represented the Cuban and Hai- tian concepts of childrearing. Results were compared with other studies of Cubans and Haitians in the literature and discussed with the interviewers, anthropologists, and key informants to determine their sociocultural basis and meaning.

Reliability was assessed through stability of content categorization by identifying frequency and percentage of content coded to the same category. Reproducability was enhanced through con- sensus coding. The two principle investigators jointly categorized responses to questionnaire items.

FINDINGS

Data related to encapsulation and cultural views of children (expected sex roles regarding qualities admired, career goals, discipline patterns, and social autonomy) are presented to show the potential for intergenerational conflict during the acculturation process.

Sociodemographic Characteristics

The sociodemographic characteristics of the Cu- ban and Haitian mothers were remarkably similar. Mean scores for both groups were: 3 for number of years in the United States; 30 years of age for participant; 2 for number of children per household; and 5 for the age of children. Ninety-three percent (28) of both groups were married or living with their mates. The Cuban mothers averaged 11 years of formal education and the Haitian mothers 5 years. Spouses averaged 9 and 7 years of education respectively. Seventy percent (21) of the Cuban mothers and 63% (19) of the Haitian mothers were Catholic. The remaining mothers were Protestant.

Household structure differed with 77% (23) of the Cuban households reported as nuclear and 23% (7) as extended. All Haitian households were nuclear.

An average of 17% (5) of Cuban households received assistance from kin with household chores (cooking, cleaning, and shopping), child care, and paying bills. No Haitian household received such assistance from kin.

Twenty-three percent (7) of the Cuban mothers, compared with 80% (24) of the Haitian mothers reported being employed outside the home. Em- ployment of mates outside of the homes was 89% (27) for the Cuban families and 96% (29) for the Haitian families. All had household incomes be- low the poverty level. The median yearly household income for the Cuban families was $7,200 and $7,800 for the Haitian families.

Encapsulation

Both groups of interviewees were relatively en- capsulated in their respective ethnic neighborhoods, where they carried out the majority of activities of daily living and sought social services. Only one Cuban mother and no Haitian mother was a member of any type of formal association or organization within or external to their ethnic neighborhood.

Cuban mothers in the study spoke only Spanish. None attempted to communicate in English in their home or to neighbors, clergy, teachers, health care providers, clerks, government officials, or social service workers. None listened to or read English language media. Only one Cuban mother and spouse had ever attended classes for English as a second language.


Haitian mothers also did not listen to or read English language media. The vast majority generally spoke Haitian Creole inside and outside the home, but 33% (10) spoke English when interact- ing with persons outside the household. Forty-two percent (13) were enrolled in classes for English as a second language as were 50% (15) of their mates.

Views of Children

Data related to views of children will focus on: (a) qualities admired in boys and girls; (b) career goals; (c) discipline patterns; and (d) social autonomy.

Qualities admired in boys and girls. Table 1 summarizes the qualities the Cuban and Haitian mothers stated were desired in children. The ideal Cuban boy and girl would have essentially the same characteristics except that the boy would be brave and strong and the girl would be sweet, helping, soft, and tender. Both should be (a) studious, intelligent, and educated; (b) respectable, decent, and good; and (c) quiet, respectful, polite, and obedient.

The Haitian mothers seemingly emphasized different qualities that typified the ideal boy or girl. The ideal Haitian boy would have two dominant groups of characteristics: (a) being strong, responsible, and brave; and (b) assuming responsibility

Table 1. Qualities Admired in Children

Cuban Male Haitian Male

Qualities % (n) % (n)

Mascul ine 40.0 (12) 50.0 (15)

Studious 90.0 (27) - - - -

Good mora ls 53.3 (16) 10.0 (03)

Obedient 50.0 (15) - - - -

Assume fami l y - - - - 70.0 (21)

responsibi l i t ies

Other 13.3 (04) 3.3 (01)

Cuban Female Haitian Female

% (n) % (n)

Feminine 46.7 (14) 50.0 (15)

Studious 96,7 (29) - - - -

Good mora ls 46.7 (14) 3.3 (01)

Obedient 66.7 (20) 56.7 (17)

Assume fami l y - - - - 16.7 (05)

responsibi l i t ies

Other 16.6 (05) 3.3 (01)

Note: Number and percent are based on the total number of

responses.

for family welfare and contributing to it financially. The Haitian gift would not be expected to assume as much responsibility for family welfare but would be: (a) helping, sweet, understanding, soft, and tender; and (b) controlled, obedient, and quiet.

Career goals. The Cuban and Haitian mothers differed greatly on the career goals they held for their children and how such goals were to be achieved. When the Cuban mothers were asked what their children should become as adults, 90% (27) stated, "Whatever they want to be." Even when pressed for specific types of appropriate oc- cupations, they gave the same response. The Cu- ban mothers saw the child as dependent on the family for success and considered it the responsibility of the family to help children develop prob- lem solving abilities and learn concepts of good citizenship. They tended to focus blame on the parents if children did not achieve or behave, say- ing the parents were not " loving", failed to try hard enough to help, or were not "good" mothers or fathers.

The Haitian mothers were much more specific when asked what they wanted their children to be as adults. Sixty-three percent (19) of the responses fell into the professional category, e.g., physician, lawyer, nurse, teacher, or architect. Another 16% (5) were in the skilled, technical category, e.g., beautician and secretary. They stated that parents were responsible for helping children make the "right" decisions and that parents needed to push and pressure children to achieve and obey. They tended to blame the children if they failed to achieve and to see themselves as victims of their children's shortcomings. Graduation from high school was considered to signify that parents had accomplished their goal of helping children better themselves and become self-sufficient.

Discipline patterns. The Cuban and Haitian mothers were asked whether children should be punished for certain behaviors and if so, how. The behaviors surveyed were swearing; hitting friends, parents, or adults; having temper tantrums; dam- aging property; disobeying parents, teachers, adults, or older siblings; talking back; and refusing to eat or take medications.

The Cuban mothers used various combinations of three types of punishment for the behaviors surveyed: (a) loss of privileges, such as playing or watching television; (b) confinement of children to


their rooms or the house; and (c) verbal reprimands described as "scolding", "tell ing" them not to do something, and "reasoning" with, "explaining", or "teaching them right from wrong". They used spanking a median of 22% of the time, with a range of 7% to 57% for the behaviors surveyed. Talking back to teachers was the only behavior that the majority of Cuban mothers would punish by spanking. The Cuban mothers saw their parental roles in matters of discipline much as they did in terms of helping children achieve in school and life, i.e., as parents who teach or instruct their children to be good citizens.

The Haitian mothers used four types of punishment: (a) spanking; (b) making children kneel for hours; (c) loss of privileges; and (d) verbal reprimands described as " sc reaming" at children. Spanking was used alone or in conjunction with the other three types of punishment from 73% to 91% of the time with a median of 90% for the behaviors assessed.

The Haitian mothers expected unquestioned obedience from their children. Questioning of parental authority was not tolerated nor was reasoning or negotiating with children.

Twenty percent (6) of the Haitian mothers expressed concern about not being able to fully control their children, and another 13% (4) were wor- ried about being reported for child abuse because of their severe methods of discipline. They re- garded such methods as absolutely essential to

raise an obedient, quiet, respectful, and responsible offspring in American society, where they considered children to be too " f ree" , unruly, and dis- respectful of elders. The Haitian mothers stated that discipline problems were the most difficult aspect of rearing children in the United States. The Cuban mothers did not voice similar concerns.

Social autonomy. Table 2 summarizes the in- dependent activities away from home that the Cu- ban and Haitian mothers would allow their children.

Both groups of mothers permitted male children more social autonomy away from home than female children for the activities surveyed. Cuban mothers were more restrictive than the Haitian mothers about girls going to activities alone and in terms of never allowing either male or female children any social autonomy.

Cuban mothers were also more restrictive in terms of the median age at which children could play away from home alone (8 years), go to the store by themselves (10 years), and go to school unaccompanied by an adult (11 years). Twenty- three percent (7) would never allow children to play away from home, and 27% (8) would only allow children to go to school without being ac- companied by an adult if transportation was pro- vided. Haitian children would be allowed to play away from home alone at a median of 5 years of age and go to the store and school at a median age of 7 years of age.

Table 2. Male and Female Activities Permitted Away from Home

Cuban

Male Female Neither

Activity % (n) % (n) % (n)

Go to store 80 (24) 60 (18) 20 (06) Go to movies 87 (26) 57 (17) 10 (03) Go to dances 67 (20) 47 (14) 33 (10)

Go to sporting events 93 (28) 73 (22) 7 (02)

Haitian

Mate Female Neither

% (n) % (n) % (n)

Go to store 100 (30) 90 (27)

Go to movies 100 (30) 43 (13) Go to dances 100 (30) 30 (09)

Go to sporting events 100 (30) 50 (15)

Note: Percentages may exceed 100% due to rounding.


DISCUSSION AND IMPLICATIONS FOR NURSING CARE

Findings will be related to: (a) the social, economic, and political factors affecting the mothers since their immigration to the United States; and (b) traditional Cuban and Haitian cultural values and beliefs. Knowledge of both areas is essential if PMH nurses are to function as culture brokers to develop transcultural nursing interventions.

Cultural Concepts of Family Functioning and Parent-Child Relationships

The varying degrees of encapsulation in their traditional culture and the willingness, need, or ability of the Cuban and Haitian mothers or their mates to speak English portends several areas of potential intergenerational conflict. In the majority of Cuban and Haitian immigrant families undergoing the acculturation process, it is the children who speak the new language and who are turned to by family members and health care providers when language becomes a barrier to care. Such empow- erment of and dependence on children to act as language and culture brokers on critical issues is contrary to traditional Cuban and Haitian concepts of family functioning and intergenerational role relationships and responsibilities.

Cuban concepts of family functioning. Famil- ismo is a central element in the Cuban world view, i.e., family members are united by powerful bonds of loyalty and commitment to each other (Bernal & Gutierrez, 1988; Sandoval & De la Roza, 1986). Cubans see themselves as dependent on an inter- dependent family unit and network for material assistance, love, support, and general well-being (Bernal & Gutierrez, 1988; DeSantis & Thomas, 1994; Sandoval & De la Roza, 1986). Parents and family elders exert strong control over family and individual decision making, are seen as always having the right and obligation to impose paternal- istic authority over children and younger members regardless of age, and tend to extend child depen- dency well beyond the legal definition of adult- hood (Bernal & Gutierrez, 1988; Ruiz, 1982; San- doval & De la Roza, 1986).

Haitian concepts of family functioning. In traditional Haitian culture, children are socialized to be self-sufficient and self-reliant at early ages. They are also taught to view themselves as subor-

dinate to lineal family authority and to show un- questioning obedience to parents and older kin (Charles, 1986; Metraux, 1967). Such unquestioned obedience is intended to instill respect for parents and older kin (Metraux, 1967). They are taught to emulate older, more competent children or adults rather than to compete for attention or material goods (Brown, 1991: Metraux, 1967). Such emulation fosters a noncompetitive and co- operative interdependence among Haitian family members, and children learn to rely on parents and other adults who are seen as stronger and wiser. It is parents and older adults that Haitian children see themselves dependent on throughout life (Brown, 1991; DeSantis & Thomas, 1994; Laguerre, 1982; Metraux, 1967).

Sex Roles and Social Autonomy

When directly asked, Cuban and Haitian mothers cited somewhat different qualities admired in male and female children. Data related to career goals and discipline patterns indicated the differences between them were, in fact, minimal (Table 1). However, data from other parts of the study indicated the differences between them were, in fact, minimal. Except for the assumption of family responsibilities, both groups valued the same qualities in their male and female children. The characteristics were valued for different purposes, af- fected by different cultural, socioeconomic, and political forces, and engendered by different childrearing practices.

Cuban perspective. The masculine and feminine characteristics are those which heavily influ- enced behavior in pre-Castro Cuba where males were to be "macho" and women were to remain attractive and submissive to men. They are still the sex role characteristics that are dominant in the South Florida community into which the interviewees have immigrated (Martin, 1994; Sando- val, 1985; Sandoval & De la Roza, 1986).

The remaining characteristics, have become more prominent throughout Cuba since the Castro revolution in 1959. Revolutionary emphasis on the "new man" (hombre nuevo) requires that a person be (a) well-educated; (b) achieve great personal joy working for the good of the State and others; (c) remain free from corruption; and (d) consider the sexes equal while according them the same op-


portunities and status (Leghorn & Parker, 1981; Roemer, 1985).

The Cuban mothers' failure to mention children assuming family responsibilities is reflective of the current Cuban political ideology and socioeconomic system in which, theoretically at least, parents are less dependent on children for financial assistance throughout their lifespan. Universal ac- cess to education achieved under Castro has also decreased the availability of children for employ- ment to make monetary contributions to the family. Because 60% (18) of the Cuban mothers cur- rently had kin contributing to household income, the need for children to contribute financially to the family was not as central as it had been and still is for immigrant Haitian households.

Haitian perspective. Haitian children are socialized at a very early age to contribute to family income and welfare and are considered by parents to be a form of old age social security (Alvarez & Murray, 1981; Brown, 1991; Charles, 1986; Metraux, 1967). Haitian males are groomed for the role of head of household throughout childhood. They are expected to hire out for wage labor when older and to send money home for the betterment of the family if they migrate or immigrate (Alvarez & Murray, 1981; Brown, 1991; Comhaire-Syl- vain, 1961; Laguerre, 1978; Miller, 1984; Staf- ford, 1987; Stepick, 1992). As Haitian parents age, they expect and come to rely on adult female offspring for physical and psychoemotional care (Brown, 1991; Charles, 1986; DeSantis, 1985; Metraux, 1967).

The apparent failure of Haitian mothers to em- phasize the qualities of morality in general or obedience in boys in particular was contradicted by their concern that the lack of extended family and their need to work prevented them from spending time with children to (a) listen to their problems and concerns; (b) protect and guide them through the "dangers" of adolescence; (c) help them make the proper decisions; and (d) assist them to become "good" human beings who are "respectful" of others (DeSantis, 1985). Haitian childrearing practices rely on linear authority and unquestioned obedience throughout the lifespan to older adults, parents, and other authority figures.

The seeming lack of value the Haitian mothers placed on studiousness as a desirable characteristic was contradicted by the career goals they held for their children, the significance they placed on chil-

dren graduating, and the directiveness they believed parents should exert on their children's career choices and daily life. The availability of free (public) education for children is cited consistently by Haitian immigrant parents in South Florida as one of the best things about having and raising children in the United States (Behavioral Science Research Institute, 1983; DeSantis & Thomas, 1989). The growing rate of school absenteeism and delinquency among Haitian children in the 1990s has become an issue of extreme concern for parents in the "Little Haiti" community of Miami (Staff, 1994; Viglucci, 1994).

IMPLICATIONS

Encapsulation and Family Functioning

Both the Cuban and Haitian immigrant families experience considerable acculturation stress because of their nuclear structure and encapsulation in ethnic neighborhoods. The strength of the traditional Cuban and Haitian family has been in sharing of responsibility and resources among the extended kin group. Neither has an extended kin support group readily available that can provide the emotional or practical assistance necessary to alleviate the social, political, and economic stress that are inherent in the immigration and acculturation processes and a poverty-level existence. The need of the immigrant family to rely primarily on itself may be most detrimental to its younger members, who are often called on to assume more and more responsibility for child care, outside employ- ment, and household responsibilities.

PMH nurses should remain alert to the fact that increased school absenteeism, dropout rates, or falling grades among Cuban and Haitian immigrant children may signal increased demands on them by their parents. PMH nurses will also need to assist Cuban and Haitian families to make the transition from reliance on kin to greater self- reliance in their new socioeconomic environment. One way is to encourage the development and/or use of cultural resources within the Cuban and Haitian communities. Culture-specific resources would include such things as (a) encouragement of informal neighborhood and other self-help col- lectives to assist in meeting community/individual needs; (b) development of neighborhood/


community leaders as ombudspersons to liaison with the formal social service, political, and health care delivery sectors, and (c) assisting church groups to address pressing community problems, such as lack of child care facilities, need for family-based activities, and inadequate transportation services (Stafford, 1987; Weidman, 1978; Wong, 1987).

PMH nurses also can assist the Cuban and Hai- tian immigrant families to develop a sense of be- longing to the new culture and an understanding of its institutions to prevent feelings of anomie and the sense of alienation that immigrant groups experience, ultimately leading to their further encapsulation and withdrawal into ethnic enclaves (Foner, 1987; Hammerz, 1980; Nash & Shaw, 1962; Orleck, 1987; Stafford, 1987). PMH nurses can undertake two simultaneous foci of action to prevent the dual sense of anomie and alienation. One is to encourage family members to learn more about, interact with, and participate in the new culture, by joining groups at school, church, and community organizations and taking classes in En- glish as a second language. The second is to assist individuals, groups, and civic, social, and religious organizations from the new culture to develop and nourish links with the Cuban and Haitian immigrant families/communities. It is through such links that members of the host culture and larger society will be able to understand the immigrants' cultural beliefs, practices, and institutions and the strengths and resources they bring to their new society. It is also through such multicultural links that members of the host culture and immigrant culture enhance each other and strengthen the civic, social, and religious organizations responsible for the health and welfare of the greater society of which each is a part (Foner, 1987; Hammerz, 1980; Orleck, 1987; Wong, 1987).

The Cuban and Haitian families will also need assistance in understanding the underlying dynam- ics of language and its effects on family functioning when children have greater command of the language and functional modes of the newer culture than do their parents. Reliance on children to verbally negotiate with the newer and dominant culture may cause perceptions of parental inade- quacy, which can presage conflict, withdrawal, and/or abuse (Levinson, 1989).

PMH nurses should remain alert for important indicators of role-related and intergenerational ac-

culturation problems, such as poor school perfor- mance, delinquency, drug use, child abuse, and child suicide. Child abuse may be a special prob- lem in the future for the Haitian immigrant communities if strict obedience is demanded of the children and hands-on modes of punishment are used to instill it. However, as data from this study and the literature indicate, the Haltians are very well aware of and concerned about that potential (Charles, 1986; DeSantis, 1985). Likewise, the Haitian mothers expressed considerable concern about raising children in the United States because of the abundance of drugs, the high crime rate, peer pressure from American children who have "too much freedom," lack of the extended family, and lack of their ability to spend time with their children because of the need to work. Perhaps the greatest ally and strength the psychiatric mental health nurse has in the area of acculturation stress with Haitian immigrant families is their awareness of and concern about such problems. It is a strength that can be used for prevention of intergenerational conflict rather than belatedly used to treat its effects.

Sex Roles and Social Autonomy

Many of the qualities listed by the Cuban and Haitian mothers as desired characteristics of femininity and masculinity are traits that have been attacked in American social science and feminist literature and the media as sexual stereotyping, i.e., males are stoic, strong, brave, the sole family wage earners, and heads of households, while females are expected to be helping, sweet, understanding, family caregivers, and remain at home during the childbearing-childrearing stages of the family life-cycle (Bernal & Gutierrez, 1989; Brown, 1991; Goldenberg & Goldenberg, 1991; Vaughan, 1983). Although the preceding characteristics do typify traditional American views of males and females, they run counter to current sociocultural trends that encourage males to be more openly nurturing and expressive of their emotions and fears and for females to be more assertive, less self-effacing and self-sacrificing, and more career oriented (Goldenberg & Goldenberg, 1991; Leg- horn & Parker, 1981; Murray & Huelskoetter, 1991; Serafica & Rose, 1982; Vanghan, 1983).

The degree of social autonomy the Cuban and


Haitian mothers believed their children should be afforded also has potential for intergenerational conflict (Table 2). As they acculturate, Cuban and Haitian children will come to expect much more of the individual autonomy that is characteristic of American childrearing practices and life, espe- cially in the areas of more autonomy away from home, individual decision-making rights, and participation in nonfamily centered or monitored group activities.

Haitian mothers will soon face the question of whether quiet, obedient, subservient, and unques- tioning children can compete successfully in an achievement oriented society that expects individual initiative; encourages expression of differing opinions; values dialogue between parents and children; and permits negotiation with and questioning of those in authority. To continue to instill obedience and subservience at home when initiative, independence, and competitiveness are required at school and elsewhere can engender intergenerational conflict, feelings of inadequate parenting, and role confusion in the family members.

PMH nurses will have to remain alert to signs of parent-child conflict so that they can provide coun- seling directly or through appropriate community agencies. If the latter, PMH nurses will need to assist staff to understand and work within the cultural, socioeconomic, and political factors affecting the conflicts. Agencies of special importance will be the school and church where attitudes and standards regarding morality, sex role behaviors, and family relationships are learned and rein- forced.

The ability of PMH nurses to intervene directly and assist Cuban and Haitian immigrant families with the difficulties inherent in sex-role stereotyping is quite unique because of their positions in agencies such as public schools, community health care clinics, crisis intervention agencies, family planning organizations and political and social as- sociations. PMH nurses are conveniently and stra- tegically able to function as culture brokers to counsel and assist family members and agency staff in understanding the variability within and among cultures in the role expectations of men, women, and children. As culture brokers, they can also work to ensure that the values and beliefs of the new society attenuate the disorganizing effects of the acculturation process and to afford families

the opportunity and right to make their own decisions about which cultural values are best suited for their particular situation.

CONCLUSIONS

The data from the Cuban and Haitian childrearing study are useful in pointing out the subtle and not so subtle mental health considerations inherent in the acculturation process and serve to remind PMH nurses of the difficulties most immigrant groups face during the acculturation process and the importance of culture as a factor in nursing treatment outcomes. The study also serves as a benchmark for future studies on other immigrant groups and the problems they may face regarding intergenerational conflict.

Limitations of the Study

Nonprobability, purposive sampling, and small sample size preclude the generalizability of results beyond the sample. The reliability and validity of the study were maximized through the use of on- going clarification and reaffirmation of the responses by the participants.

Study results could have been strengthened by the addition of participation-observation tech- niques. At the time of data collection, a large number of the participants were either undocumented aliens or in diplomatic limbo while their immigration status and/or residency claims were being re- viewed. During the review process, they were vul- nerable to deportation or to being held at detention centers if found to be ill, working without proper documentation, or to be in the country illegally. Consequently, there was great reluctance to participate in research, have pictures taken, or make tape recordings. On the advice of key informants and to assure the continued anonymity of the participants, the decision was made to do a one-time interview without audio or video taping to avoid arousing undue concern among participants or putting them at potential risk for deportation.

ACKNOWLEDGMENTS

The authors thank Maude Vincent, R.N., for her assistance in data gathering and analysis and the South Miami Unit of the Dade County Health Department for assistance in accessing part of the sample. The authors acknowledge the contribution of Janice Thomas, PhD, for her assistance in this paper.


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Potential for intergenerational conflict in Cuban and Haitian immigrant families