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Therapeutic Intervention for the Childbearing Family in a Multicultural Environment…

(…also known as Family Functions and Cultural

Considerations)

Maternity Nursing – PerinatalPeriod

Nurses, nurse practitioners, nurse midwivesClinics, MD offices, L&D units, postpartum, birthing centers, homes, ICUsTeaching, anticipatory guidance, parenting, pregnancy progress, newborn carePreconceptual thru Fourth Trimester

Philosophy of Maternity Nursing

Is family centeredIs community centeredIs research orientedAdvocates for familyIs highly independentProtects the health of next generationPersonal, cultural, stress, religious considerations can alter/influence families

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Healthy People 2010

Nation’s agenda for improving healthTwo goals: increase quality and years of healthy life; eliminate health disparities

Improve health and well-being of women, infants, children, familiesIdentifies areas of concern

Who’s YOUR Family?#1 social group – support and long-lasting emotional tiesOne of society’s most important institutionsBecause family has such an influence on the individual, nursing care that considers the family, not the individual, has become a focus of nursing practiceFor a family to adjust to a new member, the structure & roles must be flexible enough to adjust to the changes that pregnancy & a newborn will bring.

Family Defined…StructureFunctionsCompositionAffectional ties“A group of people related by blood, marriage, or adoption living together”“Two or more people who live in the same household, share a common emotional bond, & perform certain social tasks”

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Family Structure/Composition

NuclearExtendedSingle-parentBinuclearReconstitutedHomosexual

Family Functions and Tasks

Families progress thru a “life cycle” & carry out certain functions for members and society. Table 2-1Friedman – Affective, socialization, reproductive, economic, health careOther tasks – maintenance of order, division of labor, maintenance of motivation and morale

Family TheoriesSystems Theory – interaction between components of the system & between system & environmentEncourages nurses to view individual family members as part of a larger family system influenced by and influencing others.The childbearing family system interacts in the environmental suprasystem – prenatal care, childbirth educ., infant care.Closed system – family resources onlyOpen system – receptive to providers

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Family Developmental Theory

Focuses on family as it moves across time, thru phases from dependence, independence, to interdependence.Table 2-1Single adults leaving home marriageyoung children adolescents launching moving on later lifeEach has changes in family dynamics.

Family Stress Theory

How do families react to stress?Internal context – elements a family can change or control: family structure, psychologic defenses, values, beliefsExternal context – time and place where family finds itself: culture of society, economic state of society, genetic inheritance, etc.

Family Structure & Function Asmt.Type – who lives in the home?Finances – is money adequate? divided?Safety – is home safe from fire and accident?Health – nutritious diet? Adequate sleep? Immunizations? Balance work and recreation?Support – members eat together? Spend time with each other daily? Stick together? Active in organizations? Visit/ed by friends?“Name one person to rely on in crisis”

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…Roles

NurturerProviderDecision-makerFinancial managerProblem-solverHealth manager

Culture

Life experiences bound by traditional beliefs and practices. Beliefs and practices embedded in economic, religious, kinship, political structuresBehavioral norms and expectations for each stage of the perinatal cycle are in every culture.Be aware of “Nurse Bias”!!

Subculture

A group that retains its own characteristics while existing within a larger cultural systemAcculturation – changes that occur in one or both groups when people from different cultures come in contact with one anotherAssimilation – occurs when a cultural group loses its identity and becomes part of the dominant culture

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Ethnocentrism/Cultural Relativism

Ethnocentrism – the view that one’s culture’s way of doing things is right and natural way - “My group’s the best.”Cultural relativism – learning about and applying another culture to activities within that culture

Childbearing Beliefs & Practices

CommunicationPersonal spaceTimeFamily roles

Family centered care is “based on mutually beneficial partnerships among childbearing women, infants, family members and health care providers”.

Cultural CompetenceProceeds along a continuum… steps you can take to move yourself along:Knowledge of your own cultural affiliation (beliefs, values, lifeways)Knowledge of others’ cultural beliefs, values, and lifewaysNonthreatening, non-fear provoking interactionsTolerance, inclusion, appreciation for and acceptance of…

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Vulnerable Populations

Women… adolescent girls, minority women, migrant womenHomelessRefugees