Therapeutic Intervention for the Childbearing Family in a Multicultural Environment

Transcription

1 Therapeutic Intervention for the Childbearing Family in a Multicultural Environment ( also known as Family Functions and Cultural Considerations) Maternity Nursing Perinatal Period Nurses, nurse practitioners, nurse midwives Clinics, MD offices, L&D units, postpartum, birthing centers, homes, ICUs Teaching, anticipatory guidance, parenting, pregnancy progress, newborn care Preconceptual thru Fourth Trimester Philosophy of Maternity Nursing Is family centered Is community centered Is research oriented Advocates for family Is highly independent Protects the health of next generation Personal, cultural, stress, religious considerations can alter/influence families 1

2 Healthy People 2010 Nation s agenda for improving health Two goals: increase quality and years of healthy life; eliminate health disparities Improve health and well-being of women, infants, children, families Identifies areas of concern Who s YOUR Family? #1 social group support and long-lasting emotional ties One of society s most important institutions Because family has such an influence on the individual, nursing care that considers the family, not the individual, has become a focus of nursing practice For 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 Structure Functions Composition Affectional 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 2

3 Family Structure/Composition Nuclear Extended Single-parent Binuclear Reconstituted Homosexual Family Functions and Tasks Families progress thru a life cycle & carry out certain functions for members and society. Table 2-1 Friedman Affective, socialization, reproductive, economic, health care Other tasks maintenance of order, division of labor, maintenance of motivation and morale Family Theories Systems Theory interaction between components of the system & between system & environment Encourages 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 only Open system receptive to providers 3

4 Family Developmental Theory Focuses on family as it moves across time, thru phases from dependence, independence, to interdependence. Table 2-1 Single adults leaving home marriage young children adolescents launching moving on later life Each 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, beliefs External 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 4

5 Roles Nurturer Provider Decision-maker Financial manager Problem-solver Health manager Culture Life experiences bound by traditional beliefs and practices. Beliefs and practices embedded in economic, religious, kinship, political structures Behavioral 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 system Acculturation changes that occur in one or both groups when people from different cultures come in contact with one another Assimilation occurs when a cultural group loses its identity and becomes part of the dominant culture 5

6 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 Communication Personal space Time Family roles Family centered care is based on mutually beneficial partnerships among childbearing women, infants, family members and health care providers. Cultural Competence Proceeds 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 lifeways Nonthreatening, non-fear provoking interactions Tolerance, inclusion, appreciation for and acceptance of 6

7 Vulnerable Populations Women adolescent girls, minority women, migrant women Homeless Refugees 7