ISSUES OF MATERNAL AND CHILD HEALTH NURSING – AGE,GENDER, SEXUALITY AND SOCIO – CULTURAL

FACTORSIntroduction

Irrespective of the race, culture, Age, Gender the care of the ante – natal mother is to be given equally.
In a multicultural, multi ethnic societyvaluing diversity is an important aspect. An understanding of some
of thecultural differences between social groups is essential in ensuring that professional practice is
closely matched to meet the needs of individualclients. Practitioners of health and social cure must
understand the roleculture plays in determining health, health behaviours and illness so thatservices are
planned and delivered to meet the health needs of the population they serve.

Terminologies

Ethinicity

It refers to the cultural, group into which a person was born, althoughthe term is sometimes used in a
narrow context to mean only a race.

Culture

Culture is a view of the world and a set of traditions that a specificsociety groups users and transmits to
the next generation.

Cultural values

These are preferred ways of acting based on those traditions. The way people react to health care is a
cultural value.

Norms

The usually values of a group are termed more of norms.Expecting women to come for prenatal care
and for parents to bringchildren for immunizations are examples of norms in the United States, butthese
are not beliefs world wide.

Taboos

: Action that are not acceptable to a culture are called taboos. (eg)Murder The primary goal of maternal
and child health nursing care can bestated simply as the promotion and maintenance of optimal family
health toensure cycles of optimal child bearing and child rearing.

The range of Practice includes

Preconceptual health care

Care of women during 3 trimesters of pregnancy and the puerperium

Care of children during the perinatal period (6 weeks beforeconception to 6 weeks after birth).

Care of children from infancy through adolescens.

Care in settings as treated as the birthing room, paediatric intensivecare unit, and the home.Maternal
and child health nursing is always family – centered, whichmeans the family is considered the primary
unit of care.The level of family functioning affects the health status of individuals. If the family’s level of
functioning is low, the emotional, physical and socialhealth and potential of individuals in the family can
be adversely affected.A healthy family, on the other hand establishers an environment.Conducive to
growth and health promoting behaviours that sustain familymembers during crises.Similarly, the health
of individuals and the ability to stronglyinfluences the health of the family members, and overall family
functioning.Thus a family centered approach enables the nurse to better understandan individual and in
turn, provide the holistic care standards of maternal andchild health nursing practice.The importance a
society places on caring can best be measured by theconcern it places on its most vulnerable members
or its elderly,disadvantaged, and young citizens. Speciality organizations developstandards of care to
promote consistency and ensure quality nursing care intheir areas of nursing practice.

Socio – cultural aspects

Cultural values influence the manner on which people plan for child bearing and child rearing and
respond to health and illness. In a culture, inwhich men are the authority figures, for example, if might
be expected thatthe father rather than mother ensures questions about an ill child.If you are from a
culture in which women are expected to provide allchildcare, you might find it annoying to hear a man
taking over the responsesat a health interview. A nurse who has been culturally influenced to
believethat stoic behaviour is the proper response to pain may be inpatient with awomen who has been
influenced to believe that expressing discomfort duringchild birth is ‘proper’. Nurses need to include all
cultural groups in nursingresearch samples so more can be learned about cultural preferences inrelation
to nursing interventions and care.Cultural differences occur not only different ethnic backgrounds
butalso different life styles. Adolescents, urban, youth, the hearing – challenged,and gays or lesbians
have separate cultures from mainstream, for instance. A patient who has been deaf since birth, for
example, expects her deaf culture
4to be respected by having health care professionals attempt to communicatewith her in her language.A
lesbian mother could become hesitating of she is ahead, where isyour husband ? Given the cultural mix,
almost any behaviour can beconsidered appropriate for some individuals at some time and place.
Nursingcare that is guided by cultural aspects and respects individual difference istermed transcultural
nursing

Stereotyping culture

It means expecting a person to act in a characteristic way without regardto his or her individual
characteristics. It is generally derogatory in nature.Statements such as, “men never diaper babies well”
or Japanese women arenever assertive” are examples of stereo – typing. Sterotyping occurs largely
because of lack of understanding of the wide range of differences among people. In the above examples,
the first speaker, having seen one man changediapers poorly, assumes that this represents the entire
male population, usingthis sterotype, planning health may be improper and it should be avoided.On the
other hand it is important not to ignore cultural characteristics, because most people are proud of their
assessing the way in which she express cultural characteristics. Cultureinfluences health so much that
several National Health goals have beenestablished in reference to socio cultural aspects of carecultural
Assessment based on socio cultural aspects of care

It is important to be certain that care is planned not on predeterminedassumptions but on the actual
preference of the family, to do this, assess eachclient as an individual, not merely as one of a group.
Learn as much as youcan about different cultures by reading about or talking to members of asmany
different ethnic groups as possible.Assessing the culture of a community is important as
assessingindividual families because families are intrinsically joined to their community. An important
area to assess is whether the family matches thedominant culture in the community. This is important
because the type of foods stocked in the supermarket, the type of entertainment events that are
planned, and the values and history that are stressed in schools and work settings are all influenced by
the dominant culture.

6heritage. It is possible toacknowledge and celebrate a client’s culture without stereotyping by

ASSESSING FOR CULTURAL VALUES

Areas of assessmentQuestions to ask or observations to make

EthnicityWhat country or race is the family from ?

CommunicationWhat is the main language used in the home ?

•
TouchDoes the family typically touch each other ? Do theyuse intimate or conversational space

OccupationIs work important to the family ?Do they plan leisure time or leave it instructed >

PainDoes the family express pain or remain stoic in theface of it ?What do they believe relieves pain
best ?

Family structureIs the family nuclear ? Extended ? Single parent ?Are family roles clear ? Can an
individual name afamily member he/she would call on for support in acrisis ?

Male and femalerolesIs the family male or female dominant ?

ReligionWhat is the family religion ? Do they actually practice their religion ?

Health beliefsWhat does the family believe about health ?What do they believe causes illness ?Makes
illness better ? Do they use alternativetherapies or established practices ?

NutritionDoes the family eat in ethnic diet ?Are the foods they enjoy available in their

Nursing diagnosis

Powerlessness related to expectations of care not being respected

Powerlessness related to socio – cultural isolation

Impaired verbal communication related to English not being primarylanguage.

Nutrition, less than body requirements, related to cultural preferences.

•

Anxiety related to a cultural preference for not bathing while ill.

Fear related to inability to buy food due to poor economic status.

Outcome identification and planning

Planning needs to be very specific for the family and circumstanceinvolved because socio – cultural
preferences tend to be very personal. Caremay begin with in service education for health care providers
who areunfamiliar with particular cultural practice and its importance to the specificfamily involved. It
may include arranging for variations in policy, such as thelength of the family visiting. Lower types of
food served, or kind of childcare. It can make health care more acceptable.

Implementation

Appreciate that cultural values are ingrained and usually very difficultto change. An example of
implementing care might be making arrangement

for a new Native American mother to take home the placenta of that isimportant to her, or planning
home care for a Chinese – American childwhose family believer in herbal medicine. It must be
establishing a network of health care agency personnel or personnel from a nearby university or
importing firm to serve as interpreters. It might be educating a child, familyor community about the
reason for a hospital practice. A particular situationmay call for both sides to adjust (cultural
negotiation).

Outcome

Evaluation by assessing whether outcomes have been met shouldreveal that a family’s socio – cultural
preferences were considered andrespected during care.

Examples

Parents lost three ways they are attempting to presence culturaltraditions in their children.

Child states she no longer feels socially isolated because of culturaldifferences.

9Family members state they have learned to substitute easily purchasedfoods for traditional foods
unavailable in local stores in order toobtain adequate nutrition cultural competence continuum.

Cultural destructiveness
Making every one fit the same cultural pattern and exclusion of thosewho don’t fit forced assimilation.
Emphasis on difference and usingdifference as barriers.

Cultural blindness

Don’t see or believe there are cultural differences among people.Everyone is same

Cultural awareness

Being aware that we all live and function within a culture of our ownand that our identity is shaped by it.

Cultural sensitivity

Making every one fit the same cultural pattern, and exclusion of thosewho don’t fit forced assimilation.
Emphasis on differences and usingdifferences as barriers.

10Cultural blindness

Don’t see or believe there are cultural difference among people. Everyone issame.

Cultural awareness

Being aware that we all live and function with in a culture of our ownand that our identity is shaped by
it.

Cultural sensitivity

Understanding and accepting different cultural values, attitudes and behaviour.

Cultural competence

The capacity to work, effectively and with people integrating elementsof their culture, values, attitudes
rule and norms. Translation of knowledgeinto action.

Conclusion

To provide maternal and child health nursing effectively the sociocultural factors to be considered in
mind so that the wholistic care can be

11achieved fully, people also seek the health service if it is satisfied as per their custom, culture
etc.Health education can be given to modify their behaviour if they needto get change regarding the
prevention of health problems. We can’t forcethe public to follow the methods to attain the goal.
Creating the awareness insuch a way and to accept them to follow the healthy aspects to maintain their
health is most important.

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Socio –
3

cultural
aspects
Cultural values
influence the
manner on
which people
plan for
child bearing
and child
rearing and
respond to
health and
illness. In a
culture,
inwhich men
are the
authority
figures, for
example, if
might be
expected
thatthe father
rather than
mother ensures
questions about
an ill child.If
you are from a
culture in
which women
are expected to
provide
allchildcare,
you might find
it annoying to
hear a man
taking over the
responsesat a
health
interview. A
nurse who has
been culturally
influenced to
believethat stoic
behaviour is the
proper response
to pain may be
inpatient with
awomen who
has been
influenced to
believe that
expressing
discomfort duri
ngchild birth
is ‘proper’. Nur
ses need
to include
all cultural
groups
in nursingresea
rch samples so
more can be le
arned about cu
ltural preferen
ces inrelation to
nursing
interventions
and
care.Cultural
differences
occur not only
different ethnic
backgrounds
butalso different
life styles.
Adolescents,
urban, youth,
the hearing –
challenged,and
gays or lesbians
have separate
cultures from
mainstream, for
instance.
A patient
who has
been deaf since
birth,
for example,
expects
her deaf culture
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