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

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Sexual Orientation/Gender Identity

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

Copyright © 2018 Wolters Kluwer · All Rights Reserved

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%.

Copyright © 2018 Wolters Kluwer · All Rights Reserved

2020 National Health Goals Related to
Cultural Influences on Health Care #1

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%.

Copyright © 2018 Wolters Kluwer · All Rights Reserved

2020 National Health Goals Related to
Cultural Influences on Health Care #2

 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%.

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Assessing for Cultural Values

Copyright © 2018 Wolters Kluwer · All Rights Reserved

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

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Examples of Nursing Diagnoses and
Outcomes Related to Cultural Diversity

Nursing Diagnosis Outcome

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

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Quality & Safety Education for Nurses
(QSEN)

Patient-Centered Care
Teamwork & Collaboration
Evidence-Based Practice
Quality Improvement
Safety
Informatics

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Interventions Related to Rendering Culturally
Sensitive Maternal and Child Nursing Care

Nursing Diagnosis Possible Nursing and

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
Therapeutic Interventions
• Assure that a translator is
readily available when
communicating with the
family.
• Respectfully discuss the
woman’s belief about not
bathing while ill.
• Respectfully explore the
family’s expectations of their
health care.

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Evaluating Outcomes Related to Rendering
Culturally Sensitive Maternal and Child Nursing
Care

Nursing Diagnosis Outcome Evaluation

Impaired verbal communication Family expresses that they feel
related to limited English that their needs were accurately
proficiency 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

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Question #1

Which is an example of a culture-specific value or

norm?
A. The expectation that communication between the
woman and the healthcare provider will be
understood by both parties
B. The expectation to have only the spouse present
during the delivery
C. The desire to have healthy family communication
D. The desire for the family to have enough basic
necessities in life

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Answer #1

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.

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Question #2

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?
A. Assure that a translator from the healthcare
organization is present.
B. Enlist the help of a neighbor visiting the home who
speaks English.
C. Ask the oldest child in the family who has learned
English to translate.
D. Ask the family to bring a friend who speaks English
with them for the next visit.

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Answer #2

A. 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.

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Question #3

The nurse is assessing a laboring woman for pain.

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

Copyright © 2018 Wolters Kluwer · All Rights Reserved

Answer #3

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.

Copyright © 2018 Wolters Kluwer · All Rights Reserved