Culture In Nursing DQ # 5
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1. Biologic variations refer to traits of genetic disease common to a cultural group, among these traits we can mention thalassemia, a form of anemia is found in the Mediterranean’s populations, that can present in two forms, one is asymptomatic and produces mild anemia and the other is lethal and requires intense treatment from a very early age. On the populations of Asian descent is common to find lactose intolerance, that has to be considered to adapt nutrition during pregnancy and lactation period. (London et al, 2017) The African American population has a higher incidence of sickle cell disease, which is an anomaly of the hemoglobin cell, diabetes and essential hypertension are also in high prevalence in this population. On the Ashkenazi Jewish population there is the possibility of Tay-Sachs disease (fatal neurodegenerative disorder). (https://www.drugtopics.com, n.d.)
Knowledge of possible conditions related to the cultural background of the patients is important to have, this will enable the nurse to educate the parents on the genetic risk of the pregnancy and offer genetic testing that would help determine any conditions the fetus may have. Also the knowledge of prevalence of conditions like diabetes and hypertension among certain culture groups should help guide the prenatal care that the mother receives, helping her to make better dietary choices and modifications that are both culturally appropriate and that will help with a healthier pregnancy. (London et al, 2017)
2. Depending of the origin of the family, the nurse needs to keep in mind their beliefs about the possible causes of the cord accident. For example for the Mexican population it is believed that the cord can wrap around the baby’s neck if the mom raises her arms overhead during pregnancy. If they are of Cuban origin they may believe that the cord wrapped around the baby’s neck because the mother wore a necklace during pregnancy or she raised her arms overhead during gestation. This is an important knowledge to have in order to plan appropriate nursing interventions for the situation, including education about the incidence and causes of cord accidents. Additionally proper assessment for the mother feeling of guilt and possible depression or suicidal ideations need to be implemented, this mother may be tormented by feelings that the death of the child is only her fault. Also it would be important to prepare space for the mourning, given that most Hispanic families will mourn together, accommodations should be made for them to have room and privacy to grief.
3. Prescriptive beliefs are those that suggest to the mother what to do for a successful pregnancy and a healthy baby, for example in the Cuban culture they expect he mother to eat for two, (Purnell, 2014). This is culturally accepted belief to have a positive result to the pregnancy, but given the biologic variations of this particular population that includes hypertension, diabetes and obesity, this belief could cause unnecessary risk during pregnancy because over eating and excessive weight gain may happen, besides it will increase risks of pre-eclampsia and gestational diabetes. Education should be provided to the mother to dispel this beliefs.
Restrictive beliefs are those that tell the mother what not to do in order to have a healthy child. For example in the Puerto Rican population some women believe that having intimate relationships after the first trimester may directly harm the fetus or cause preterm labor. (Purnell, 2014). As a nurse you can provide education to dispel this belief but being always respectful the patient desires, further instructions can be provided on sexual positions that maybe more comfortable for the mother if she so desires. Other popular prescriptive belief is that raising arms overhead will result in the strangulation of the child with the umbilical cord. (Purnell, 2014). This is a belief that should be addressed early in the pregnancy and being careful of not diminishing the cultural belief of the parents more information about causes and incidence of this happening should be provided.
4. Many Asian cultures believe that the mother should avoid cold up to a month postpartum, to help decrease the ying or cold energy, this includes not drinking or eating cold food or beverage and also includes not exposing the body to cold air or cold showers (Purnell, 2014). These practices should be supported and respected as long as they don’t represent a risk for the mother. Among the nursing interventions that maybe put in place are raising the room temperature so the mother feels safe uncovering herself for assessments or interventions, offering teas and warm beverages to keep the mother properly hydrated. Always being respectful to the mother’s belief and remembering that they may also refuse to bath for the first month of postpartum, in which case instructions about perineal care should be given in order to avoid infections.
References
https://www.drugtopics.com. (n.d.). Retrieved June 1, 2020, from https://www.drugtopics.com/top-news/common-health-problems-selected-minority-ethnic-and-cultural-groups
London, M. L., Ladewig, P. W., Davidson, M. R., Bindler, R. C., Ball, J. W., & Cowen, K. J. (2017). Maternal and Child Nursing Care. Philadelphia, PA, PA: Pearson Education, Incorporated.
Purnell, L. D. (2014). Guide to Culturally Competent Health Care. Philadelphia, PA, PA: F.A. Davis Company
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