Hispanics or more commonly known as Latinos have been considered as the largest and youngest minority group in the United States. According to latest surveys, the United States is currently composed of 14% Latinos or Hispanics. Individuals belonging to this minority group share a common cultural heritage and even language. However, being classified as a Latino or Hispanic does not necessarily mean that the individual share common race or ancestry with other individuals in the minority. More often than not, individuals belonging to this group are a mixture of European, Native American, and even African ancestries (Burchard, et al., 2005).
Hispanics are only one of the several minority groups currently residing in the United States. The continuous increase of the multicultural profile of the population of United States is one of the critical factors and purpose of establishing and acknowledging the need of nurses to provide a culturally competent nursing care. The American Nurses Association have already acknowledged the importance of providing culturally competent nursing care when the said practice and concern have been included in the code of the Association. Nurses, especially critical care nurses, must practice culturally competent nursing care to be able to communicate effectively and efficiently with patients regardless of their ethnicity or race. Being culturally competent also allows accurate assessment, development, and implementation of the various interventions and programs designed by nurses and other health professionals to meet the needs of the patients. The main focus of cultural competence is the establishment of unbiased interaction and provision of care to patients regardless of their backgrounds. It was also emphasized that being culturally competent meant being fully aware of your own opinions, beliefs, sensations, thoughts, and environment without letting it affect your own perception of another individual with different beliefs, opinions, sensations, and background (Flowers, 2004).
Pregnancy, childbirth, and even the first three years of a child’s life comprise the perinatal period which has always been considered as a vulnerable and critical phase of every family especially when it comes to the parents and the infant. Due to the vulnerability of these individuals during the perinatal period, majority of new parents have relied on their own traditions, values, and cultural beliefs and practices. Since infant mortality has been a common knowledge and event in various Latino or Hispanic countries, they have developed and maintained various prescriptions and practices to ensure the normal progression and development of the pregnancy (Maldonado-Duran, et al., 2002). Currently, Hispanic teenagers have been reported as the major ethnic and racial group with the highest rates of teenage pregnancy. Thus, it is also important to consider the practices of Hispanic teenagers (Scott, et al., 2014).
Some of these practices include temazcal baths or vapor baths and sersobada or “to have a massage”. Temazcal baths are common among Hispanics living in the more traditional areas of Central America and Mexico. This ritual has been practiced by Hispanic women to aid in the removal of toxic products through sweating. In this ritual, the pregnant woman enters a bathhouse composed of adobe which is structurally similar to an igloo. Inside the bath house, the water is poured on hot stones which results to the evaporation of the water producing vapor or steam. The vapor produced is then believed to cleanse the body of the pregnant woman. On the other hand, sersobada is usually performed by a traditional healer or curandero. In sersobada, even the abdomen of the pregnant woman is manipulated and massaged along with the rest of her body. This practice is believed to help in the preparation for the birth of the baby. Moreover, female relatives are expected to accompany pregnant women duringcheck-ups and prenatal care. Hispanics also believed that cravings of a pregnant woman should be satisfied since failure to do so may result to various defects and injuries affecting the baby (Maldonado-Duran, et al., 2002).
The temazcal baths and the sersobada meet the sociocultural needs of the mother by adhering to the culture and traditions practiced by her ancestors during pregnancy. These practices give a sense of belongingness and importance. Since the mentioned practices can be considered as modes of relaxation for the mother, the environmental and physical needs of the mother have been met. Provision of a relaxing environment and ambiance helps the mother relax and forget negative energies and emotions which have been commonly seen in pregnant women. In addition, other beliefs fulfill the emotional and sociocultural needs of the mother because she is still utilizing and applying the practices and rituals of her roots. The assistance of relatives and strong family ties are also a great help in providing emotional support to the pregnant woman. For the Hispanic belief on cravings, the physical needs of the pregnant woman are met because the food and delicacies that the pregnant woman desires are always be given and provided. On the other hand, prohibition of taking vitamins and various supplements does not meet the physical needs of the pregnant woman. Provided that the health status of a pregnant woman is considered vulnerable, supplements and other vitamins should be taken to ensure that the pregnant individual is well enough for herself and for the baby (Maldonado-Duran, et al., 2002; Greene, 2007).
Engaging in premarital sex and risky sexual behaviors because of their need to belong and to attract attention are some of the reasons behind the alarming incidence of teenage pregnancy among Hispanic teenagers. These practices may meet the sexual and physical needs of mothers but major consequences arise from such behaviors. Some of these consequences include delayed education, early parenthood, and even early maturity which can greatly affect the emotional and financial balance of youth (Scott, et al., 2014).
All of the above mentioned beliefs are not dangerous to the mother especially if appropriate care has been provided. Still, there should also be precautions when adhering with the various beliefs mentioned especially with the Hispanics’ belief on cravings, temazcal baths, and sersobada. Possible danger may result when the cravings of the mother include delicacies which she is allergic to because allergies may lead to anaphylactic shock. Moreover, some food may be dangerous to the child especially when there has already been studies proving that the particular food is not safe for consumption. Temazcal baths can also be dangerous especially when exposed for long periods of time due to the steam bath’s production of carbon monoxide.The sersobada can also be harmful because massage may hurt the fetus in the womb and worse, may lead to miscarriage. On the other hand, not taking of any supplements and medications may also endanger the health of the mother and the child because the health status of the mother is not well enough to support both herself and the baby (Maldonado-Duran, et al., 2002).
There is no better way to assess a pregnant woman during her pregnancy than to respect and acknowledge her culture, beliefs, and practices but also endorse and suggest other ideas when it comes to the health and care of the mother and the child. It is also important for the communication between the nurse, patient, and relative to be open. By communicating with them, awareness of the different practices of the Hispanic woman is increased. Since it has been mentioned that they are fond of temazcal baths and the sersobada, nurses should prioritize recommendation of various medical procedures and techniques which has similar concept and idea as these rituals and practices. In addition, since some of the practices can be harmful to the pregnant woman, the nurse should be able to correctly inform the mother of possible hazards and harms associated with certain practices (Greene, 2007). When dealing with Hispanic teenagers, proper consultation of the teenagers along with their parents and relatives must be done to understand the reasons behind early engagement with sexual practices. Training and proper sex education should also be reinforced to prevent acquiring diseases from sexual intercourse. Prevention programs that address the cultural values and beliefs of the mothers should also be considered to attempt to break possible misconceptions about pregnancy and child-bearing (Scott, et al., 2014).
On the other hand, when it comes to labor and birth, Hispanics fear to undergo C-Section because they prefer the natural way of delivering a baby. Additionally, they also believe that walking can help quicken the delivery. During labor, female relatives are also expected to assist and accompany the pregnant woman. In relation with the beliefs and practices of Hispanics, unnecessary and dangerous medical procedures are feared. Fear of undergoing unnecessary medical procedures and C-section is common among pregnant woman. These beliefs on labor and birth meet the sociocultural and emotional needs of the mother because relatives are present during the delivery for support and traditions and culture are still intact. Besides, the environmental and physical needs are also met due to the supportive ambiance and environment set by the relatives but the same fear of unnecessary medications and medical procedures may lead to potential danger. Since normal delivery as the best option for pregnancy also occurs, denying medical procedures and taking medications can worsen the delivery process which can also lead to death. Thus, it is important that the Hispanics are also open to other options especially when it comes to provision of medications and medical procedures (Maldonado-Duran, et al., 2002).
The beliefs, traditions, and practices of the patients should be considered by the nurse in charge when making conversations and suggestionsespecially in terms of various medical procedures. For example, since Hispanics believe that female relatives should be physically present during the labor and birth of the child, it is important for the nurses to acknowledge and respect these beliefs. Nonetheless, if this practice is not allowed or permitted in the hospital, it is also the job if the nurses to calmly explain the rules and circumstances to the relatives to avoid miscommunication and misunderstandings. Furthermore, a culturally sensitive obstetrical nurse should take into consideration the wants and requests of the patient especially when it comes to suggesting possible alternatives during unavoidable circumstances (Greene, 2007).
One of the major events after giving birth is postpartum depression. According to the study of Ruiz et al. (2012), Hispanic women born in the United States obtained higher depressive scores. The study also found that undiagnosed women suffering from depression during pregnancy are at higher risk of experiencing preterm birth (PTB). On the other hand, a study by Lara et al. (2013) evaluated the measures and scales used to assess postpartum depression screening procedures. Based on the results of the study, the Spanish Postpartum Depression Screening Scale (PDSS-Spanish Version) was highly sensitive but not highly specific. Thus, the study concluded that the cutoff to be used should be dependent on the purpose. Another study conducted by Callister, et al. (2011) described the perceptions of Hispanic women who experiences postpartum depression symptoms. Based on their findings, majority of the Hispanic women does not acknowledge postpartum as the reason for their sadness. Rather, they consider financial concerns, family problems, and work problems as the major cause of their sadness. Some of the barriers to seeking mental health services identified in the study include emotional health beliefs, stigma associated with the mental illness, hesitancy with dealing and asking for treatments, and cultural beliefs.
The barriers to seeking mental health services among Hispanics do not meet the physical and environmental needs of the mother because postpartum depression is not cured or treated. This finding contributes to the higher number of undiagnosed woman which are at higher risk of developing preterm birth. These barriers and findings are considered important because these are concerns that should be addressed by health practitioners and nurses. Additionally, these practices are considered potentially dangerous to the mother because undiagnosed and untreated postpartum depression and symptoms can lead to various serious mental and health concerns (Ruiz, et al., 2012; Lara, et al., 2013).
Culturally sensitive obstetric nurses will be really helpful in assisting mothers especially during the vulnerable stage which is during postpartum period. They can ensure that the mothers feel that they are understood and appreciated. Additionally, since barriers and perceptions of Hispanic women on mental health and postpartum depression have already been identified. It is the job of the nurses to take into consideration these beliefs especially when handling mothers who are suffering from postpartum depression (Ruiz, et al., 2012).
In terms of newborn infants, studies have shown that breastfeeding is the best for feeding newborn infants. It has been acknowledged that infants who have been breastfed have lower risk of developing illnesses like pneumonia, gastroenteritis, and sudden infant death syndrome (Waldrop, 2013). Another care for newborn infants include newborn screening. According to the study conducted by Newcomb, et al. (2013), revealed that the knowledge of mothers on dried bloodspots and newborn screening is inadequate. Moreover, these mothers acquired the information on newborn screening from nurses. Lastly, since childhood obesity has been prevalent in the United States, it is important for mothers to have knowledge on early prevention. Since Hispanic children have the highest rates of childhood obesity, it is important for Hispanic mothers to know more about the disease and prevention strategies (Bender, et al., 2014).
The practices, rituals, values, and beliefs mentioned above meet the sociocultural, environmental, and physical needs of the newborn infant. Since newborn infants require nutrition and immune defense from the mother, it is important for them to be breastfed. Newborn screening also meets the needs of the newborn infant because potential child diseases and disorders can be screened and identified earlier which can contribute to the reduction of child mortality and morbidity especially for illnesses and diseases which can be easily prevented and treated. Lastly, provision of primary prevention strategies against childhood obesity also meets the needs of the childhood infant because utilizing these strategies can greatly help in the reduction in the incidence and prevalence of childhood obesity especially among Hispanic children. Since most of the practices are beneficial to the newborn infant, possible dangers and hazards associated with the above mentioned practices are not evident. Thus, practicing these practices is necessary especially among Hispanic mothers and children. Yet, other feeding practices such as allowing children to drink coffee early and mixing of dilute milk can have potential hazards to the newborn infant. Since the physical make-up and development of a newborn is completely different from an adult, food which is complex by nature should not be given (Gribble and Hausman, 2012).
As a culturally sensitive obstetrical nurse, communicating with the parents and knowing their practices should be the first step in dealing with individuals of different culture and tradition. For example, the fact that Hispanics have been known to give coffee to their kids early should be understood by culturally sensitive obstetrical nurse. To handle this situation, the nurse should provide different studies focused on the effects of dilute milk, coffee, and other complex food to the development of a newborn. Fortunately, Hispanics are considered to be open-minded when it comes to newborn screening procedures since data revealed that they are at higher risk of acquiring diseases tested in newborn screening procedures. Knowing this, nurses should present the benefits and different procedures of newborn screening (Khoury, et al., 2000).
Hispanics are considered as a rapidly growing minority in the United States, thus, their beliefs, culture, practices, and traditions should be studied by nurses and other health professions. It is also necessary for culturally sensitive nurses to study various health practices and traditions associated with health care and status.
Currently, culturally competent nursing care has been focused on the Hispanic population due to the rapid increase in their population. Studies have already been published which support the current status of culturally competent nursing care dealing with pregnancy, labor and birth, postpartum, and care of newborn infant.
References
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