CHAPTER 2

Prepared by: Ms. Donna S. Carcueva, RN, MN

DIVERSITY AND MATERNAL CHILD NURSING

METHODS TO RESPECT DIVERSITY IN MATERNAL AND CHILD HEALTH NURSING

1. Stereotyping is expecting a person to act in a characteristic way without regard to his or her individual traits.
2. Prejudice is a negative attitude toward members of a group or is an intellectual act.
3. Discrimination is the action of treating people differently based on their physical or cultural traits or acts.

CULTURAL COMPETENCY FOR NURSES

● Transcultural nursing is care guided by cultural aspects and respects individual differences
● Terminologies:
1. Culture-specific values are norms and patterns of behavior unique to one particular culture.
2. Culture universal values refers to values, norms, and patterns shared across almost all cultures.
3. Ethnicity refers to the cultural group into which a person was born, although the term is sometimes used in a
narrower context to mean only race.
4. Race, a social construct, refers to a category of people who share a socially recognized physical characteristic,
often skin color or facial features. It can also refer to a group of people who share the same ancestry.
5. Acculturation refers to the loss of ethnic traditions because of disuse.
6. Cultural assimilation means people blend into the general population or adopt the values of the dominant
culture.
7. Ethnocentrism is the belief one’s own culture is superior to all others.
8. Cultural awareness is being aware cultural differences exist.
9. Cultural competence is respecting cultural differences or diversity.
10. Cultural humility is a lifelong process of self-reflection and self-critique that begins, not with an assessment of a
patient’s beliefs, but rather with an assessment of your own.
11. Mores or Norms - the usual values of a group
12. Taboos - actions not acceptable to a culture.
a. universal taboos: murder, incest, and cannibalism.
b. controversial taboos: abortion, robbery, and lying

WHEN A FAMILY HAS LIMITED ENGLISH PROFICIENCY

1. Assess each patient’s reading level as well as speaking level.
2. Use a medical translator. Do not use a family member or friend to provide interpretation.

USE OF CONVERSATIONAL SPACE

● People of different cultures use the space around them differently:
1. Intimate space is the space closely surrounding a person. Physical examinations are conducted in this very tight
space because palpation and auscultation are parts of the examination.
2. Conversational space is usually 18 inches to four feet away.
3. Business space - beyond four feet, this amount of distance allows room for a desk between parties.
4. Public space is any distance beyond business space such as shouting across a parking lot.
● Be aware that women from Middle Eastern cultures adhere to a level of modesty exceeding what you may
appreciate, so it’s a courtesy to add additional modesty sheets for physical examinations.

NATIVE AMERICANS WHITE AMERICANS

 no eye contact  Future time: on time
 Speak in low tone  Eye contact
 Touch hand for greetings  Germ theory
 Indian time: do not arrive on a specified time  Autopsy - ok
 Harmony with nature  Leading causes of death:
 Sacred meal: blue cornmeal 1. CAD’s
 DM type 1/Juvenile DM 2. MI
 Renal Failure 3. Cancer
 Alcoholism 4. Respiratory disease
 Lowest survival for cancer 5. Accidents
** encourage massage of mother & child 6. Diabetes mellitus
** prohibit touching of dead body 7. Influenza
** encourage to bring personal items to make them 8. Pneumonia
comfortable 9. Alzheimer’s
10. Kidney disease
11. Septicemia
 CHAPTER 2
Prepared by: Ms. Donna S. Carcueva, RN, MN

ASIAN / CHINESE AMERICAN JAPANESE AMERICANS

 Fruits and vegetables  Future time: ON TIME
 Yin: cold/ Yang: hot  Technology: Life is Fast
 Reluctant to donate blood  Great value of time
 40 days belief  Father: decision maker
 Disease: Tuberculosis  Leukemia
 Traditional Medicine: ex. ventosa (Cupping)  Cancer: skin, breast, brain
 Flexible Time Schedule  Food: Miso soup
 Professional Interpreter  Cancer: stomach
 Eye avoidance  (smoked/cured foods)
 Do not touch head  Foods that cause cancer
 smiles and nods without understanding  Grilled, Processed, Pickled, dried ramen, dried
** dominant male father or eldest son fish, fermented foods, (alcohol)
 Dokutoru- doctor
MEXICAN AMERICANS AFRICAN AMERICAN
 Sickness punishment for God  Privacy / Confidentiality valued
 Magical thinking  Time: Flexible
 Usog: “Evil Eye” / Mal de Ojo  Sickness: Demon and Spirits
 Amulet “Senior Milagrosa”  Significant person: Religious leaders: church:
 Curandero / Curandera mother
 Post-partum practices  Soul food: fried food
 Cancer: gallbladder  High fat and Cholesterol
 Catholic Parish Priest/Chaplain  Hypertension / stroke
 Protestant: Preacher/Pastor/Minister  Cancer
 Spanish Interpreter  Diabetes mellitus type: 2 Glaucoma
 Wide frame attitudes: time  Skin assessment:
 Father: decision-maker PALLOR – buccal mucosa & conjunctiva
 Children: most important person PETECHIAE – palms & soles
 Soul food: tortillas and chilli JAUNDICE – Sclera & Nail beds
 High fat diet
BUDDHISM JEHOVAH’S WITNESSES
 Belief: enlightenment  Food: no BLOOD of Animals
 Practice: meditation  Blood Transfusion: only plasma expanders to
 Food: vegan maintain fluid in body.
 Organ donation: yes  Can donate organ but with no blood coming
 Death and Dying: positive feeling from other person.
 Allow burial and cremation
 Postmortem Care: allow the body to be SEVENTH DAY ADVENTIST
untouched for three days  Food Leviticus food (AVOIDED)
 After death: first touch the top of the head and -Fish without fins and scales, No squid, No
say “go to the pure land, or precious human birth, shrimp, No pork, No crab.
or safe place.  Holy day of obligation: SABBATH day (starts 5
pm Friday to Saturday 5 pm)
HINDUISM JUDAISM
 Belief: Reincarnation  Torah - Bible
 Practice: Yoga / Meditation  5 books of Moses: Genesis, Exodus Leviticus,
 Food: vegan, strictly vegetarian Deuteronomy, Numbers
 Organ donation: yes  Stress
 Postmortem Care: body wrapped in white /  Ulcerative Colitis, Crohn’s disease
orange cloth then cremated  Cooley’s anemia / Thalassemia-
** Ashes: thrown to the holy river Mediterranean anemia stop
MAILINE PROTESTANT  Rabbi - priest
 No Tobacco & No Alcohol  Circumcision is sacred, male infants
MORMONS circumcise at birth
Food restrictions: no tea, no caffeine, no alcohol, no  Kosher: lawful diet & allowed; should be
chocolates, no cola slaughtered; no beef & dairy at same time - 6
 No Alcohol hours apart
** discourage autopsy
 CHAPTER 2
Prepared by: Ms. Donna S. Carcueva, RN, MN
 CHAPTER 2
Prepared by: Ms. Donna S. Carcueva, RN, MN

ROMAN CATHOLIC ISLAM

 Belief: no abortion, natural method of family  Food: no Pork, no Elixir, no PORCINE Insulin
planning, Holy Trinity  Halal: lawful
 Organ Donation: yes  Ramadan
 Abortion: no  Doctors / Nurses: female for female patients
 Death and Dying and meds on right hand minimizing touch
 Sacraments: therapy
a) Penance  Koran (Quran)
b) Holy communion  Evil eye
c) Anointing of the sick  Male: Dominant
 Food: No meat on Good Friday and Ash  Death and Dying: Doctor declares death never
Wednesday touch dead body; body washed by relative of
same sex, wrapped in white body positioned
facing Mecca (east)
** discourage autopsy

SEXUAL ORIENTATION
● Sexual orientation is an enduring pattern of romantic or sexual attraction (or a combination of these) to persons
of the opposite sex or gender, the same sex or gender, or to both sexes or more than one gender.
● Terminologies:
1. Heterosexual: A heterosexual person is someone who finds sexual fulfillment with a member of the
opposite gender. Straight is often used in place of heterosexual.
2. Homosexual: A homosexual person is someone who finds sexual fulfillment with a member of his or her own
sex. This term is often disparaged in the LGB community. Same-sex partner and gay (for men or women) can be
umbrella terms to use instead of homosexual.
3. Gay: Male-identified individuals who are sexually attracted to male partners. This term is also sometimes used to
refer to both men and women who have same-sex partners.
4. Lesbian: Female-identified individuals who are sexually attracted to female partners.
5. MSM*: men who have sex with men.
6. WSW*: women who have sex with women
7. Bisexual: People are bisexual if they achieve sexual satisfaction from both same-sex and heterosexual
relationships.

GENDER IDENTITY
● Gender identity is the inner sense a person has of being male or female, which may be the same as or different
from sex assigned at birth.
● Terminologies:
1. cisgender: when an individual feels their gender and their sex match
2. Transgender: when an individual feels their gender and their sex do not match
3. MTF: male-to-female transition; usually prefers female pronouns
4. FTM: female-to-male transition; usually prefers male pronouns
5. Hormone replacement therapy: use of estrogens and antiandrogens for MTF individuals and testosterone for
FTM individuals to gain characteristics of their gender identity
6. Gender affirmation surgery: surgical procedures to change body characteristics to match an individual’s gender
identity
7. Sex assigned at birth is usually based on a person’s chromosomal sex: male (XY) or female (XX).
8. intersex: with ambiguous genitalia, where sex was assigned based on a provider’s assessment of the genitalia
alone.
9. Gender expression refers to the behavior a person exhibits, which may or may not be the same as the person’s
gender identity or sex assigned at birth.
● Sexual orientation and gender identity are separate from each other. Just like a cisgender man could be attracted
to women (heterosexual) or men (gay), a transgender man could also be attracted to women (heterosexual) or
men (gay).