Transcultural Nursing Children
Transcultural Perspectives in Nursing large percentage of the
Care of Children remainder speaks a variety of
Children in a Culturally Diverse Society Asian languages
● Cultural survival depends on the ● California, New York, Texas,
transmission of values and Florida, New Jersey, Illinois, and
customs from one generation to Massachusetts are homes for
the next, this process relies on almost two-thirds of all foreign-
the presence of children for born children.
success. ● Georgia, Virginia, Washington,
● This interdependent nature of Arizona, and Maryland also have
children and society reinforces relatively high numbers of
the need for the greater society to children whose parents recently
nurture, care for, and socialize immigrated to the United States
members of the next generation. (U.S. Census Bureau, 2013).
● In Canada, most immigrants
Children as a Population Consider: reside in one of the major
● Racial & Ethnic makeup metropolitan areas: Toronto,
● Impact of Poverty Vancouver, and Montreal are
● Health Status home for the majority of children
of recent immigrants. (Statistics
Cross-cultural differences in: Canada, 2015)
● growth and development
● infant attachment, and PHILIPPINES
● crying ● The Philippines is inhabited by
more than 175 ethnolinguistic
Racial & Ethnic Composition nations
● MORE THAN 35 MILLION ● The largest Filipino ethnic groups
CHILDREN IN THE UNITED include the Tagalog, Cebuano,
STATES ARE FOREIGN BORN, Ilocano, Bicolano, Kapampangan,
AND MILLIONS MORE ARE THE Maranao, Maguindanao, and
CHILDREN OF RECENT Tausug.
IMMIGRANTS
● Many of these children constitute Poverty
more than 10.9 million than ● The impact of poverty on
English school-age children who children's health is cumulative
speak a language other than at throughout the life cycle, and
home (Ryan, 2013) disease in adulthood frequently is
● Approximately two-thirds of these the result of early health-related
children come from episodes that become
Spanish-speaking homes, and a compounded over time.
Transcultural Nursing Children
● Example: Malnutrition ● malnutrition, and violence
○ Catastrophic and
Irreversible Consequences Children's Health Status
○ Results to Neurologic and Indicators of child health status include:
Musculoskeletal Systems ● birth weight,
Damage ● infant mortality, and
● immunization rates.
Health status is influenced by many
factors, including ACCESS TO HEALTH
SERVICES.
Numerous barriers to quality health
care services for children, such as:
● poverty,
● geography
● lack of cultural
competence by health
care
Child poverty in the United States ● racism, and other forms of
continues to grow: prejudice.
● One in five children (16.1 million) ● pronders
was poor in 2012. 40% of whom
lived in extreme poverty at less Growth & Development
than half of the federal poverty Growth and development of children are
level. similar in all cultures, important racial,
● A disproportionate number of ethnic, and gender differences can be
children in poverty are from identified.
African American and Latino ● For example, there is
backgrounds. cross-cultural similarity in the
sequence, timing, and
Research links poverty to numerous achievement of developmental
risks and disadvantages for children, milestones such as smiling,
including: separation anxiety, and language
● increased abuse, acquisition.
● neglect ● The growth spurt of adolescence
● lower reading scores. involves the skeletal and
● overall less success in the muscular systems, leading to
classroom, significant changes in size and
● failure strength in both sexes but
● delinquency particularly in boys.
Transcultural Nursing Children
Other growth and development patterns Puerto Rican
seem to be specific to cultural groups. ● describe children in terms
● For example, in some cultures, congruent with Puerto Rican
the standard Western mobility culture: emphasis is placed on
pattern of relatedness (e.g., affection,
sitting-creeping-crawling-standing dignity, respectfulness,
- walking-squatting is not responsiveness to mother) and
followed. proximity seeking
● The Balinese infant goes from
sitting to squatting to standing. Anglo-American mothers
● tend to give greater emphasis to
Infant Attachment qualities associated with
● Relationship that exists between individualism such as autonomy,
a child and their primary self control, and activity
caregiver, which provides a
secure base from which to African Children
explore and when necessary, as ● is strongly related to the
a haven of safety and a source of nutritional status of the child:
comfort those who tend to be
malnourished have lessened
German and Anglo-American attachment
mothers:
● expect early autonomy in the Studies suggest that differences in
child and have fewer physical infant attachment are linked to:
interventions as the child plays, ➤ cultural variations in parenting
thus encouraging exploration and behavior and
independence ➤ life experiences
Japanese
● children are seldom separated Crying
from their mother, and there is ● Cultural differences exist in the
close physical interaction with the way mothers perceive, react, and
child (Dewar, 2014). behave in response to their
infants' cues, behaviors, and
Puerto Rican and Dominican mothers demands.
● display close mother-child
relationships with more verbal
and physical expression of
affection than European
American parents.
Transcultural Nursing Children
Culture-Universal & Culture- Specific across cultures, differences in
Child Rearing sleep patterns and bedtime
rituals exist.
Infants & children represent the promise Bedsharing
of future generations ● is the practice of a child sleeping
with another person on the same
-sleeping surface for all or part of
the night
● DUE TO FINANCIAL
NECESSITY
● cultural phenomenon in many
societies that emphasize
closeness, togetherness, and
interdependence (Jain, Romack,
& Jain, 2011).
Cosleeping
● the practice of parents and
children sleeping together in the
same bed for all or part of the
night
Nutrition: Feeding & eating Behaviors ● Reasons might be cultural or
● In many cultures, breast-feeding some may be to facilitate
is traditionally practiced for breastfeeding, comfort, improve
varying lengths of time ranging the child's sleeping, attachment
from several weeks to several
years. Elimination
● Some cultural feeding practices ● primary concern to parents of
might result in threats to the toddlers and preschoolers is
infant's health. bowel and bladder control
○ Propping ● Toileting or toilet training is a
○ Premastication major developmental milestone
○ Malutrition and is taught through a variety of
○ Fastfood/junk foods cultural patterns
○ View of illness as ● Some cultures start toilet training
punishment a child before his or her first
birthday and consider the child a
Sleep "failure" if dryness is not achieved
● Although the amount of sleep by 18 months.
required at various ages is similar
Transcultural Nursing Children
● Some cultures start toilet training ● Buddhist and Hindu women do
a child before his or her first not enter the kitchen and may
birthday and consider the child a sleep in separate/special rooms
"failure" if dryness is not achieved during menses
by 18 months. Parent-child Relationship &
Discipline
Menstruation ● In some cultures, both parents
● In most cultures globally, assume responsibility for the care
menarche signals that a girl's of children, whereas in other
body IS physiologically becoming cultures, the relationship with the
ready for motherhood mother is primary and the father
● Attitudes toward menstruation are remains somewhat distant.
often culturally based, and the
adolescent girl might be taught African American families
many folk beliefs. ● encourage children to express
● For example, in traditional opinions verbally and to take an
Mexican American families, girls active role in all family activities
and women are not permitted to
walk barefooted, wash their hair, Asian
or take showers or baths39 ● parents value respectful,
during menses. deferential behavior toward
● Some Mexican Americans adults, who are considered
believe that sour or iced foods experienced and wise;
cause the menstrual flow to ● children are discouraged from
thicken making decisions independently
● Some Puerto Rican teenagers
have been taught that drinking The witty, fast reply that is viewed in
lemon or pineapple juice will some US, Canadian, European, and
increase menstrual cramping Australian cultures as a sign of
● Adolescent girls of Islamic intelligence and cleverness might be
religious backgrounds have punished in some non-Western circles
cultural and/or religious as a sign of rudeness and disrespect.
prohibitions and duties during
and after menstruation. Native North American
● In Islamic law, blood is ● physical punishment is rare
considered unclean. The blood of ● generally discipline with a quiet
menstruation, as well as blood voice, telling the child what is
lost during childbirth, is believed expected
to render the female impure.
Transcultural Nursing Children
African American Some Middle Eastern & Mexican
● tend to point out negative Societies
behaviors of a child and may use ● fondling of the genitals of -infants
spanking and physical and young children is used to
punishment as a strategy to soothe them or encourage sleep.
quickly gain the child's attention
and rapidly get him or her to Gender Differences
behave, especially in public ● Normal newborn boys are larger,
more active, and have more
Child Abuse muscle development than
● Practices that are acceptable in newborn girls.
the culture in which they occur ● Normal newborn girls react more
may be considered abusive or positively to comforting than do
neglectful by outsiders newborn boys.
African Nations Health and Health Promotion
● continue to practice rites of ● The concept of health varies
initiation for boys and girls, widely across cultures.
usually at the time of puberty. In ● Regardless of culture, most
some cases, ritual parents desire health for their
circumcision-of both boys and children and engage in activities
girls-is performed without that they believe to be health
anesthesia, and the ability to promoting.
endure the associated pain is
considered to be a manifestation Illness
of the maturity expected of an ● Every society has an organized
adult. response to defined health
problems. Certain people are
US, Canada, Southeast Asia designated as being responsible
● Folk healing practices such as for deciding who is sick, what
coining, cupping, and burning kind of sickness the person has,
that produce marks on the body and what kind of treatment is
are used for treatment of upper required to restore the person to
respiratory illnesses, pain relief, health.
and various other illnesses.
Health Belief Systems and Children
● Among many cultural groups,
traditional health beliefs coexist
with Western medical beliefs
Transcultural Nursing Children
A Mexican American family, ○ falling on the head.
● might take a child to a physician ○ abruptly removing the
and/or a traditional healer nipple from the infant's
(curandero). After visiting the mouth, and
physician and the curandero, the ○ failing to place a cap on
mother might consult with her the infant's head.
own mother and then give her Hindus from Northern India
sick child the antibiotics ● Empacho
prescribed by the physician and ○ there is a strong belief in
the herbal tea prescribed by the ghost illness and ghost
traditional healer possession. These
culture-bound syndromes,
Hispanic Culture or folk illnesses, are based
● Susto (cultural illness) is caused on the belief that a ghost
by a frightening experience and is enters its victim and tries
recognized by nervousness, loss to seize the soul. If the
of appetite, and loss of sleep. ghost is successful, it
● Pujos (grunting) is an illness causes death
manifested by grunting sounds
and protrusion of the umbilicus, Biocultural Influences on Childhood
believed to be caused by contact Disorders
with a woman whos is
menstruating ● Children may be born with
● The evil eye, mal ojo, is an genetic traits inherited from their
affliction feared throughout much biologic parents, who have
of the world. The condition is said inherited their own genetic
to be caused by an individual compositions.
who voluntarily or involuntarily ● Other factors responsible for
injures a child by looking at or differing susceptibilities to specific
admiring him or her. conditions are variations in
● dehydration-the most serious natural and acquired immunity,
threat to the infant with mal ojo. intermarriage, geographic and
climatic conditions, ethnic
Mexican American background, race, and religious
● caida de la mollera, or fallen practices.
fontanel, can be attributed to a
number of causes such as: Immunity
○ failure of the midwife to ● The most frequently cited
press preventively on the examples of the connection
palate after delivery, between immunity and race is
Transcultural Nursing Children
that of malaria and the sickle cell presence of a child with a
trait in Africans. disability might be something
about which the family is deeply
Black Africans ashamed or with which they are
● possessing the sickle cell trait are unable to cope.
known to have increased
immunity to malaria, a serious Culturally Competent Nursing Care
endemic disease found in warm, for Children and Adolescents
moist climates. Thus, blacks with 1. Nursing Assessment of the Family
the sickle cell trait survived 2. Cultural Background
malarial attacks and reproduced 3. Family Belief system
offspring who also possessed the 4. Family Structure
sickle cell trait.
Intermarriage
● Intermarriage among certain
cultural groups has led to a wide
variety of childhood disorders.
● For example, there is an
increased incidence of ventricular
septal defects (VSDs) among the
Amish
● Amyloidosis among
Indiana/Swiss and Maryland/
German families, and
● Intellectual disability in several
other groups
Beliefs Regarding the Cause of
Chronic Illnesses and Disabilities
● Inherited disorders and illnesses
are frequently envisioned as
being caused by a family curse
that is passed along from one
generation to the next through
blood.
● When disability is seen as a
divine punishment, an inherited
evil, or the result of a personal
state of impurity, the very
