Differences in ethnic beliefs about the perceived need for local anesthesia for tooth drilling and childbirth labor were surveyed among Anglo-Americans, Mandarin Chinese, and Scandinavians (89 dentists and 251 patients) matched for age, gender, and occupation. Subjects matched survey questionnaire items selected from previously reported interview results to estimate (a) their beliefs about the possible use of anesthetic for tooth drilling and labor pain compared with other possible remedies and (b) the choice of pain descriptors associated with the use of nonuse of anesthetic, including descriptions of injection pain. Multidimensional scaling, Gamma, and Chi-square statistics as well as odds ratios and Spearman's correlations were employed in the analysis. Seventy-seven percent of American informants reported the use of anesthetics as possible remedies for drilling and 51% reported the use of anesthetics for labor pain compared with 34% that reported the use of anesthetics among Chinese for drilling and 5% for labor pain and 70% among Scandinavians for drilling and 35% for labor pain. Most Americans and Swedes described tooth-drilling sensations as sharp, most Chinese used descriptors such as sharp and "sourish" (suan), and most Danes used words like shooting (jagende). By rank, Americans described labor pain as cramping, sharp, and excruciating, Chinese used words like sharp, intermittent, and horrible, Danes used words like shooting, tiring, and sharp, and Swedes used words like tiring, "good," yet horrible. Preferred pain descriptors for drilling, birth, and injection pains varied significantly by ethnicity. Results corroborated conclusions of a qualitative study about pain beliefs in relation to perceived needs for anesthetic in tooth drilling. Samples used to obtain the results were estimated to approach qualitative representativity for these urban ethnic groups.
The purpose of the study was to explore the encounters with the health care system in Sweden of women from Somalia, Eritrea, and Sudan who have been genitally cut. A qualitative study was performed through interviews with 22 women originally from Somalia, Sudan, and Eritrea who were living in Sweden. The women experienced being different and vulnerable, suffering from being abandoned and mutilated, and they felt exposed in the encounter with the Swedish health care personnel and tried to adapt to a new cultural context. The results of this study indicate a need for more individualized, culturally adjusted care and support and a need for systematic education about female genital cutting for Swedish health care workers.
To explore the connections between culture and expectations surrounding the childbirth experience for professional Chinese Canadian women.
Descriptive and qualitative, using ethnographic interview.
Women were recruited from a community health care center in metropolitan Toronto.
Six professional Chinese Canadian women who had experienced at least one childbirth.
The respondents described adherence to many traditional values, beliefs, and practices throughout the pregnancy and childbirth experience. However, some practices were modified to address functioning in a context that could not support full expression of cultural traditions. Recent immigration to Canada was associated with less adherence to traditional Chinese rituals and beliefs.
Nurses cannot make assumptions about who will use traditional cultural practices or about the circumstances in which they are relevant. Nurses need to be aware of cultural expectations so they can provide culturally competent care, but they should also be aware of how to engage in discussions to clarify individual patient priorities.
Childbirth for many Aboriginal women living in remote communities of the Northwest Territories, Canada, includes separation from their family and community for weeks at a time. This colonialization of childbirth, enforced for decades, is true for Dogrib Dene. Colonialization produces serious social consequences on the everyday lives of pregnant Aboriginal women, which results in lower health outcomes. This article provides a literature review of colonialization in Canada's far north establishing the position that colonialization is a determinant of health. The purpose of this article is to generate knowledge that will inform health professionals and ultimately reduce health disparities as experienced and evident among Dogrib women. By highlighting the concept of colonialization and establishing this concept as a determinant of health, nurses and midwives will identify disparities created through stressors of power and control. From there, culturally meaningful health promotion strategies will be developed and implemented within their nursing practice.
This descriptive, phenomenological study investigated the cultural and spiritual meanings of the childbirth experience from the personal perspectives of 30 Canadian Orthodox Jewish and 30 American Mormon women. Fewer Jewish women had childbirth education and attendance of their partners during childbirth than did Mormon women. Participants in the study, having codified belief systems, expressed the primary importance of bearing children in obedience to religious law. Birth was articulated as a bittersweet paradox, often accompanied by a sense of empowerment. Women described the importance of personal connectedness with others and with God, the importance of childbearing, and the spiritual and emotional dimensions of their childbirth experiences. Religious beliefs help women define the meaning of childbirth and may provide coping mechanisms for the intensity of giving birth. It is essential for holistic nurses to value and acknowledge the cultural and spiritual dimensions of the childbirth experience.
The purpose of the study was to analyze how Swedish midwives (n = 26) discuss sexuality in circumcised African women patients. In focus groups and interviews, discussions concentrated on care provided to circumcised women, training received for this care, and midwives' perceptions of female circumcision. An analytic expansion was performed for discussions pertaining to sexuality and gender roles. Results from the analysis show the following: (1) ethnocentric projections of sexuality; (2) a knowledge paradox regarding circumcision and sexuality; (3) the view of the powerless circumcised women; and (4) the fact that maternity wards function as meeting places between gender and culture where the encounters with men allow masculine hegemonic norms to be ruptured. We conclude that an increased understanding of cultural epistemology is needed to ensure quality care. The encounters that take place in obstetrical care situations can provide a space where gender and culture as prescribed norms can be questioned.
Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic College of Medicine, 200 First Street Southwest, Charlton 6-273, Rochester, MN 55901, USA. firstname.lastname@example.org
BACKGROUND: Among Alaska Native women residing in the Yukon-Kuskokwim (Y-K) Delta region of Western Alaska, about 79% smoke cigarettes or use smokeless tobacco during pregnancy. Treatment methods developed and evaluated among Alaska Native pregnant tobacco users do not exist. This pilot study used a randomized two-group design to assess the feasibility and acceptability of a targeted cessation intervention for Alaska Native pregnant women. METHODS: Recruitment occurred over an 8-month period. Enrolled participants were randomly assigned to the control group (n = 18; brief face-to-face counseling at the first visit and written materials) or to the intervention group (n = 17) consisting of face-to-face counseling at the first visit, four telephone calls, a video highlighting personal stories, and a cessation guide. Interview-based assessments were conducted at baseline and follow-up during pregnancy (>or=60 days postrandomization). Feasibility was determined by the recruitment and retention rates. RESULTS: The participation rate was very low with only 12% of eligible women (35/293) enrolled. Among enrolled participants, the study retention rates were high in both the intervention (71%) and control (94%) groups. The biochemically confirmed abstinence rates at follow-up were 0% and 6% for the intervention and control groups, respectively. DISCUSSION: The low enrollment rate suggests that the program was not feasible or acceptable. Alternative approaches are needed to improve the reach and efficacy of cessation interventions for Alaska Native women.
BACKGROUND: Tobacco dependence interventions developed for Alaska Natives are virtually nonexistent. Alaska Natives residing on the Yukon-Kuskokwim (Y--K) Delta in southwestern Alaska use a unique form of smokeless tobacco (ST) known as Iqmik. This study employed focus group methodology to explore attitudes toward tobacco use and tobacco dependence interventions among Alaska Natives residing on the Y-K Delta. METHODS: Twelve focus groups of former and current tobacco users were conducted in four villages in the Y-K Delta. Participants were 35 adults (83% female) and 22 adolescents (27% female). Participants completed a brief demographic and tobacco use history form. Statements from the focus groups were transcribed for content coding and analysis of the major themes. RESULTS: Use of Iqmik in the villages is thought to be ubiquitous. Y-K Delta Alaska Natives are introduced to Iqmik at a very young age. Iqmik is mostly used and prepared by young Alaska Natives and adult women. There are few perceived adverse health effects of Iqmik or other tobacco use. Although there is interest in stopping, there is a perceived lack of availability of tobacco dependence interventions. The major barriers to preventing the initiation of and stopping tobacco use are the social acceptance and widespread use and availability of tobacco. CONCLUSION: The attitudes toward tobacco and identified barriers to stopping will be useful in developing tobacco dependence interventions for Alaska Natives.
The number of rural hospitals offering maternity care in British Columbia has significantly declined since 2000, mirroring trends of closures and service reductions across Canada. The impact on Aboriginal women is significant, contributing to negative maternal and newborn health and social outcomes. The present qualitative case study explored the importance of local birth for Aboriginal women from a remote BC community after the closure of local maternity services. Data collection consisted of 12 interviews and 55 completed surveys. The average participant age was 32 years old at the time of the study. From the perspective of losing local services, participants expressed the importance of local birth in reinforcing the attributes that contributed to their identities, including the importance of community and kinship ties and the strength of ties to their traditional territory.
To describe the meaning of the childbirth experience to Orthodox Jewish women living in Canada.
In this phenomenologic study, audiotaped interviews were conducted. Tapes were transcribed verbatim and analyzed for emergent themes. Demographic data also were collected.
Thirty Orthodox Jewish women who had given birth to healthy full-term newborns at a university-affiliated Jewish hospital in Montreal, Canada, participated in the study. Data were collected within 2 weeks after childbirth, either in the mother's postpartum hospital room or in her home.
The following themes reflecting spiritual/cultural dimensions of the childbirth experience were identified: (a) birth as a significant life event, (b) birth as a bittersweet paradox, (c) the spiritual dimensions of giving birth, (d) the importance of obedience to rabbinical law, and (e) a sense of support and affirmation.
This study documents cultural, religious, and spiritual dimensions of the childbirth experience of Orthodox Jewish women living in Canada. Knowledge and appreciation of the multiple dimensions of childbirth reflected by this study's findings can contribute to holistic and culturally competent nursing care of women and newborns.