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Item type Presentation

Format Text-based Document

Title Teaching Students and Nurses Evidence-BasedRecommendations for Culturally Sensitive Perinatal Careof Somali Immigrant Women

Authors Missal, Bernita Eileen; Clark, Connie Lynn

Downloaded 6-May-2018 11:35:10

Link to item http://hdl.handle.net/10755/603774

Teaching Students and Nurses Evidence-based Recommendations of Culturally Sensitive Perinatal Care for

Somali Immigrant Women

Bernita Missal, PhD, RNConnie Clark. PhD, RNBethel University

Objectives:

1. The learner will be able to examine the evidence related to culturally sensitive care for Somali immigrant new mothers.

2. The learner will be able to integrate recommendations for culturally sensitive care for Somali immigrant new mothers into nursing and patient education.

Somalia: History

• 1960: Somalia becomes independent from Britain andItaly.

• 1969: Dictatorial socialist state with persecution, torture, and jailing of opponents.

• 1991: Regime overthrown. Clan warfare.

Central government and infrastructure destroyed.Metz, 1993; CIA The World Factbook, 2013; Encyclopedia Britannica, 2013.

CIA The World Factbook. (n.d.). Retrieved from https://www.cia.gov/library/publications/the-world-

factbook/geos/so.html

Somalia: Refugees & Diaspora• Est. 300,000 Somalis died during the war

• Over 1 million refugees

• Somalia - 3rd largest number of of refugees in the world

(UNHCR, 2013).

Al Jazeera.. (2013). Retrieved from http://stream.aljazeera.com/story/somalias-global-diaspora-0022000

(United Nations (UN], n.d.)

(United Nations High Commissioner for Refugees [UNHCR], 2013).

Harrison, J. Oxfam International Blog.. (2011). Retrieved from http://blogs.oxfam.org/en/blog/11-07-26-dadaab-diary-fleeing-famine

CNN. (2009). Retrieved from http://www.cnn.com/2009/WORLD/africa/09/03/somalia.refugee.conditions/

“Discover, document, know, and explain the interdependence of care and culture phenomena with differences and similarities between and among cultures” (Leininger & McFarland, 2006, p.4).

Cultural Care Diversity & Universality Theory

University of Washington School of Nursing. (2012). Retrieved from

http://nursing.uw.edu/newsroom/press-releases/remembering-madeleine-

leininger-leader-in-transcultural-nursing-and-former-d

Purpose of Study

Minnesota Public Radio. (2011). Retrieved from http://minnesota.publicradio.org/display/web/2009/02/26/mosque_openhouse

To explore Somali immigrant new mothers’ experience of childbirth in Minnesota

Design

• Qualitative research • Twelve female participants• In-depth individual interviews• Semi-structured open-ended

questions

BBC. (2013) . Retrieved from http://www.bbc.co.uk/news/world-africa-20033839

Data Collection

• Collaborated with Somali women community leaders • Snowball sampling technique• Interviews at varied locations

Minnesota Historical Society. (2004). Retrieved from http://education.mnhs.org/immigration/narrators/somali/abdisalam-

adam/raising-children-in-somalia

Evidence for Culturally Sensitive Care to Somali Immigrant New Mothers

1) Family’s & friends’ support2) Cultural & religious practices3) Relationships with nurses4) Views on Cesarean section5) Postpartum blues/depression

USA_Mania-Job-Recruitment Ads. (n.d.). Retrieved from http://usamania.wikispaces.com/Job+-+Recruitment+Ads

• Loss of mother’s help & advice• Loss of traditional family support

Family

Retrieved from madaale.com

“Don’t have a family here.

Think about family and get sad.”

Husband’s Support

“Culturally, boys don’t cook. He washed, cleaned the house, vacuumed.”

Different from Somalia: • Husband’s presence in

the delivery room.• Husband’s extensive help

with household tasks.

Salon. (2002). Retrieved from http://www.salon.com/2002/09/05/jama/

• Any available family member or friend helped.

Extended Family and Friends’ Support

Minnesota Historical Society. (2004). Retrieved from http://education.mnhs.org/immigration/narrators/somali/hared-mah/many-somalis-came-from-other-

states-because-there-were-jobs-available-her

“Sister-in-law lived with me for two years”.

“If you are Somali, you are friends.”

Cultural & Religious Practices

• Traditional foods• 40-day postpartum

period• Prayer at the time

of birth

Somaliweyn. (2009). Retrieved from http://www.somaliweyn.org/pages/news/Oct_09/23Oct24.html

• Food brought by family & friends to the hospital: oatmeal & tea – for breast milk.

• Traditionally Somali women eat during labor.

Traditional Foods

“‘No, I am going to eat hospital food’, and she

[friend] was like: ‘No, you are a new mother and you are

going to get hungry in the middle of the night.’ “And

4:00 in the morning came and I was so hungry and I had my

porridge and I was so grateful.” The Phoenix of Somalia. (n.d.). Retrieved from

http://thephoenixofsomalia.wordpress.com/2011/03/13/somali-spiced-tea/

“‘She has no energy, how is she supposed to push the baby?’ My mom was really angry.”

In Somalia:• Mother stays at home and only cares for the baby• Female relatives do all household work

At the end of 40 days: • Special celebration with the extended family & friends• Special food and clothes

40-day Postpartum Period

“All that she does is feed the baby and sleep, that’s it.”

“In America nobody gets that time. When we got out, we went to Target. That is very strange.”

• Father whispers prayer in baby’s ear

Prayer at Birth

“Prayer for help, for the mother and baby to

have a happy face.”

Relationships with Nurses

Superscholar. (n.d.). Retrieved from http://www.superscholar.org/top-nursing-jobs-degrees/

• Physical care• Emotional support• Teaching “One nurse was the

best. She was coming to visit me often. She taught me about the

baby and to care for the baby. She was nice. She

was talkative.”

Views on Cesarean Section

Aversion towards C/S

Avoid going to the hospital

Family strongly disapproves Commercial interest of

physicians

Punishment

Why is it necessary?

• Not common in Somalia• Viewed as a weakness

Postpartum Blues/Depression

“You’re by yourself, you’re so tired. You don’t get to rest. My sister had a

different experience because her mother-in-law always cooked. The

food was not there [for me], that was a big challenge.”

[Husband says] “What are you doing? My mom had 12 kids, never cried. You’re weak.”

Recommendations for Staff Nurses

Retrieved from http://www.preemiesinapod.com

/who-is-your-primary-nurse/

Husband Ask woman about his companionship during labor & delivery.Include husband in pre- and postnatal teaching.

Family & Friends Ask woman about preferred guests.Monitor traffic in the room.

Cultural Aspects Be aware of loss of social support & 40-day period. Permit food.

Postpartum Depression/Blues

Be aware of its prevalence, denial, and stigma. Educate.

Build Trusting Relationships

Share personal experiences with children; allow time for questions, give rationale

Recommendation for Nurse Educators

• Teach students to be sensitive to the challenges of being in a second culture

• Teach students about importance of cultural and religious practices

• Teach importance of establishing trusting relationships

• Teach use of community resources

Recommendations for Administrators

• Establish policies that provide for cultural sensitivity

• Provide educational opportunities for inter-professional and ancillary groups

• Partner with community to understand health issues of the Somali community