This research study was funded by PSC-CUNY Research Grant for 2001-2002.
This cross-cultural descriptive study compared the childbearing concerns and experiences of Korean and Western postnatal mothers in three areas: physiological, psychosocial and infant care. In order to ascertain whether there were cultural differences in these three areas, a survey was conducted. Fifty Western postnatal mothers who were born in America, or who came from European countries, and fifty eight Korean postnatal mothers who came from Korea were surveyed. The t-test for independent samples were computed on the scores obtained for concerns related to three areas. Korean postnatal mothers rated significantly higher in concerns of physiological needs (t= -3.158, p<0.002 F= .993). Korean postnatal mothers rated significantly higher in psychosocial concerns ( t= -2.038 p<0.045 F=12.6). Korean postnatal mothers rated significantly higher in concerns of infant care ( t= -2.914, p<0.005 F=14.27)
Purpose and Significance of this Study
The United States is a multicultural society in which many peoples have retained their cultural heritage and values concerning health care approach. In particular the childbearing process poses many challenges for nurses in caring for patients from different cultural backgrounds. The trend toward a shorter length of hospital stay for postnatal women and newborns is due in part to efforts to reduce health care costs (Nichols, 2000). There is a need to make maximum use of postnatal teaching in a minimal amount of time. To provide optimum health care for the postnatal mother, nurses must know which content is most needed by mothers to care for themselves and their newborns, as well as the priority of their desires for learning and concerns according to cultural differences. The health care providers often observe behavior in patients from other cultures that is incomprehensible and the perceptions received from different cultures have frequently been misinterpreted by health care providers. To provide optimum health care for the postnatal mothers, the health care providers need to understand further postnatal mothers’ cultural and personal values. Few research study have been developed and conducted.
American society is like a salad. All immigrants who have different values and cultures came together and function in a unique way in American society. Every culture contains an important meaning, value and should be recognized.
Reviews of the Literature
According to Horn(1981), Western new mothers are expected to become as physically active as possible, shortly after delivery. Asians mothers (Chinese, Korean, Japanese, South-Eastern Asians) avoided cold foods during the postpartum recovery period and preferred bed rest for more than couple weeks. The Korean postnatal mother is encouraged to take seaweed soup with rice as a main meal for about one week. Seaweed soup contains iodine and is considered to speed up recovery and to replace the blood which they lost during childbearing.
According to Gruis'(1977) survey, the most common concern of American postnatal mothers is their desire to return to their body shape. Harrison’s (1983) study showed that seventy percent of Canadian mothers demonstrated a similar concern to return their body to their pre-pregnant state. Martell et al (1989)’s study showed that the two highest ranked postpartum information needed for the postnatal women were “warning signs for health threats” and “infant care”. Ruchala (2000) compared the priorities of teaching content of new mothers by nurses and the priorities of learning content by new mothers. Findings revealed that nurses gave priority to teaching about infant care, whereas new mothers gave priority to their own care. Through literature reviews, this investigator found quite a number of postnatal research studies in the United States, but discovered only a few research studies of the Postnatal mothers who came from different cultures and socioeconomic levels, particularly cross-cultural studies.
The United States is a multicultural society. Culture is learned, varied and constantly changing. Culture contains its’ own values and attitude.
Conceptual framework
The conceptual framework used to guide the current research study is the assessment model for transcultural health care developed by Giger and Davidhizar (1999), Leininger’s Sunrise Model designed for Nursing (Leininger, 1988) and the cognitive field theory of learning derived from Gestalt Paychology (Babcock & Miller, 1994).
The cognitive field theory of learning is that the individuals’ perceptions are dissimilar and sometimes it is difficult for a person to have other perceptions of the same event. An individual tends to assume that others perceive events as he or she does and may not be aware that others have different perceptions. The post-partum mother’s perception may be affected by her ability to learn, given biologic, psychologic, sociologic, and cultural factors (Ruchala, 2000).
Culture is learned, varied, and constantly changing. Culture has a powerful influence on one’s interpretation of and responses to health care. Clients and health providers have the right to be understood, respected, and treated as individuals despite their differences in their beliefs, values and attitudes.
Transcultural nursing is focused on client centered health care. Therefore it is very important for nurses to keep in mind that culture does influence how clients are viewed and the care they are given (Potter & Perry, 2001).
Research questions or hypotheses
This study addresses three research questions.
1) Are there differences in the physiological concerns/interests of Korean and Western postnatal mothers?
2) Are there differences in the psychosocial concerns/interests of Korean and Western postnatal mothers?
3) Are there differences in the infant care of Korean and Western postnatal mothers?
For this research study, terms are defined as follows:
Physiological concerns/interests: Concerns or interests about altered physical or health status due to childbirth, which postnatal mothers may or may not have until restored to non-pregnant normal health conditions.
Psychosocial concerns/interests: Concerns about fulfilling roles of mother and wife and about maternal self-image and personal esteem.
Infant care concerns/interests: Concerns about the new born baby’s well-being.
Postpartum (Postnatal): From the day after childbirth to the end of the second week.
NO concerns: The areas in which the postnatal mothers already have sufficient knowledge, which require no help from professional health care providers or in which mothers are not interested in obtaining any knowledge.
Minor concerns: Concerns in areas about which the postnatal mothers already have some knowledge, which only rarely require help from professional health care providers or which mothers are not interested in knowing any more about.
Moderate concerns: Concerns in areas about which postnatal mothers know something related to concern areas, but are willing to learn again if the opportunity is given, in addition they think it is still a problem but are not seriously concerned about it, or are interested in it to some extent, but not greatly.
Major concerns: Concerns in area about which postnatal mothers have no knowledge, need help from professional health providers, are very interested in, or feel very serious about the concern.
Design and Methodology
The data on the physiological, psychosocial, and infant care concerns of Korean and Western postnatal mothers were obtained in order of their priority, and compared to determine if a difference existed between the two groups.
The first group consisted of Western postnatal mothers who were born in America or came from European countries. The second group consisted of Korean postnatal mothers who were born in Korea and resided in the United States. These subjects were selected from the Obstetrical floor of Flushing Hospital Medical Center, Flushing, New York.
Whenever the investigator arrived in Flushing Hospital Medical Center to collect data, the charge nurse on the postnatal unit was consulted to determine which postnatal mothers were considered to be at low risk and select qualified subjects for Western postnatal mothers.
Upon the approval, the investigator approached prospective participants to explain the purpose of the study and the method of participation. Upon their approval by oral consent, they signed the consent form and filed out a demographic and questionnaire. Assurance of confidentiality to all subjects was given.
Instruments
Using an interval scale, each specific concern in each area was scored as follows:
a no concern is scored 0
a minor concern is scored 1
a moderate concern is 2
a major concern is 3
Each group score was obtained by adding all scores marked on all concern areas. Statistical analysis was done by computing the means of scores and compared two groups by utilizing t-tests. Levels of significance were set as a = 0.05. The questionnaire was modified on the questionnaire developed by Gruis’ (1977) postpartum concerns of mothers.
To determine the content validity of the postnatal questionnaire, six nurses with clinical expertise in maternity nursing reviewed all versions: Child-bearing nursing instructors (native Korean and American), O.B./GYN nurse practitioners and staff nurses.
Each participant completed a data form that contained demographic information and questionnaire. Completion time for the demographic information and the questionnaire was approximately 5-10 minutes.
“Patients have a right to care that protects their personal dignity and respects their cultural, psychosocial, and spiritual values.” by JCAHO ( The Joint commission on Accreditation of Healthcare Organization, 1996)
According to the JCAHO
Assessment of patient educational needs should consider the patient’s cultural and religious practices, ability to learn and language barriers, among other factors. To work effectively in multicultural society, nurses must be able to provide efficient care to persons from different cultural backgrounds.
Copyrighted by Sung H. Gwak, 2003
Online Notes
