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海地儿童腹泻相关的健康观念:构建跨文化护理知识

Health beliefs related to diarrhea in Haitian children: building transcultural nursing knowledge.

作者信息

Kirkpatrick S M, Cobb A K

出版信息

J Transcult Nurs. 1990 Winter;1(2):2-12. doi: 10.1177/104365969000100202.

Abstract

Regardless of where they live or under what circumstances, mothers throughout the world seem to have a compelling desire to provide the best possible health care for their children (Huston, 1979). Haitian mothers living in the Dominican Republic were no exception. The health beliefs and practices of these mothers related primarily to diarrhea among their children which demonstrated a concern and resourcefulness that is commendable. The results of this study clearly indicate the importance of transcultural nurses conducting culturally relevant research as a basis to develop sound health programs in developing countries. Diarrhea was identified as the single most important threat to a child's health in these communities. That mothers did not know about the correct ingredients and/or proportions for oral rehydration solutions (Western views) was of interest. Although the Dominican government makes some commercial packets of ORS, most of the women interviewed did not have ready access to this product. This finding reflected the need for transcultural nurses to offer to teach mothers how to make ORS using the sugar, salt, and water they had available. Since the mothers' perception that diarrhea was a dangerous threat to their children's health, was verified by childhood mortality statistics in the bateys, it would seem that ORS could make a significant impact on the health status of the children. Breastfeeding also was a major health belief factor associated with the treatment of diarrhea. Even though the majority of mothers believed breast feeding should be continued if a child had diarrhea, a number believed it should be discontinued. Nurses working with CHWs will need to emphasize the importance of breastfeeding and help them to develop creative ways of communicating this information to the mothers. The second most dangerous threat to the child identified by the mothers was respiratory ailments. This suggests a new area of concentration for future research and training of CHWs. A host of new questions related to respiratory problems such as health beliefs, causative factors, course of disease, traditional treatments, mortality rate, etc. need to be investigated. When transcultural nurses plan health care programs for women and children in other cultures, it is important to recognize the concerns mothers have for their children, and their intense desire to nature and care for them. In this study, mothers willingly participated and demonstrated active interest in learning to use methods to improve the health and well being of their children. It is well documented (Lieban, 1977) that established health beliefs are not automatically discarded when new knowledge is made available, but that exploration and incorporation of new information when presented in a culturally relevant framework does occur. An understanding of local beliefs surrounding health is fundamental to the development of appropriate transcultural nursing interventions.

摘要

无论身处何地或处于何种环境,全世界的母亲似乎都有一种强烈的愿望,要为自己的孩子提供尽可能好的医疗保健(休斯顿,1979年)。生活在多米尼加共和国的海地母亲也不例外。这些母亲的健康观念和做法主要与她们孩子的腹泻有关,这显示出她们值得称赞的关切和机智。这项研究的结果清楚地表明,跨文化护士开展与文化相关的研究对于在发展中国家制定完善的健康项目至关重要。腹泻被确定为这些社区中对儿童健康的唯一最重要威胁。母亲们不知道口服补液溶液的正确成分和/或比例(西方观点),这一点很有意思。尽管多米尼加政府生产一些商业包装的口服补液盐,但大多数接受采访的妇女无法轻易获得这种产品。这一发现反映出跨文化护士需要主动教母亲们如何用她们现有的糖、盐和水来制作口服补液盐。鉴于母亲们认为腹泻对孩子的健康是一种危险威胁这一观点,在甘蔗种植园社区的儿童死亡率统计数据中得到了证实,那么口服补液盐似乎可以对儿童的健康状况产生重大影响。母乳喂养也是与腹泻治疗相关的一个主要健康观念因素。尽管大多数母亲认为如果孩子腹泻,应该继续母乳喂养,但也有一些母亲认为应该停止。与社区卫生工作者合作的护士需要强调母乳喂养的重要性,并帮助她们想出有创意的方式将这些信息传达给母亲们。母亲们确定的对儿童的第二大危险威胁是呼吸道疾病。这表明社区卫生工作者未来的研究和培训有了一个新的关注领域。一系列与呼吸道问题相关的新问题,如健康观念、致病因素、病程、传统治疗方法、死亡率等,都需要进行调查。当跨文化护士为其他文化背景的妇女和儿童制定医疗保健项目时,重要的是要认识到母亲们对孩子的关切,以及她们对养育和照顾孩子的强烈愿望。在这项研究中,母亲们愿意参与,并表现出积极的兴趣,学习使用各种方法来改善孩子的健康和幸福。有充分的文献记载(利班,1977年),当新知识出现时,既定的健康观念不会自动被摒弃,但当以与文化相关的框架呈现新信息时,对新信息的探索和纳入确实会发生。了解围绕健康的当地观念是制定适当的跨文化护理干预措施的基础。

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