McMillian-Bohler Jacquelyn, Richard-Eaglin Angela
Creat Nurs. 2021 Feb 1;27(1):61-65. doi: 10.1891/CRNR-D-20-00066.
After controlling for education, socioeconomic status, and genetic factors, Black and African American patients in the United States are three to four times more likely to die in childbirth than are White patients. The literature is replete with strategies to improve maternal outcomes for Black and African American patients. Existing strategies focus on addressing poverty and individual risk factors to reduce maternal mortality, yet maternal outcomes are not improving for these patients in the United States. Recent literature suggests that a nuanced approach that considers the effects of individual and structural racism could improve maternal outcomes, especially for Black and African American patients. As nurses comprise the largest component of the health-care system, their collective power and influence can provide a powerful tool for dismantling structural racism. Some important concepts to consider regarding the care of the Black and African American population are cultural intelligence (CQ), allostatic load, and humanitarian ethos. By developing CQ and consistently including the four CQ capabilities (drive/motivation, knowledge/cognition, strategy/metacognition, and behavior/action) in all aspects of practice, nurses can help to uproot racism and cultivate experience to improve maternal health outcomes for Black and African American patients.
在控制了教育程度、社会经济地位和遗传因素之后，美国的黑人及非裔美国产妇分娩时死亡的可能性是白人产妇的三到四倍。文献中充斥着改善黑人及非裔美国产妇结局的策略。现有策略侧重于解决贫困问题和个体风险因素以降低孕产妇死亡率，但在美国，这些产妇的结局并未得到改善。近期文献表明，一种考虑到个体和结构性种族主义影响的细致入微的方法可能会改善产妇结局，尤其是对于黑人及非裔美国产妇。由于护士是医疗保健系统的最大组成部分，他们的集体力量和影响力可为消除结构性种族主义提供有力工具。在照顾黑人及非裔美国人群体时需要考虑的一些重要概念包括文化智力（CQ）、应激负荷和人道主义精神。通过培养文化智力并在实践的各个方面始终纳入文化智力的四个能力要素（动力/动机、知识/认知、策略/元认知和行为/行动），护士可以帮助根除种族主义并积累经验，以改善黑人及非裔美国产妇的健康结局。
