Barriers Present in the Process of Construction of the Cultural Family Care to the Child in the Hospital: Transcultural Approach

Abstract

Objective: To know the barriers in the process of building family cultural care for the child in the hospital. Methodology: This is a qualitative study with a cross-cultural theoretical reference of Madeleine Leininger, called Theory of Diversity and Cultural Universality of Care, and with a methodological reference of the ethno-inference. It was developed in 2017 at the pediatric unit of a university hospital in the south of Brazil, through non-participant observation, participant observation and interview with 15 family caregivers of hospitalized children. The data was coded, classified and scrutinized to identify the saturation of ideas and similar or different patterns; also, it was re-coded and the theoretical formulations and recommendations were performed. Ethical aspects were followed, according to the Resolution of the National Research Ethics Council 466/2012. Results: The data showed as a barrier the need for hospitalization as a factor of family vulnerability, control of the unit’s health team members, hospital norms and routines, and the need to transgress as a manifestation of family care. Conclusion: Cultural care is a process that aggregates knowledge and can be considered a new paradigm for the accomplishment of nursing care by providing the mutual growth and construction of new knowledge, an affective, reflexive, human and empathic relationship between the nurse, the child and the family.

Family culture versus institutional hospital culture: a relation between two worlds

“…Organizations are characterized by social interactions that comprise cultural, symbolic, and imaginary systems, with values and norms that guide the behavior of its members. The fact that there are different groups with different cultures in the hospital shows the possibility of different human groups being able to share, even if temporarily, values and beliefs, conditioning their actions in the organizational environment (9,14) .…”

“…In this sense, the nursing professional who works in the hospital needs to consider the client's culture when planning care, as the family can remain healthy according to their care practices, that are based on their beliefs, values, and the knowledge acquired both in the popular system and in the professional care system (2,9) . Thus, one of the strategies to provide care is trying to know the ways of life of the being who is receiving care, seeking to understand them in their multiple dimensions, including the cultural one.…”

Crenças de enfermeiros do contexto hospitalar sobre a inclusão da família no cuidado de enfermagem

“…A falta de conhecimento sobre esta abordagem pode ser reflexo de um ensino tradicional da enfermagem que é voltado para o cuidado individual em detrimento de uma abordagem familiar (10,15) . (18,19) . Porém, quando a família, por algum motivo, é questionadora, ou seja, é vista pelo enfermeiro como alguém que pressiona de alguma forma a equipe, ela perde a oportunidade de receber os ensinamentos e orientações que irão auxiliar no cuidado em casa.…”

The care provided by the family to the premature newborn: analysis under Leininger’s Transcultural Theory

“…During the observation in the field, it was noticed that part of the care delegated to the family are those considered relevant by the professionals and involve, in most cases, hygiene and food actions, disregarding the importance of building the therapeutic plan shared between the team and family members. These are measures linked to health policies from a theoretical perspective: they encourage restricted and specific care, seek to meet outdated standards, routines and protocols, without valuing the family's needs and prior knowledge (27)(28) .…”