Cultural Differences and Parental Responses to the Preterm Infant at Risk: Strategies for Supporting Families

Abstract

Parenting a preterm infant at risk for developmental disabilities can be a profoundly stressful experience. For parents from minority cultures, language barriers and cultural differences can increase feelings of uncertainty and inability to cope. Research suggests that cultural differences influence not only parents' emotional responses to and perceptions of disability, but also their utilization of services and their interaction with health professionals. The Neonatal Intensive Care Unit of Mount Sinai Hospital (MSH), Toronto, provides care to a culturally diverse community, and approximately 45 percent of patients receiving care represent minority ethnic groups. Although efforts to provide culturally sensitive care have been made, they have tended to be isolated initiatives lacking consistency and coordination. This article describes the initiation and development of a multicultural program at MSH to support families of infants at risk for developmental disabilities. This article provides valuable guidance to other neonatal units that are attempting to support parents from diverse cultural groups.

Stress in fathers of premature newborns admitted in a neonatal intensive care unit

“…Research has primarily focused on mothers and only recently has stress among fathers been studied [1][2][3][4][5][6][7]. Reports on parental stress from developing countries and from cultural minorities in Western countries suggest that the causes of stress and responses thereof do not always fit into the Western paradigm [8][9][10]. We planned this study with the objective of quantifying the stress perceived by fathers of preterm infants requiring NICU care in India.…”

Migrant and minority family members in the intensive care unit. A review of the literature

“…Parents of NICU patients from this study suggest strategies for improving communication and decreasing stress as follows: answer questions carefully, teach by demonstration, take time to explain in simple English, set up an environment of trust so that families feel “safe” to ask questions [46]. Migrant parents of NICU babies in a North American study verbalized a need for readily available translators and translated educational materials [5]. In a quasiexperimental study, mothers of preterm infants were paired with a buddy (matched based on language, culture, ethnicity, and characteristic of infant) and compared to a control group.…”

“…Intervention participants reported feeling more confidence, a better understanding of the medical condition of the infant, and an improved quality of listening support [35]. A similar buddy system was used in a Canadian NICU, where a multicultural committee developed the program to improve cross-cultural care, but outcomes were not measured [5]. “The complex medical issues that arise in the ICU environment require a trained interpreter to communicate effectively” [10].…”

“…Because of the acuity of the patient in these settings, the families themselves are extremely emotionally vulnerable and depleted [39]. In migrant populations, the families are at an even higher risk for emotional and psychological depletion because the normal stress of having a loved one in the ICU is potentiated by the stress of cultural isolation [5]. The concept of family-centered care is perhaps most applicable in specific populations where the patient is most vulnerable such as in the ICU where neurological deficit, severity of illness, or levels of sedation impair the patient making family a focal point in decision making [12].…”

Communication entre intervenants oeuvrant auprès de l’enfant d’âge préscolaire et les familles immigrantes : étude de la portée

“…Par exemple, il peut s'agir de créer un comité multidisciplinaire ayant le mandat de mettre en place des pratiques culturellement sensibles (Bracht, Kandankery, Nodwell et Stade, 2002). L'identification des besoins des familles immigrantes, la façon de tenir compte lors des interventions des différences culturelles, le développement de nouveaux moyens pour soutenir les familles et la sensibilisation des membres du comité aux problématiques figurent parmi les objectifs de ces comités (Bracht et al, 2002). Un autre exemple concerne un programme de jumelage entre parents de culture ou de langue similaire.…”