Mexican Immigrant Mothers' Expectations for Children's Health Services

Abstract

Women of Mexican descent living in the United States raise children who use health care services. What do immigrant Mexican mothers expect from children's health care services? And how do their expectations for children's health services compare to acculturated Mexican American mothers' expectations? This focused ethnographic study, based on repeated interviews with 28 mothers of varying acculturation levels, describes their expectations and experiences with children's health care services in the United States. Findings support a shared core of expectations for both Mexican immigrant and Mexican American mothers, and differences in health care access and financing, time spent in health care encounters, and cultural and linguistic expectations for care. Health care providers can use this information to approach Mexican-descent mothers and children with their expectations in mind, and craft a negotiated plan of care congruent with their expectations.

The Voices of Limited English Proficiency Latina Mothers on Pediatric Primary Care: Lessons for the Medical Home

“…However, families often waited many hours to be seen, were seen by whichever provider was available, and felt rushed during visits. The importance of same-day sick care among Latina mothers is not unique to this study and may be related to immigrant Latinos’ being accustomed to a walk-in system of care, common in Mexico and many Central American countries, or culturally-based fears about fever and other signs/symptoms of illness [38, 39, 43–45]. Prioritization of same-day sick care among Latina mothers, may contribute to reported disparities in the timeliness of care for Latino children [13, 46, 47].…”

The Case for Studying Cultural Competence from the Perspective of the Hispanic Immigrant Patient: A State of the Science

“…The studies included two case studies (Barone, 2010;Derose, 2000), ten qualitative studies using interviews or focus groups (Bergmark, Barr, & Garcia, 2010;Carbone, Rosal, Torres, Goins, & Bermudez, 2007;Clark & Redman, 2007;Collins, Villagran, & Sparks, 2008;Cristancho, Garces, Peters, & Mueller, 2008;Frazier, Garces, Scarinci, & Marsh-Tootle, 2009;Harari, Davis, & Heisler, 2008;Keller, 2008;Nailon, 2004;Warda, 2000); a descriptive correlational study (Castro & Ruiz, 2009); three reviews of the literature (Cooper & Ballard, 2011;Mayo, Sherrill, Sundareswaran, & Crew, 2007;Padilla & Villalobos, 2007); five studies using survey data (Gonzalez, Vega, & Tarraf, 2010;Johnson, Saha, Arbelaez, Beach & Cooper, 2004;Riffe, Turner, & Rojas-Guyler, 2008;Sorkin, NgoMetzger, & DeAlba, 2010;Wallace, DeVoe, Rogers, Protheroe, Rowlands, & Fryer, 2009), and a mixed methods study (Lassetter & Baldwin, 2004) While the majority of the selected studies focused on the patient's perspective, only a few studied cultural competence as a whole (Barone, 2010;Carbone, Rosal, Torres, Goins, & Bermudez, 2007;Nailon, 2004). The majority of studies focused on investigating aspects affecting cultural competence including themes such as barriers to health care (Bergmark, Barr, & Garcia, 2010;Collins, Villagran, & Sparks, 2008;Cristancho, Garces, Peters, & Mueller, 2008;Derose, 2000;Frazier, Garces, Scarinci, & MarshTootle, 2009;Harari, Davis, & Heisler, 2008;…”

“…Having to wait up to 12 hours or more for an appointment has been shown to be a barrier to accessing care in this population (Cristancho, Garces, Peters, & Mueller, 2008;Derose, 2000;Nailon, 2004;Sorkin, Ngo-Metzger, & DeAlba, 2010) as the expectation is often for timely care with treatments that provide rapid results (Clark & Redman, 2007). Castro and Ruiz (2009) in their study comparing nurse practitioner levels of cultural competence with Latina patient satisfaction scores found that longer wait times were associated with lower satisfaction scores.…”

“…Warda (2000) described this concept as a "formal friendliness" where adequate time is taken to visit with patients openly and in a caring manner. The concept of personalismo has been repeatedly found as an important element in culturally competent encounters (Clark & Redman, 2007;Cooper & Ballard, 2011;Keller, 2008). The idea of spending time visiting with a patient on a more personal level and making sure they understand what they need to during each visit often goes against the more time constrained clinical aspects of health care appointments in the U.S., but for the Hispanic immigrant, relationship building and fostering a respectful and sympathetic connection between provider and patient is at the heart of culturally competent health care (Bergmark, Barr, & Garcia, 2010;Castro & Ruiz, 2009;Clark & Redman, 2007;Cristancho, Garces, Peters, & Mueller, 2008;Keller, 2008;Lassetter & Baldwin, 2004;Nailon, 2004;Padilla & Villalobos, 2007;Wallace, DeVoe, Rogers, Protheroe, Rowlands, & Fryer, 2009).…”

“…With language services being one of the governmental mandates associated with the CLAS standards (OMH, 2007), studying the use and effectiveness of interpretation services or other means of interpretation has abounded. Almost without fail, cultural competence is perceived as being greater when health care practitioners are able to speak Spanish or when there are adequate interpretation services available (Barone, 2010;Castro & Ruiz, 2009;Clark & Redman, 2007;Sorkin, Ngo-Metzger, & DeAlba, 2010). Often times, Hispanic immigrants consider interpretation services to be inadequate and they question the accuracy of the information being translated (Cristancho, Garces, Peters, & Mueller, 2008;Derose, 2000;Harari, Davis, & Heisler, 2008;Nailon, 2004).…”