The Lived Experience of Postpartum Intergenerational Conflict of Vietnamese American Women with their Vietnamese Immigrant Parents: It's A Generational Thing!

PURPOSE: US-born Vietnamese women who are in their childbearing years are more likely to identify with "western" perspectives when compared to their immigrant mothers who were born in Vietnam. Still, a gap in knowledge exists of their intergenerational differences. The purpose of this study was to explore and better understand Vietnamese American women's experiences of postpartum intergenerational conflict. STUDY DESIGN AND METHODS: van Manen's methodological approach (1997) was used. The purposive sample included 11 US-born Vietnamese women who experienced postpartum intergenerational conflict with their parents. Data were transcribed verbatim and analyzed using thematic analysis. The researcher transcended the themes through music. Songs and lyrics were arranged for guitar to bring the phenomenon to life. RESULTS: Four themes were identified: (1) "It's a Generational Thing!" (Mot dieu the he): Leaning both ways; (2) "To rebel or not" (Noi loan hay không): Weighing the evidence of postpartum cultural practices; (3) "Stand My Ground" (Giu vung lap trÆ°ong cua tôi): Keeping my newborn safe and healthy; and (4) "See Me" (Nhìn con): My mental health overshadowed by my mother's thoughts. This study revealed that the intergenerational conflict was influenced by the family's understanding over the division of infant care tasks, disagreements over cultural practices, and generational differences such as age, consistent with previous research. CLINICAL IMPLICATIONS: Tailored interventions for Vietnamese American women should consider the family as a whole. Nurses can assess proactively in prenatal care if there are cultural issues such as family hierarchy, gender, and history influencing one's choices or maternal autonomy.

Global Health Care Experiences of Female Survivors Who Experienced Trafficking: A Meta-Ethnography.

INTRODUCTION: Most nurses and midwives do not feel adequately prepared to respond to the complex trauma and social and cultural needs of female clients who have experienced trafficking. There are data to support a lack of knowledge among health care providers about the types of human trafficking as well as poor structural supports within health care systems. The purpose of this review was to gain a more comprehensive understanding of the global health care experiences of females who have experienced trafficking. METHODS: Noblit and Hare's 7-step meta-ethnographic approach was used. We analyzed constructs, concepts, themes, and metaphors using reciprocal translations. The guidelines for preferred reporting the synthesis of qualitative research were adhered to enhancing transparency (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). RESULTS: The collaborative search process in the PsycINFO, CINAHL, and Scopus databases resulted in 7 high-quality research studies published between January 2016 and January 2021. Most studies explored individuals' experiences of trafficking and views of health care services, challenges, and service use barriers. A total of 228 female survivors who experienced trafficking participated. They primarily experienced trafficking within different parts of North America, Eastern Europe, Africa, and South and Southeast Asia. Three main themes emerged: privacy, confidentiality, and identity problems; powerlessness; and clinician recognition and responsiveness. DISCUSSION: All participants reported being exposed to extremely high levels of physical and mental abuse before, during, and after exiting trafficking. Therefore, clinicians will require ongoing training and clearer guidance from clinical leadership to adequately care for the varying health needs of women and girls who have experienced trafficking or are currently in a trafficking situation. Adoption of a culturally sensitive, patient-centered, and trauma-informed approach is needed, as clients' reasons for staying in a trafficking situation vary. Relationships of trust should be formed in which rapport is cocreated and in which members of the health care team and client work hand in hand together to envision, identify, and pursue future-oriented and strength-based goals toward healing.

Southeast and East Asian immigrant women's transnational postpartum experiences: A meta-ethnography.

The increase in births to Southeast and East Asian (SEEA) immigrants in their adopted countries is of international importance. SEEA women experience the postpartum period differently than that of the general population. Despite the documented difference, there is limited representation of SEEA women in the literature. The purpose of this meta-ethnography is to synthesise the qualitative findings from different research studies examining the experiences of SEEA immigrant women during the first 4-6 weeks of the postpartum period and has been written in adherence with enhancing transparency in reporting the synthesis of qualitative research (PRISMA). Noblit and Hare's meta-ethnographic approach was used. Seven articles (four qualitative and three mixed-methods studies) were reviewed, analysed and synthesised. Four themes emerged: two were facilitators of birth culture (availability and quality of social support and maternity care provider cultural knowledge and response) and two were barriers to birth culture (lack of structural and social support and cultural alienation after childbirth). Due to lack of structural and social support in SEEA immigrant women's adopted countries, they also experienced social and economic hardships after childbirth and made conscious decisions to modify their postpartum cultural practices out of convenience and practicality. SEEA immigrant women also experienced discrimination from maternity care providers, which prevented them from fully engaging in postpartum cultural practices. Maternity care providers can advocate and intervene for SEEA immigrant women by eliciting any postpartum cultural beliefs, assess their social and economic needs early on in prenatal care and make culturally congruent referrals based on those assessments.

Global mental health experiences of single mothers: A mixed methods research synthesis.

AIM: The aim of this research is to synthesize findings from primary studies (quantitative and qualitative) that investigated the global mental health experiences of single mothers to provide a deeper understanding to better care and respond to the support needs of single mothers. DESIGN: Hayvaert et al.'s mixed methods research synthesis approach. DATA SOURCES: The search process in the following databases, CINAHL, PsycINFO, and Scopus resulted in eight high-quality studies (5 qualitative and 3 quantitative) published between June 2016 and July 2021. REVIEW METHODS: Descriptive statistics and instrument scores were provided in summary form. Themes were analysed using Krippendorff's content analysis. A joint display was provided to reveal a complementary relationship between two different data sets. RESULTS: A total of 348 single mothers participated. Amongst the pooled sample, women identified as: Japanese (n = 174), Israeli (n = 147), Black African (n = 18), African American (n = 9), Native American (n = 5), Burundian-Australian (n = 8), UK British (n = 12), Asian (n = 3), South Korean (n = 7), Indian (n = 2), Malaysian (n = 44), Hispanic/Latina (n = 1) and Eastern European (n = 3). Four themes were identified: (1) Learning to let go of the past, (2) It takes a whole village: Importance of social support, (3) Seeking a self-reliant life: Challenges with balancing career & childcare and (4) Finding strength within: Personal growth. Only one intervention utilizing creative group counselling was found to significantly decrease depression (p = .008), anxiety (p = .005), and stress (p = .012) whilst increasing self-compassion (p = .013). CONCLUSION: It is important for clinicians who care for single mothers, particularly if they recently immigrated, are multiparous, and an ethnic minority to encourage engagement in peer-initiated counselling and obtain mental health care as necessary. IMPACT: This study identified and addressed the mental health issues that single mothers face worldwide. This is also the first mixed methods research synthesis to report single mothers' ethnicity in nursing and midwifery literature. Thus, findings from this mixed methods research synthesis can help nurses worldwide build culturally-concordant programs in their respective community organizations and partners (e.g. community health centres, mother-child enrichment clubs), inform health policies, and promote safer spaces for many single mothers, particularly for those who will immigrate to the Global North (i.e. UK, US, Canada) and become an ethnic minority.

Self-perceived Burden: A Critical Evolutionary Concept Analysis.

The purpose of this article is to critically analyze the concept of self-perceived burden. The Rodgers Evolutionary Model is augmented with concept critique, a dialogic process grounded in critical hermeneutics. Self-perceived burden is a relatively mature concept with psychological, relational, and dimensional attributes that are shaped by culture and sociopolitical structures. The antecedents are demographics, circumstances, diagnoses, symptoms, prognosis, comorbidities, and knowledge and beliefs. The consequences are psychological, decisional, relational, and existential. Sociocultural factors such as universal health coverage, Confucian ethics, Buddhist/Taoist ethics, karma, and individualist- versus communitarian-based relationships are brought to light. Psychological and relational antecedents and consequences of self-perceived burden were found to be salient.

Patterns of Knowing and Being in the COVIDicene: An Epistemological and Ontological Reckoning for Posthumans.

The crucible of the COVIDicene distills critical issues for nursing knowledge as we navigate our dystopian present while unpacking our oppressive past and reimagining a radical future. Using Barbara Carper's patterns of knowing as a jumping-off point, the authors instigate provocations around traditional disciplinary theorizing for how to value, ground, develop, and position knowledge as nurses. The pandemic has presented nurses with opportunities to shift toward creating a more inclusive and just epistemology. Moving forward, we propose an unfettering of the patterns of knowing, centering emancipatory knowing, ultimately resulting in liberating the patterns from siloization, cocreating justice for praxis.

Immigrant Southeast and East Asian mothers' transnational postpartum cultural practices: A meta-ethnography.

OBJECTIVE: Southeast and East Asian mothers experience the postpartum period differently than that of the general population. Despite the documented difference, there is limited representation of postpartum cultural practices in nursing and midwifery research. The purpose of this meta-ethnography is to synthesize qualitative findings from studies that examined postpartum cultural practices of Southeast and East Asian mothers globally to ensure better maternal health outcomes. METHODS: Noblit and Hare's seven-step meta-ethnographic approach was used. We analyzed constructs, concepts, themes, and metaphors using Krippendorff's content analysis. The guidelines for preferred reporting the synthesis of qualitative research were adhered to enhancing transparency (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). RESULTS: The collaborative search process in the following databases, PsycINFO, CINAHL, and Scopus, resulted in eight high quality research studies published between January 2017 and February 2020. Five studies discussed postpartum traditions of immigrant mothers (n = 67) living in North America (n = 67), while three studies explored that of mothers living in Southeast and East Asian. Mothers (n = 132) from China, Hong Kong, Taiwan, Korea, Vietnam, and Hmong participated. FINDINGS: Three themes emerged: (1) importance of maintaining postpartum cultural practices; (2) barriers of "doing-the-month"; and (3) modification: practicality over tradition. Although participants recognized value in postpartum traditions, the lack of social support deterred more immigrant than non-immigrant Southeast and East Asian mothers from "doing-the-month." Due to the influence of western medicine, clinicians' postpartum care suggestions, and use of modern technology (e.g., Internet), Southeast and East Asian mothers had informed choices to adapt, modify, or "break with tradition." CONCLUSION: Similarities and differences existed in how each Southeast and East Asian mother accepted and engaged with postpartum cultural practices, a process which aligned with one's definition of health. Maternity care providers should further elicit Southeast and East Asian mothers' needs based on individualized assessments beginning in prenatal care with emphasis on social support for mothers who have recently immigrated and given birth in their adopted countries.

Cultural alienation: A concept analysis.

AIM: To analyze the concept of cultural alienation BACKGROUND: Culturally diverse populations are increasing nationwide. However, many culturally diverse clients have experienced cultural alienation. DESIGN: Rodgerian's method of concept analysis DATA SOURCE: Literature in CINAHL, PubMed, PsycINFO, JSTOR, Scopus, LGBT Life, and Oxford Bibliographic databases were searched. Inclusion criteria were full text, peer-reviewed, English language, and published within 5 years. REVIEW METHODS: Articles were read in their entirety and reread to determine more contextual data. Antecedents, attributes, and consequences were extracted. RESULTS: Fifteen studies were included. Antecedents included: identification with racial, ethnic, sexual minority, disability, chronic illness, and threat to way of life. Attributes were traditional, different, negotiator, preserving, and sustaining. Consequences resulted in sociocultural deprivation, resistance, mistrust, distrust, loss of identity, and racism. CONCLUSIONS: Nurses, health care providers, and communities can better support and engage their clients by working together to create an inclusive environment, in which exists a safe space to work, play, and heal. Findings highlight the need to examine one's own assumptions, inquire about the client's cultural care needs, tailor communication at the client's level, acknowledge individual strengths, provide empathetic support, and promote autonomy.