TRANSCULTURAL NURSING PAPER

APPLICATION OF TRANSCULTURAL NURSING

By Focus Group 5

Bianti Ayu D. 1706038840

Nabila Tasya Ayuputri 1706978181
Nabilah Marsya Al-Farihiyyah 1706039093
Putri Amalia Novianty 1706039023

UNIVERSITAS INDONESIA

DEPOK

2018
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ABSTRACT

Caring is the essence of nursing care. Nurse spreads the care through many
aspects, one of the aspects is culture. Culture itself is different from one and the
other range. Clients also have their own beliefs, values, cultural perspectives and
perceptions, and ritual among their cultures. Nurse have to be competent to
provide care by apply the nursing care related to the client’s cultural background,
particularly the interventions. Nurse have to let the culture goes on without the
probability of harming the client occurs. The culture care and cultural competence
needed by the transcultural nurse to handle the clients, especially the clients with
the strong background of culture.

Keywords: caring, culture, transcultural nursing.

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TABLE OF CONTENT
ABSTRACT............................................................................................................................... i
TABLE OF CONTENT ............................................................................................................ ii
CHAPTER I .............................................................................................................................. 1
1.1 Background ............................................................................................................. 1
1.2 Statement of Problem ............................................................................................. 1
1.3 Purposes and Objectives......................................................................................... 1
CHAPTER II............................................................................................................................. 3
2.1 New-Born Care in General Medical Care ............................................................ 3
CHAPTER III ........................................................................................................................... 7
3.1 The Case................................................................................................................... 7
3.2 Nursing Care Plan................................................................................................... 7
CHAPTER IV ......................................................................................................................... 10
4.1 Conclusion ............................................................................................................. 10

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CHAPTER I

PREFACE

1.1 Background
The material of culture contains a lot of things to be underlined by nurse.
One of the main things like a ritual or traditional event. Every range has its
own cultural values, the clients think that the values have to be applied.
The continuum of nursing care that will be discussed is based on the case.
Case talks about the couples that have a newborn baby who live with Javanese
traditions and things. It started with the theory review of newborn care, how
Javanese people have their own cultural beliefs and perspectives, and myths
surrounding it. The assessment applied regarding the Leininger’s theory of
culture care with specific data related to the Sunrise Model. The diagnosis
talks about the wellness diagnosis, and the planning and implementation based
on the outcomes set. At the evaluation, the result will be re-assessed and see
either the goals are achieved or not then nurse should provide the other
nursing care plans that suits and more appropriate.

1.2 Statement of Problem

1. What kind of newborn care is good for their health?
2. What health promotion is suitable for newborns?
3. What is the perspective of Javanese people in caring for a newborn baby?
4. What are the Javanese cultural myths about newborn care?
5. How to prevent the culture from harming the baby?
6. How do nursing care plans for families who have newborns with cultural
constraints surrounding the myth of care for newborns?

1.3 Purposes and Objectives

1. Identify correct newborn care
2. Identify health promotions that are suitable for newborns
3. Identify the perspective of Javanese culture in caring for newborns
4. Identify Javanese cultural myths about the care of developing newborns

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5. Identify culturally sensitive nursing interventions according to the case

given

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CHAPTER II

THEORY REVIEW

2.1 New-Born Care in General Medical Care

When individual becomes a parent, it does not make oneself

competent even expert to apply the newborn and infant care tasks.
Pediatric nurse takes a role to understand the needs and be able to teach
and demonstrate the interventions to the parents.

Hygiene and personal care:

1) Bathing

The newborn does not need a daily bathing in the first week, notes,
preparation, and procedure.

2) Skin care

The newborn has a fragile and sensitive skin, acts as a protector from
chemical and organisms.

3) Oral care

The newborn needs a good oral hygiene twice a day to prevent oral
infections, sooth the gums, and comfort the child when the teeth
grow.

4) Sleep

Supine position.

5) Clothing

Prevent the constriction the child’s extremities.

Nutrition care:

1) Breast-feeding

Human milk is available, not expensive, and takes a role of bonding

between the mother and the child.

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2) Positioning

Proper position during breast-feeding.

3) Bottle-feeding

The choice is up to the mother.

Elimination

Injury and Illness Prevention

1) Home safety

Parents should understand about the first aid and emergency

preparation.

2.2 Health Promotion for New-Born Care

Adjustment to extra uterine life that newborn physiologic change is

transition from fetal to independent.

1) Immediate adjustment (respiratory and circulatory system)

2) Physiologic status (the other system)

3) Nursing care

4) Protect from infection and injury

5) Provide optimum nutrition

6) Promote parent-infant bonding (attachment)

7) Preparation for discharge planning and home care

2.3 Javanese People’s Perspective about New-Born Care

Javanese people, especially the one who still believe in the

tradition often do kinds of thing to the new-born baby. They believe that if

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they do this care, the baby will be prevented from the devil and etc. Most
of Javanese still have this kind of perspective about certain care.
1) Put scissor under the baby’s pillow
Javanese believe that the scissor will protect the baby from
the devil and nightmare, so the baby won’t be easy to wake at night
and have a better sleep.
2) “Bau tangan”
“Bau tangan” is a condition that Javanese believe when the
baby don’t want to be put down and only want to be held by the
mother. They believe that this condition appears because the mother
doesn’t have the heart to leave the baby when the baby is crying.
3) Put “benggol” on the umbilicus

This is Javanese do to prevent the umbilicus of the baby

becoming “bodong”.

4) The baby is not allowed to leave the house before 40 days

Javanese believe that the devil will bother the baby and the
baby will be possessed by the devil.
5) Bury the placenta along with scissor, stationary, and beauty kit

Javanese believe that the scissor, stationary, and beauty kit

can be used by the placenta properly, because they believe that the
placenta is the “dead twin” of the baby.

6) 3 days old new-born is fed with banana

They believe that the banana will make the baby grow up
healthy and quickly.

2.4 Javanese’s Ritual for New-Born

1) Bury the placenta

Javanese believe that placenta or as they call it “ari-ari” is the dead
twin of the baby. Because of that, they think that Javanese should

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properly bury them like they bury human. Burying the placenta is
also a common belief by Muslim’s.
2) Brokohan
Brokohan is a Javanese tradition ceremony to celebrate the baby’s
birth one day after the labour.
3) Sepasaran
Sepasaran is a celebration ceremony to express the parent’s
gratefulness and to announce the baby’s name. This celebration
usually is being held in the 5th day after the labour.
4) Puputan
Puputan is a ceremony when the umbilical cord is detached from
the umbilicus.
5) Aqiqah
Aqiqah is a ceremony where the parent cut a goat (for girl) or two
goats (for boy) to express their gratefulness to God. This ceremony
is also an adaptation for Muslim’s tradition.

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CHAPTER III

CASE DISCUSSION

3.1 The Case

Young couples who just have new born babies who live
temporarily with in-laws who have many traditions in baby care (Javanese
tradition)

3.2 Nursing Care Plan

3.2.1 Assessment

Cultural assessment tends to be broad and comprehensive because

they are related to cultural values, belief systems and one's way of life.
Cultural assessment in culturally sensitive nursing care focuses on the
assessment of the patient's culture and is a systematic examination of
patients (individuals, groups or communities) of beliefs, values and habits
to determine real care needs and interventions in the patient's cultural
context. In the case, it is explained that young couples who just have a
newborn baby and live temporarily with in-laws that have Javanese
tradition in baby care.

In conducting the assessment, the nurse needs to interview the

baby's parents and in-laws to understand the family's culture. In the
Sunrise model by Leininger, the areas that need to be assessed are cultural
values, beliefs, and practices; religious and philosophical beliefs; kinship
and social factors; technological factors; political and legal factors;
economic factors; and educational factors (Leininger, 2001). The results of
interviews with parents of newborn and in-laws will later serve as the basis
for determining nursing diagnosis.

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3.2.2 Diagnose

The right diagnosis for young couples who have a newborn is

readiness for enhanced childbearing process: after birth. The
characteristics that appear on the client and in accordance with the nursing
diagnosis are expressing desire to enhance use of support system. Living
with in-laws shows that the client (parent of the baby) needs a support
system to adapt with the situation. Also, expect learning about
newborn care techniques from experienced people (in-laws).

3.2.3 Planning and Implementation

Planning Implementation

Identify client’s perspective to enhance Ask the client about what things have
attachment behaviour after birth (health been done for baby care, and point to
behaviour) the good things according to medication

Identify what the client will do in
preparing baby care according to the
client's views (i.e myths)
Ask the client about myths that the
client still believe, give information
how to prepare the baby care, and help
client to know which one is good based
on client’s belief

Help client to enhance baby care Ask client’s techniques to enhance baby
techniques care according to client’s cultural
background and help client to know the
best things to do based on medication

Help client to enhance baby feeding Ask client’s behaviour in feeding the
techniques baby based on the techniques that is
usually used in client’s culture

Help client to know more about good Ask the client’s point of view about
nutritions for the baby based on nutritions based on client’s culture and
medication give information about good nutritions
for the baby (i.e abstinence and

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necessity)

Identify what client do to enhance
environmental safety for the baby
based on client’s culture
Ask about what client has been done for
enhanced baby’s enviromental safety,
ask client’s usually do to keep the baby
safe, and give tips about things that
client should do based on medication to
enhance baby’s safety

Identify client’s post partum lifestyle in
baby care, such as elimination, sleep
behaviour and personal hygiene
Give informations to the client how to
keep baby’s personal hygiene in a safe
way based on medication and ask about
elimination and sleep behaviour
according to client’s culture

Identify client’s preparedness to
enhance use of support system for the
baby
Ask the client about what usually client
uses to support the baby’s life while the
baby lives in a place that has lots of
rules, ask the client if the rules
troublesome in the use of support
systems or not, then help client to
enhance the use of support system.

3.2.4 Evaluation

For evaluation, the nurse needs to assess the result from the
implementation that the nurse already gave to the client in certain period
of time. In evaluation we can see either the goals already achieved or not.
When the goals are not achieved yet, so the nurse should provide other
plan and implementation that suits the best

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CHAPTER IV

FINALE

4.1 Conclusion

When individual becomes a parent, it does not make oneself

competent even expert to apply the newborn and infant care tasks.
Pediatric nurse takes a role to understand the needs and be able to teach
and demonstrate the interventions to the parents. Parents should be aware
about the personal care for the baby such as sleep, personal hygiene,
baby’s nutritions, and so on. in Javanese culture, of course there are many
myths that are still believed in caring for newborns. Parents need to
understand things that are good for their baby's safety and health because
every culture will treat the baby in a different way according to their
views. So, the parents should be ready for enhanced their knowledge too
about myths and how to prevent it to happen (i.e kinds of rituals).

4.2 Suggestion

In preparing for the birth of a baby, it is strongly recommended

that parents prepare what things will be given to the baby. For examples,
habits in their environment or cultural background, contrary to the safety
and health of the baby or not, and also increase knowledge about myths
that may still be attached and they still believe.

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BIBLIOGRAPHY

Bowden V. R., & Greenberg, C. S. (2010). Children and their families: The
continuum of care, 2nd ed. China: Wolters Kluwer Health.

Hockenberry, M. J., & Wilson, D. (2015). Wong’s nursing care of infants and
children, 10th ed. Missouri: Mosby.

Kinanti, A. A. (2013, Mei 8). Pusar Bayi Ditindih Koin Agar Tidak Bodong,
Mitos atau Fakta? Retrieved from DetikHealth:
https://health.detik.com/ulasan-khas/d-2241225/pusar-bayi-ditindih-koin-
agar-tidak-bodong-mitos-atau-fakta

Kurnia, R. D. (2016, Agustus 16). 13 Mitos Soal Ibu Hamil dan Bayi yang Cuma
Dipercaya Orang Indonesia. Retrieved from IDN Times:
https://www.idntimes.com/life/family/riza-dian-kurnia/mitos-soal-ibu-
hamil-dan-bayi-yang-dipercaya-orang-indonesia

Swasono, M. A. (2019, April 19). Adat dan Budaya Selamatan Kelahiran.

Retrieved from Academia.edu:
https://www.academia.edu/36485712/adat_dan_budaya_kelahiran_Bayi

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