Cultural Care of Pregnancy and Home Birth: An Application of the Sunrise Model

Model of Maternal Behavior in Pregnancy-Based Care Transcultural Care Theory (Sunrise Model) and Precede-Based

INTRODUCTION: Maternal mortality is still a problem in Indonesia. The current maternal mortality rate is 305 per 100.000 live births and is still far from the SDGs target, which is 70 per 100.000 live births in 2030. The direct causes of maternal death are related to maternal health conditions since pregnancy, while the indirect causes are related to social, economic conditions, behavior, community culture, and lifestyle. The purpose of this study was to develop a behavioral model based on transcultural care (sunrise model) and precede in caring for pregnant women. MATERIALS AND METHODS: It is an observational study, cross-sectional approach. The study was conducted from March to October 2021. The population in this study were all pregnant women who visited with a sample of several pregnant women in the working area of the Public Health Center of the Surabaya Health Service, Indonesia. The sample was determined using the rule of thumb formula, the sample size was 288 respondents and was selected by simple random sampling. The independent variables are Transcultural Care (technological factors, religion and philosophy of life, social and family attachments, cultural values and lifestyle, regulations and policies, economy, and education) and Precede (predisposing factors, supporting factors, and reinforcing factors). Inferential analysis was performed using the Partial Least Square (PLS) method. Path analysis model was performed on all latent variables, external model and internal model. RESULTS: Showed that the regularity of antenatal care was influenced by the factors of technology, religion and philosophy of life, social and family attachments, regulations and policies, education and the reinforcing factors. The accuracy of taking medication or vitamins in pregnant women was influenced by social and family attachments, cultural values and lifestyles, regulations and policies, economics, and the predisposing factors, enabling factors and reinfording factors. Diet in pregnant women was influenced by the factors of technology, social and family attachments, regulations and policies, predisposing factors, enabling factors and reinforcing factors. Monitoring of fetal movement in pregnant women was influenced by technological factors, predisposing factors and enabling factors. Activity patterns in pregnant women were influenced by the factors of religion and philosophy of life, cultural values and lifestyles, regulations and policies, education, enabling factors and reinforcing factors. Conclusion: Based on the results of this study, it can be concluded that the Transcultur Care and Preced Methods are proven to be effective in improving maternal health behavior in caring for pregnancy.

Tecnologia para consulta de enfermagem às mulheres transexuais à luz da teoria transcultural de Leininger

RESUMO Objetivo: Descrever a construção e validação de tecnologia para consulta de enfermagem às mulheres transexuais. Métodos: Estudo metodológico desenvolvido em três etapas com construção pautada na Teoria Transcultural de Leininger, validação de conteúdo realizada por especialistas em saúde sexual de transgêneros e avaliação por enfermeiros da assistência às mulheres transexuais. Consideraram-se validados os itens com concordância mínima de 80%, conforme o Índice de Validade de Conteúdo e teste binomial. Resultados: A tecnologia contém 59 itens em três blocos: o primeiro, para Identificação da mulher transexual; o segundo, com os Dados Clínicos; e o terceiro, referente à Propedêutica da Assistência. Todos os itens alcançaram concordância superior a 0,8 e Índice de Validade global de 80%. Conclusões: A tecnologia foi validada quanto ao conteúdo e avaliada pelos enfermeiros e pode ser aplicável tanto na prática clínica e ambulatorial quanto na academia a fim de promover a qualidade assistencial às mulheres transexuais.

Technology for nursing consultation with transsexual women in the light of Leininger’s transcultural theory

ABSTRACT Objective: to describe the construction and validation of a nursing consultation technology for transgender women. Methods: a methodological study developed in three stages with construction based on the Leininger’s Cross-Cultural Theory, content validation performed by experts in transgender sexual health and evaluation by nurses of care for transgender women. Items with a minimum agreement of 80% were considered validated, according to the Content Validity Index and binomial test. Results: the technology contains 59 items in three blocks: the first, for identification of the transsexual woman; the second, with the Clinical Data; and the third, regarding the Propaedeutics of Care. All items reached agreement higher than 0.8 and an overall Validity Index of 80%. Conclusions: the technology was content-validated and evaluated by nurses and can be applicable in clinical and outpatient practice as well as in academia to promote quality care for transgender women.