Research Lessons Learned: Occupational Therapy with Culturally Diverse Mothers of Premature Infants

Abstract

French

Background. Evaluation studies of the effectiveness of home-based occupational therapy are scarce but are needed to justify the impact of occupational therapy intervention. When the intervention is for persons from diverse cultural backgrounds, additional research challenges arise.

Purpose. To share lessons learned in conducting home-based occupational therapy research with Canadian, and immigrant South Asian and Chinese mothers of premature infants in a large Canadian city.

Key issues. Lessons learned were to implement a culturally sensitive recruitment process, change the research design to include more interviews and focus groups, and be aware of the need for culturally appropriate instruments.

Implications. Researchers need to be sensitized to the Western cultural values upon which most research designs and instrumentation are constructed. Involvement of a culturally diverse research team, openness to feedback, adaptability, and critical reflection on what is important to the cultural groups are among the suggestions for researchers planning home-based occupational therapy research with culturally diverse populations.

Keywords

Culture Home health care Mother-infant relations Occupational therapy Research

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References

Atlas.ti (Version 5.2) [Computer software]. Berlin, Germany: Atlas.ti Bernstein

V. J.

Harris

E. J.

Long

C. W.

Iida

Hans

S. L.

(2005). Issues in the multi-cultural assessment of parent-child interaction: An exploratory study from the starting early starting smart collaboration. Journal of Applied Developmental Psychology, 26, 241–275. doi: 10.1016/j.appdev.2005.02.002

Black

M. M.

Dubowitz

Hutcheson

Berenson-Howard

Starr

R. H.

(1995). A randomized clinical trial of home intervention for children with failure to thrive. Pediatrics, 95, 807–814

Bregman

(1998). Developmental outcome in very low birthweight infants: Current status and future trends. Pediatric Clinics of North America, 45, 673–690. doi: 10.1016/S0031-3955(05)70035-3

Burns

K. A.

Chethik

Burns

W. J.

Clark

(1998). The early relationship of drug abusing mothers and their infants: An assessment at eight to twelve months of age. Journal of Clinical Psychology, 53, 279–287. doi: 10.1002/(SICI)1097-4679 (199704)53:3<279::AID-JCLP11>3.0.CO;2-F

Canadian Institute for Health Research. (2009). Too early too small: A profile of small babies across Canada. Ottawa, ON: Author

Chao

R. K.

(2000). The parenting of immigrant Chinese and European American mothers: Relations between parenting styles, socialization goals, and parental practices. Journal of Applied Developmental Psychology, 21, 233–248. doi: 10.1016/S0193-3973(99)00037-4

Chatoor

Getson

Menvielle

Brasseaux

O'Donnell

Rivera

Mrazek

D. A.

(1997). A feeding scale for research and clinical practice to assess mother-infant interactions in the first three years of life. Infant Mental Health Journal, 18, 76–91. doi: 10.1002/(SICI)1097-0355(199721)18:1<76::AID-IMHJ6>3.0.CO;2-Z

Canadian Institute for Health Research. Too early too small: A profile of small babies across Canada (Ottawa, Ont.: CIHI, 2009)

Clark

(1985). The Parent-Child Early Relational Assessment: Instrument and manual. Madison, WI: University of Wisconsin Medical School, Department of Psychiatry

10.

Clark

(1999). The Parent-Child Early Relational Assessment: A factorial validity study. Educational & Psychological Measurement, 59, 821–846. doi: 10.1177/00131649921970161

11.

Clark

Paulson

Conlin

(1993). Assessment of developmental status and parent-infant relationships: The therapeutic process of evaluation. In Zeanah

C. H.

(Ed.), Handbook of infant mental health (pp. 191–209). New York: Guilford Press

12.

Culley

(1996). A critique of multiculturalism in health care: The challenge for nurse education. Journal of Advanced Nursing, 23, 564–570. doi: 10.1111/j.1365-2648.1996.tb00020.x

13.

Darmstadt

G. L.

Saha

S. K.

(2002). Traditional practice of oil massage of neonates in Bangladesh. Journal of Health, Population and Nutrition, 20, 184–188

14.

Fitzgerald

H. E.

(2006). Cross cultural research during infancy: Methodological considerations. Infant Mental Health Journal, 27, 612–617. doi: 10.1002/imhj.20111

15.

Foss

(1996). A conceptual model for studying parenting behaviors in immigrant populations. Advances in Nursing Science, 19, 74–87

16.

Goldberg

DiVitto

(1995). Parenting children born preterm. In Bornstein

M. H.

(Ed.), Handbook of parenting, Vol. 1: Children and parenting (pp. 209–231). Mahwah, NJ: Lawrence Erlbaum Associates

17.

Grych

Clark

(1999). Maternal employment and development of the father-infant relationship in the first year. Development Psychology, 35, 893–903

18.

Hamilton

B. E.

Martin

J. A.

Sutton

P. D.

(2004). Births: Preliminary data for 2003. National Vital Statistics Report, 53(9), 1–17

19.

Hughes

M. B.

Shults

McGrath

Medoff-Cooper

(2002). Temperament characteristics of premature infants in the first year of life. Journal of Developmental and Behavioral Pediatrics, 23, 430–435

20.

Jeng

S. F.

Yau

K. I. T.

Chen

L. C.

Hsiao

S. F.

(2000). Alberta Infant Motor Scale: Reliability and validity when used on pre-term infants in Taiwan. Physical Therapy, 80, 168–178. doi: 10.1080/01942630802224892

21.

Johnson

M. A.

(2007). The social ecology of acculturation: Implications for child welfare services to children of immigrants. Children and Youth Services Review, 29, 1436–1438. doi: 10.1016/j.childyouth.2007.06.002

22.

Kim

S. Y.

Wong

V. Y.

(2002). Assessing Asian and Asian American parenting: A review of the literature. In Kurasaki

K. S.

Okazaki

Sue

(Eds.), Asian American mental health: Assessment theories and methods (pp. 185–201). New York: Kluwer

23.

Kim-Godwin

Y. S.

Clarke

P. N.

Barton

(2001). A model for the delivery of culturally competent community care. Journal of Advance Nursing, 5, 918–925. doi: 10.1046/j.1365-2648.2001.01929.x

24.

Kivijärvi

Voeten

M. J. M.

Niemelä

Räihä

Lertola

Piha

(2001). Maternal sensitivity behavior and infant behavior in early interaction. Infant Mental Health Journal, 22, 627–640. doi: 10.1002/imhj.1023

25.

Levine

(1984). The cultural aspects of home care delivery. American Journal of Occupational Therapy, 38, 734–738

26.

Maiter

George

(2003). Understanding context and culture in the parenting approaches of immigrant South Asian Mothers. Affilia, 18, 411–428. doi: 10.1177/0886109903257589

27.

Marin

B. V.

(1991). Research with Hispanic populations. Newbury Park: Sage Publications

28.

Maynard

A. E.

(2008). What we thought we knew and how we came to know it: Four decades of cross-cultural research from a Piagetian point of view. Human Development, 51, 56–65. doi: 10.1159/000113156

29.

Piper

M. C.

Darrah

(1994). Motor assessment of the developing infant. Philadelphia, PA: WB Saunders Company

30.

Reid

Chiu

Sinclair

Wehrmann

(2007a, July). Quality of mother-infant interaction on the context of home-based occupational therapy. Paper presented at the meeting of Canadian Association of Occupational Therapists, St. John's, NL

31.

Reid

Chiu

Sinclair

Wehrmann

(2007b). Home-based occupational therapy for infants: Impact on infant development and caregiver-infant interaction. Final Report Submitted to Hospital for Sick Children Foundation HSCF Research Grant No. HC 05-311R

32.

Research and Evaluation Branch, Citizenship and Immigration Canada. (2009). Facts and figures: Immigrant overview- Permanent and temporary residents. Retrieved from http://www.cic.gc.ca/english/pdf/research-stats/facts2009.pdf

33.

Romeo

(2007). Caring for culturally diverse patients: One agency's journey towards cultural competence. Home Healthcare Nurse, 25, 206–213. doi: 10.1097/01.NHH.0000263439.97759.cb

34.

Skaff

M. M.

Chesla

C. A.

de los Santos Mycue

Fisher

(2002). Lessons in cultural competence: Adapting research methodology for Latino participants, Journal of Community Psychology, 30, 305–323. doi: 10.1002/jcop.10007

35.

Statistics Canada. (2003). Table 102-4005: Low birth weight (less than 2,500 grams) and borderline viable birth weight-adjusted low birth weight (500 to less than 2,500 grams), by sex, Canada, provinces and territories, annual. Retrieved from http://cansim2.statcan.gc.ca/cgi-win/cnsmcgi.exe?Lang=E&RootDir=CII/&ResultTemplate=CII/CII__&Array_Pick=1&ArrayId=1024005

36.

Statistics Canada. (2010). Projections of the diversity of the Canadian population: 2006 to 2031 (Catalogue No. 91-551-X). Retrieved from http://www.statcan.gc.ca/pub/91-551-x/91-551-x2010001-eng.pdf

37.

Stevenson

M. B.

Roach

M. A.

ver Hoeve

J. N.

Leavitt

L. A.

(1990). Rhythms in the dialogue of infant feeding: Preterm and term infants. Infant Behavior and Development, 13, 51–70. doi: 10.1016/0163-6383(90)90005-S

38.

Tajima

E. A.

Harachi

T. W.

(2010). Parenting beliefs and physical discipline practices among Southeast Asian immigrants: Parenting in the context of cultural adaption to the United States. Journal of Cross-Cultural Psychology, 41, 212–235. doi: 10.1177/0022022109354469

39.

Thomé

Dykes

A. K.

Hallberg

I. R.

(2003). Home care with regard to definition, care recipients, content and outcome: Systematic literature review. Journal of Clinical Nursing, 12, 860–872. doi: 10.1046/j.1365-2702.2003.00803.x

40.

World Health Organization. (2005). Report on the regional consultation towards the development of a strategy for optimizing fetal growth and development. Retrieved from http://www.who.int/nutrition/publications/FinalReportRegCons.pdf