Graduation Date

Summer 8-15-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Nursing

First Advisor

Tiffany Moore

Abstract

Persistent racial and ethnic disparities in perinatal outcomes in the United States demand attention to the relational dynamics that shape cross-cultural care experiences. This dissertation examined patient-clinician interactions for Black birthing people in perinatal care, examined the concept of nurse cultural humility, and explored OB nurses’ experiences delivering cross-cultural care. This was first accomplished by conducting an integrative review of the literature that reported on patient-clinician interactions during the perinatal period for Black birthing people. Next, a concept analysis was completed on nurse cultural humility using descriptive statements from the literature. Finally, a hermeneutic phenomenological study was completed exploring the lived experience of OB nurses delivering care to diverse patient populations. Major findings of the integrative review reveal a patient-clinician relationship characterized by mistrust, ineffective communication, lack of established relationship, and unequal power dynamics. The concept analysis provided a conceptual definition of nurse cultural humility that included the attributes of a lifelong process of reflexivity, engaging in active listening to learn from patients, an understanding and appreciation that the cultural background of both nurse and patient influences health care encounters, and a commitment to redress and mitigate power imbalances in the patient-clinician relationship. Major findings of the hermeneutic phenomenological study revealed five interrelated patterns: (1) Relational Openness: Attending to the Other with Curiosity and Care; (2) Moving Beyond the Tasks: The Art of Nursing; (3) Navigating Ethical Crossroads: When Values Collide in Care; (4) Reframing Cultural Knowing: From Preconception to Patient Presence; and (5) Becoming Aware: The Clinician as a Work in Progress. This dissertation study further illuminates how cultural humility can be enacted in practice and developed through relational experience and reflection. Together, this work offers a foundation for reimagining perinatal nursing through the lens of cultural humility, with the goal of honoring the full humanity of every birthing person.

Comments

2025 Copyright, the authors

Available for download on Sunday, August 01, 2027

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