TRANSCULTURAL NURSING

INTRODUCTION

Madeleine Leininger is considered as the founder of the theory of transcultural nursing.

Her theory has now developed as a discipline in nursing.

Evolution of her theory can be understood from her books:

Culture Care Diversity and Universality (1991)

Transcultural Nursing (1995)

Transcultural Nursing (2002)

Transcultural nursing theory is also known as Culture Care theory.

Theoretical framework is depicted in her model called the Sunrise Model (1997).

ABOUT THE THEORIST

One of the first nursing theorist and transcultural global nursing consultant.

MSN - Catholic University in Washington DC.

PhD in anthropology - University of Washington.

She developed the concept of transcultural nursing and the ethnonursing research model.

For more details: http://en.wikipedia.org/wiki/Madeleine_Leininger

DEFINITIONS

TRANSCULTURAL NURSING
Transcultural nursing is a comparative study of cultures to understand similarities (culture universal) and
difference (culture-specific) across human groups (Leininger, 1991).

CULTURE

Set of values, beliefs and traditions, that are held by a specific group of people and handed down from
generation to generation.

Culture is also beliefs, habits, likes, dislikes, customs and rituals learn from one’s family.

Culture is the learned, shared and transmitted values, beliefs, norms and life way practices of a
particular group that guide thinking, decisions, and actions in patterned ways.

Culture is learned by each generation through both formal and informal life experiences.

Language is primary through means of transmitting culture.

The practices of particular culture often arise because of the group's social and physical environment.

Culture practice and beliefs are adapted over time but they mainly remain constant as long as they
satisfy needs.

RELIGION

Is a set of belief in a divine or super human power (or powers) to be obeyed and worshipped as the
creator and ruler of the universe.

ETHNIC

refers to a group of people who share a common and distinctive culture and who are members of a
specific group.

ETHNICITY

a consciousness of belonging to a group.

the sense of being part of an ethnic group or culture

CULTURE-UNIVERSALS

commonalities of values, norms of behavior, and life patterns that are similar among different cultures.

CULTURE-SPECIFIES

values, beliefs, and patterns of behavior that tend to be unique to a designate culture.

MATERIAL CULTURE

refers to objects (dress, art, religious arti1acts)

NON-MATERIAL CULTURE

refers to beliefs customs, languages, social institutions.

SUBCULTURE

composed of people who have a distinct identity but are related to a larger cultural group.

BICULTURAL

a person who crosses two cultures, lifestyles, and sets of values.

DIVERSITY

refers to the fact or state of being different. Diversity can occur between cultures and within a cultural
group.

ACCULTURATION

People of a minority group tend to assume the attitudes, values, beliefs, find practices of the dominant
society resulting in a blended cultural pattern.
CULTURAL SHOCK

the state of being disoriented or unable to respond to a different cultural environment because of its
sudden strangeness, unfamiliarity, and incompatibility to the stranger's perceptions and expectations at
is differentiated from others by symbolic markers (cultures, biology, territory, religion).

ETHNIC GROUPS

share a common social and cultural heritage that is passed on to successive generations.,

ETHNIC IDENTITY

refers to a subjective perspective of the person's heritage and to a sense of belonging to a group that is
distinguishable from other groups.

RACE

the classification of people according to shared biologic characteristics, genetic markers, or features. Not
all people of the same race have the same culture.

CULTURAL AWARENESS

It is an in-depth self-examination of one's own background, recognizing biases and prejudices and
assumptions about other people.

CULTURALLY CONGRUENT CARE

Care that fits the people's valued life patterns and set of meanings -which is generated from the people
themselves, rather than based on predetermined criteria.

CULTURALLY COMPETENT CARE

is the ability of the practitioner to bridge cultural gaps in caring, work with cultural differences and
enable clients and families to achieve meaningful and supportive caring.

NURSING DECISIONS

Leininger (1991) identified three nursing decision and action modes to achieve culturally congruent care.
Cultural preservation or maintenance.

Cultural care accommodation or negotiation.

Cultural care repatterning or restructuring.

MAJOR CONCEPTS [LEININGER (1991)]

Illness and wellness are shaped by a various factors including perception and coping skills, as well as the
social level of the patient.

Cultural competence is an important component of nursing.

Culture influences all spheres of human life. It defines health, illness, and the search for relief from
disease or distress.

Religious and Cultural knowledge is an important ingredient in health care.

The health concepts held by many cultural groups may result in people choosing not to seek modern
medical treatment procedures.

Health care provider need to be flexible in the design of programs, policies, and services to meet the
needs and concerns of the culturally diverse population, groups that are likely to be encountered.

Most cases of lay illness have multiple causalities and may require several different approaches to
diagnosis, treatment, and cure including folk and Western medical interventions..

The use of traditional or alternate models of health care delivery is widely varied and may come into
conflict with Western models of health care practice.
Culture guides behavior into acceptable ways for the people in a specific group as such culture
originates and develops within the social structure through inter personal interactions.

For a nurse to successfully provide care for a client of a different cultural or ethnic to background,
effective intercultural communication must take place.

APPLICATION TO NURSING

To develop understanding, respect and appreciation for the individuality and diversity of patients
beliefs, values, spirituality and culture regarding illness, its meaning, cause, treatment, and outcome.

To encourage in developing and maintaining a program of physical, emotional and spiritual self-care
introduce therapies such as ayurveda and pancha karma.

HEALTH PRACTICES IN DIFFERENT CULTURES

USE OF PROTECTIVE OBJECTS

Protective objects can be worn or carried or hung in the home- charms worn on a string or chain around
the neck, wrist, or waist to protect the wearer from the evil eye or evil spirits.

USE OF SUBSTANCES .

It is believed that certian food substances can be ingested to prevent illness.

E.g. eating raw garlic or onion to prevent illness or wear them on the body or hang them in the home.

RELIGIOUS PRACTICES

Burning of candles, rituals of redemption etc..

TRADITIONAL REMEDIES

The use of folk or traditional medicine is seen among people from all walks of life and cultural ethnic
back ground.

HEALERS
Within a given community, specific people are known to have the power to heal.

IMMIGRATION

Immigrant groups have their own cultural attitudes ranging beliefs and practices regarding these areas.

GENDER ROLES

In many cultures, the male is dominant figure and often they take decisions related to health practices
and treatment. In some other cultures females are dominant.

In some cultures, women are discriminated in providing proper treatment for illness.

BELIEFS ABOUT MENTAL HEALTH

Mental illnesses are caused by a lack of harmony of emotions or by evil spirits.

Problems in this life are most likely related to transgressions committed in a past life.

ECONOMIC FACTORS

Factors such as unemployment, underemployment, homelessness, lack of health insurance poverty

TIME ORIENTATION

It is varies for different cultures groups.

PERSONAL SPACE

Respect the client's personal space when performing nursing procedures.

The nurse should also welcome visiting members of the family and extended family.

NURSING PROCESS AND ROLE OF NURSE

Determine if any of his health beliefs relate to the cause of the illness or to the problem.

Collect information that any home remedies the person is taking to treat the symptoms.

Nurses should evaluate their attitudes toward ethnic nursing care.

Self-evaluation helps the nurse to become more comfortable when providing care to clients from
diverse backgrounds

Understand the influence of culture, race &ethnicity on the development of social emotional
relationship, child rearing practices & attitude toward health.

Collect information about the socioeconomic status of the family and its influence on their health
promotion and wellness

Identifiy the religious practices of the family and their influence on health promotion belief in families.

Understanding of the general characteristics of the major ethnic groups, but always individualize care.

The nursing diagnosis for clients should include potential problems in their interaction with the health
care system and problems involving the effects of culture.

The planning and implementation of nursing interventions should be adapted as much as possible to the
client's cultural background.

Evaluation should include the nurse's self-evaluation of attitudes and emotions toward providing nursing
care to clients from diverse sociocultural backgrounds.

Self-evaluation by the nurse is crucial as he or she increases skills for interaction. .

Nurses need to be aware of and sensitive to the cultural needs of clients.

The practice of nursing today demands that the nurse identify and meet the cultural needs of diverse
groups, understand the social and cultural reality of the client, family, and community, develop expertise
to implement culturally acceptable strategies to provide nursing care, and identify and use resources
acceptable to the client (Andrews & Boyle, 2002).

REFERENCES

Murphy SC. Mapping the literature of transcultural nursing.J Med Libr Assoc. 2006 Apr;94(2 Suppl):E143-
51.

Leninger M. Culture Care Theory: A Major Contribution to Advance Transcultural Nursing Knowledge
and PracticesJournal of Transcultural Nursing, Vol. 13 No. 3, July 2002 189-192.

Leininger M. Culture care diversity and universality: A theory of

nursing. New York: National League for Nursing Pres; 1991.

Leininger M.Transcultural nursing: Concepts, theories, research,

and practice. Columbus, OH: McGraw-Hill College Custom Series; 1995.

Andrews MM, Boyle JS.Transcultural concepts in nursing care. J Transcult Nurs. 2002 Jul;13(3):178-80.

George Julia B. Nursing theories: The base of professional nursing practice 5rd edition. Norwalk, CN:
Appleton and Lange; 2002.

Kozier B, Erb G, Barman A, Synder AJ. Fundamentals of nursing; concepts, process and practice, Edn 7th,
2001.

Leninger M, McFarland M. Transcultural Nursing: Concepts, Theory, Research, and Practice; Edn 3rd,
McGraw-Hill Professional; New York, 2002.
Potter PA, Perry AG. Basic Nursing, 6th edition. St. Louis, Mosby;2007.

This page was last updated on: 04/12/2020