TIM SPECIFIC CONTENT AV TEACHER EVALUATIO

E OBJECTIVE AID STUDENT N

S S ACTIVIT
Y
TRANSCULTURAL NURSING
INTRODUCTION

 The founder of the theory of Transcultural Nursing / Culture Care Theory

 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)

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

 One of the first nursing theorists 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.

IMPORTANCE OF TRANSCULTURAL NURSING

1) There is a marked increase in the migration of

people within and between countries world wide.
2) There has been a rise in multicultural identifies, with people expecting their cultural belief, values, and
lifeways to be understood and respected by nurses and other health care providers.
3) The increased use of health care technology sometimes conflicts with cultural values of clients.
4) World wide there are cultural conflicts, clashes, and violence that have an impact health care as more
cultures interact with one another.
5) There was an increase in legal suits resulting from cultural conflict, negligence, ignorance, and
imposition of health care practices.
 6) There is an increase in the number of people travelling and working in many different parts of the
world.
7) There has been a rise in feminism and gender issues, with new demands on health care systems to meet
the needs of woman and children
8) There has been an increased demand for community and culture based health care services in diverse
environmental contexts.

TRANSCULTURAL NURSING THEORY

MIDDLE RANGE NURSING THEORY

THEORETICAL SOURCES

 Derived from the discipline of anthropology; conceptualized the theory to be relevant to nursing.

USE OF EMPIRICAL EVIDENCE

 Leininger favors ethnomethods as the desired and meaningful approach to study care because these
methods are directed toward discovering the people’s“truth” views, beliefs, and patterned lifeways.

MAJOR CONCEPTS AND DEFINITIONS

TRANSCULTURAL NURSING - is acomparative 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.

- also beliefs, habits, likes, dislikes, customs and

rituals learn from one’s family.

- 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.

CULTURAL IDENTITY - 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-SPECIFICS - values, beliefs, and patterns of behavior

that tend to be unique to a designate culture.

MATERIAL CULTURE - refers to objects (dress, art, religious artifacts)

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 as it 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 - 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 - 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 ASSUMPTIONS

 Illness and wellness are shaped by 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 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

 Use of Substances
 Religious Practices
 Traditional Remedies
 Healers
 Immigration
 Gender Roles
 Beliefs about mental health
 Economic Factors
 Time Orientation
 Personal Space
GOAL OF TRANSCULTURAL NURSING
“to give culturally congruent nursing care, and to provide culture specific and universal nursing care practices
for the health and well- being of people or to aid them in facing adverse human conditions, illness or death in
culturally meaningful ways.”

THE SUNRISE MODEL

• Symbolizes the “rising of the sun (care)”

• The upper half of the circle depicts components of the social structure and world view factors that
influence care and health through language and environment. These factors influence the folk,
professional, and nursing system(s), which are in the lower half of the model.
• The two halves together form a full sun, which represents the universe that nurses must consider to
appreciate human care and health.
• The nursing subsystem can act as a bridge between the folk and personal health systems through the
three types of nursing care actions: cultural care preservation, cultural care accommodation, and cultural
repatterning.
ACCEPTANCE BY THE NURSING COMMUNITY

PRACTICE
 Accepted in the nursing practice;
 Communities are becoming more multicultural, and
health personnel are being expected to respond to client’s diverse cultural needs. Immigrants and people from
unfamiliar cultures are generally expecting nurses to respect their cultural values, beliefs, and lifeways.

EDUCATION
 Since 1980, An increasing number of nursing curricula emphasize transcultural
nursing and care.

RESEARCH
  Several research nurses are testing transcultural nursing in US and other
countries. Many cultures have been studied
utilizing this theory.

CRITIQUE
 Simplicity – not simple; truly transcultural, global in scope, and highly complex; holistic and
comprehensive
 Generality – general; qualitatively-oriented theory that is broad, comprehensive, and worldwide in
scope; useful and applicable to groups and individuals with the goal of rendering culture- specific
nursing care.
 Empirical Precision – researchable; qualitative research has been the primary paradigm to discover
largely unknown phenomena of care and health in diverse cultures
 Derivable Consequences – has important outcomes for nursing; culture-specific care is necessary and
essential new goal in nursing; useful and applicable to nursing practice, education, and research

 This model was developed in 1988 in response to the need for nursing students in an undergraduate
program to assess and provide care for patients that were culturally diverse.
 Giger and Davidhizar have identified six cultural phenomena that vary among cultural groups and affect
health care.

1. COMMUNICATION
  Communication is the means by which culture is transmitted and preserved. Both verbal and nonverbal
communications are learned in one’s culture.
 Verbal and nonverbal patterns of communication vary across cultures, and if nurses do not understand
the client’s cultural rules in communication, the client’s acceptance of a treatment regimen may be
jeopardized.
 Accurate diagnosis and treatment is impossible if the health-care professional cannot understand the
patient.
 Culture not only determines the appropriateness of the message but also influences all the components
of communication.
 Thus, an assessment of communication should
consider:
1) dialect,
2) style,
3) volume, including silence,
4) touch,
5) context of speech or emotional tone, and
6) kinesics, including gestures, stances, and
eye behaviour

2. SPACE
 Space refers to the distance between individuals when they interact. All communication occurs in the
context of space.
 There are four distinct zones of interpersonal
space: 1)inmate zone (extends up to 1 ½ feet),
 2)personal distance (extends from 1 ½ to 4 feet),
 3)social distance (extends from 4 to 12 feet) and
 4)public distance (extends 12 feet or more)

3) SOCIAL ORGANIZATION:
Social organization refers to the social group organizations with which clients and families may identify.

4) TIME ORIENTATION
Time is an important aspect of interpersonal communication. Some cultures are considered future oriented,
others present oriented, and still others past oriented
 These differences in time orientation may become important in health-care measures such as long- term
planning and explanations of medication schedules.
eg:Latin Americans, Native Americans, and Middle Easterners are present oriented cultures and may neglect
preventive health care measures. They may show-up late or not at all for appointments

5. ENVIRONMENTAL CONTROL
Environmental control refers to the ability of the person to control nature and to plan and direct factors in the
environment.
Some groups perceive man as having mastery over nature; others perceive humans to be dominated by nature,
while others see harmonious relationships between humans and nature
For example, Asians and Native Americans may perceive that illness is a disharmony with other forces and that
medicine is only capable of relieving the symptoms rather than curing the disease. These groups are likely to
look for naturalistic solutions, such as herbs and hot and cold treatments to resolve or cure a cancerous condition

6. BIOLOGICAL VARIATIONS
Biological variations are:
(1) body structure,
(2) skin colour,
(3) other visible physical characteristics,
(4) enzymatic and genetic variations,
(5) electrocardiographic patterns,
(6) susceptibility to disease,
(7) nutritional preferences and deficiencies, and
(8) psychological characteristics

1) Theoritical foundations of Transcultural Nursing.

2) Cultural information gathering.
3) Caring and healing systems.
4) Cultural health patterns and caring patterns.
5) Health care planning.
6) Evaluation.
7) Research.
8) Professional development.

REFERENCES
 www.currenrnursing.com
 Tomey, A.M., (1994). Nursing Theorists and Their Work. 3rd ed. Missouri: Mosby
LESSON PLAN ON

TRANSCULTURAL
NURSING