NCM 120 LEC – Week 2 (PRELIM)
Orientation
THE IMPORTANCE OF TRANSCULTURAL
NURSING
Leininger (1995) cites eight factors that
influenced her to establish transcultural
nursing:
1. There was a marked increase in the migration
of people within and between countries
worldwide.
2. There has been a rise in multicultural
identities, with people expecting their cultural
beliefs, 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, such as Amish prohibitions against using
certain apnea monitors, IV pumps, and other
such health care technologic device in the
home.
4. Worldwide, there are cultural conflicts,
clashes, and violence that have an impact to
health care as more cultures interact with one
another.
5. There was an increase in the number of
people travelling and working in many different
parts of the world.
6. There was an increase in legal suits resulting
from cultural conflict, negligence, ignorance,
and imposition of health care practices.
7. There has been a rise in feminism and gender
issues, with new demands on health care
systems to meet the needs of women and
children.
8. There has been an increases demand for
community and culturally based health care
services in diverse environmental contexts.
HISTORICAL PERSPECTIVES
 In 1950’s Dr. Madeleine Leininger noted
cultural differences between patients
and nurses while working with
emotionally disturbed children.
 This experience led her in 1954 to study
cultural differences in the perceptions
of care, and in 1965 she earned a
doctorate in cultural anthropology from
the University of Washington.
 Nursing is a HUMANISTIC and
SCIENTIFIC mode of helping through
CULTURESPECIFIC PROCESS
 Emphasizes human caring varies among
cultures
 Culture Care Preservation and
Maintenance
 Culture Care Accommodation
and Negotiation
 Culture Care Restructuring and
Repatterning
According to American Nursing Association:
TRANSCULTURAL NURSING is consideration of
individual value system and lifestyle should be
included in the planning and health care for
each client. Nursing curriculum recognize the
contribution of nursing to the health care needs
of a diverse and multicultural society life style
may reflect culture heritage.
Definition of Transcultural Nursing
A substantive area of study and practice
focused on comparative cultural care (caring)
values, beliefs, and practices of individuals or
groups of similar or different cultures with the
goal of providing culture-specific and universal
nursing care practices in promoting health or
well-being or to help people to face unfavorable
human conditions, illness, or death in culturally
meaningful ways.
PURPOSES OF TRANSCULTURAL NURSING
  To make growing awareness patterned way”. By: Leininger (1985a,
acceptance of diversity and willingness 1985b, 1991 and Leininger & McFarland
to maintain and support ethnic and (2006)
cultural heritage.
“CULTURAL VALUES are unique expressions of a
 To give competent and sensitive health
particular culture that have been accepted as
care.
appropriate over time. They guide actions and
 To provide holistic and comprehensive
decision making that facilitate self-worth and
approach in client care.
self-esteem. By: Leininger (1985a, 1991)
Transcultural Nursing – Ma’am VAB
Cultural Self-Assessment
“A humanistic and scientific area of formal
 Before you can provide culturally
study and practice nursing which focuses on
competent care for people from diverse
differences and similarities amongst cultures
backgrounds, it’s important to engage
with respect to human care health, and illness
in a cultural self-assessment.
based upon their cultural perspectives. Then to
 When interacting with clients from
use this knowledge to provide culturally
various cultural backgrounds, you must
sensitive nursing care.” (Leininger, 2008).
be aware of your own cultural values,
Culture Defined attitudes, beliefs, and practices.
 Through self-assessment, it is possible
 CULTURE is a patterned behavioral
to gain insights into the health-related
response that develops over time as a
values, attitudes, beliefs, and practices
result of imprinting the mind through
that have been transmitted to you by
social and religious structures and
your own family.
intellectual and artistic manifestations.
 After you have engaged in a cultural
 CULTURE is also a result of acquired
self-assessment, it is possible to
mechanisms that may have innate
conduct a cultural assessment of
influences but are primarily affected by
others.
internal and external environmental
 (Activity 2: Self-Assessment)
stimuli.
 CULTURE is shaped by values, beliefs, Cultural Assessment
norms, and practices that are shared by
members of the same cultural group.  In a pluralistic society, nurse
practitioners need to be prepared to
 CULTURE is shaped by values, beliefs,
provide culturally appropriate nursing
norms, and practices that are shared by
care for each client, regardless of that
members of the same cultural group.
client’s cultural background. To provide
 CULTURE guides our thinking, doing,
culturally appropriate nursing care,
and being and becomes patterned
nurses must understand specific factors
expressions of who we are. These
that influence individual health and
patterned expressions are passed down
illness behaviors”. By: Tripp-Reimer,
from one generation to the next.
Brink, & Saunders, 1984)
 “CULTURE is the values, beliefs, norms,
and practices of a particular group that “The goal of TCN practice is to promote health
are learned and shared and that guide and well-being of individuals and populations by
thinking, decisions, and actions in a reducing health and care disparities through
culturally congruent and competent approaches
at the multilevel context of care” (Douglas,
2010, p.55)
Transcultural Nursing
 “The ultimate goal of Transcultural
Nursing is use of relevant knowledge to
provide culturally specific and culturally
congruent nursing care to people”. By:
Leininger (1985a, 1985b; Leininger &
Application of Theory to Nursing
McFarland, 2006)
Principles of TCN:
1. Cultures have diverse living, caring, and
healing modes that nurses must
understand to work effectively with
people.
2. Care is a basic human need.
3. Understanding one’s own culture is the
first essential expectation to
understand other cultures.
4. People have right to have their cultural
values known, respected, understood,
and used in nursing and health care
services.
Models Used for Cultural Competency Care
 Substantive theory-based research
knowledge was greatly needed with
global and comparative focus to care
people of diverse cultures.
 The philosophical roots of the theory
derive from extensive and diverse
nursing experiences, insightful
anthropology, life experiences, values
and creative thinking.
 To be culturally competent nurses, we
must be openminded to the diversity
among the patient we serve.
 This in fact will provide a global focus of
care to people of diverse cultures.
 On a daily basis nurses care for
individuals from a wide variety of
cultures. The Leininger theory engages
us to respect and care for patients as
individuals.
 As nurses utilizing this theory, there is a
greater awareness of the complex
issues that surround the delivery of
health care from our patient’s
viewpoint.

 Nursing Theories have developed

Models to support culturally
competence care
 Leininger’s Cultural Care Model
(Leininger, 1999)
 Purnell Cultural Competency
Model (Purnell & Paulanka,
2003)
 Jezewski’s Culture-Brokering
Model (Jezewski,1993)

Origin of Selected Theory

Leininger’s Theory
 Theory was initiated from clinical
experiences recognizing that culture, a  The Sunrise Enabler
holistic concept, was the missing link in  The theory includes an enabler.
nursing knowledge and practice. It serves as a conceptual guide
or cognitive map to guide
 nurses in the systematic study
of all dimensions of the theory.
 This map or guide is called the
Sunrise Enabler. (Leininger,
2006)
 Leininger’s Sunrise Model
 From this theoretical
perspective, Leininger provides
a comprehensive transcultural
theory and assessment model.
 For more than 30 years, this
model has helped nurses
discover and understand what
health acre means to various
cultures.
Top 10 Reasons to Use Leininger’s Sunrise
Model
1. You will provide culturally congruent
care that fits reasonably with client’s
needs and realities.
2. You can establish a Transcultural
Nursing Society chapter in town near
you.
3. The theory will expand nurses’ thinking
from a unicultural to multicultural,
holistic and comparative perspective.
4. You can attend conferences in faraway
exotic places
5. 5. You will have a systematic and
focuses way to develop new knowledge
and insights from examining the
worldwide, social structure factors,
environmental contexts, ethnohistory
and language usage different cultures.
6. You can become a clinical nurse
specialist (CNS) in transcultural nursing
in the culture of your choice.
7. You can use the Sunrise Model as a
cognitive map to tease out emic or etic
phenomena in different historical,
cultural, and environmental context.
8. You get to spend quality time with
fellow nurse theorist.
9. You can eliminate the phrases “nursing
intervention” and “patient problems”
from your vocabulary since these terms
may be viewed as a cultural imposition.
10. You can participate in and publish an
ethno-nursing qualitative research
study.
IMPORTANCE TO FUTURE NURSES
 A major question for nursing educators
worldwide is how best to prepare
nursing students and registered nurses
so that they are able to provide
culturally congruent care
Contemplate on the ff:
1. Own Culture
2. Personal Values, Prejudices & Biases
3. Difficulties in Communication
4. Norms & Tradition
5. Discrimination
Have you “ASKED” yourself?
 A-wareness: Am I aware of my personal
biases and prejudices towards cultural
groups different than mine?
 S-kills: Do I have the skill to conduct a
cultural assessment and perform a
culturally-based physical assessment in
a sensitive
 K-nowledge: Do I have the knowledge
of the patient’s world view.
 E-ncounters: How many face-to-face
encounters have I had with patients
from diverse cultural backgrounds?
 D-esire: What is my genuine desire to
“want to be” culturally compentent?