REFERENCES

NURSING 201
BEHAVIORAL FOUNDATIONS IN
HEALTH AND ILLNESS
Prepared By: Gerald B. Toledana, RN
 OBJECTIVES
1. Describe concept of Transcultural Healthcare:
a. Explain key concepts
b. Know the components of cultural assessment
c. Identify the components of cultural assessment
d. Differentiate Emic View from Ethic View
2. Integrate concepts of Transcultural Healthcare throughout life span:
a. Cultural Belief Systems & Practices Related to Childbearing
b. Birth and cultures
c. Postpartum Rituals
3. Identify nursing frameworks & theories applicable to Transcultural
Healthcare:
a. Examine the culturally related issues across the lifespan.
b. Explore the role of family & cultural practices related to the developmental stages.
4. Point-out criticisms of Transcultural Healthcare
 HISTORY
The foundress, Dr. Madeleine M. Leininger has
established transcultural practice as a formal area of
academic study. In 1954, a clinical experience led Dr.
Leininger to study cultural differences in the perception of care
while working with emotionally disturbed children.
Since the 1950s up to 1970s, a substantial and
important body of transcultural theoretical research and
evidenced-based knowledge has been generated across the
globe.
 The Importance of Transcultural Healthcare
1. Marked increase in the immigration of people within and
between countries worldwide.
2. Rise in multicultural identities.
3. Increase use of healthcare technology.
4. Cultural conflicts.
5. Increase in the number of people travelling and working in
many different parts of the world.
6. Increase in legal suits resulting in cultural conflicts, negligence,
ignorance, and imposition of healthcare practices.
7. Rise in feminism and gender issues.
8. Increase demand in community and culturally based health care
services.
 COMPONENTS OF CULTURAL ASSESSMENT
Giger and Davidhizer (1991) proposed six cultural
phenomenon that the nurse must understand to provide
effective care for all patients.
1. Communication
2. Space and Distancing
3. Social Organizations
4. Time and Punctuality
5. Environmental Control
6. Biological Variation
Communication
1. Issue of informed consent and full disclosure
2. Maintaining eye contact
3. Greet the patient using his last name or complete name.
4. Proceed in an unhurried manner.
5. Speak in a low, moderate voice.
6. Use short simple sentences.
7. Avoid using contractions, such as “don’t”, “can’t”, “won’t”.
8. Pantomime words.
9. Discuss one topic at a time.
Space and Distancing
1. People from the United States, Canada and Great Britain
require the most personal space between themselves.
2. People from Latin America, Japan and the Middle East
need the least amount of space and feel comfortable
standing close to each other.
Social Organization
1. People from patterns of cultural behavior learned through
enculturation.
2. Consist of shared beliefs, assumptions, perceptions and
norms leading to specific patterns of behavior.
3. It is self-reinforcing.
Time and Punctuality
1. The United States’ culture for the time are extremely
important.
2. Hispanic people makes primary distinction between day
and night but not hours of the day.
3. Countries from India and China seem to be past oriented.
4. Filipino cultures finds scolding or acting annoyed when a
patient is late would undermine his confidence in the
healthcare system and might result in more missed
appointments or indifference to patient teaching.
“Being flexible in regard to schedules is the best way to
accommodate these differences.”
Environmental Control
1. Patient’s attitude toward his treatment and prognosis is
influenced by his environment. American Indians and
Asian Americans believes about chances & lucks and
control over events.
2. Hispanic and Appalachian patients tend to be more
fatalistic about nature, health and death feeling they can’t
control these things.
Biological Variations
1. Patients may metabolize drugs in different ways at a
different rates.
2. Antihypertensive drugs don’t work well for African
Americans as they do for white ones.
3. Values and beliefs on herbal supplements.
Cultural Belief Systems & Practices Related to
Childbearing
1. The United States spends more money than any other
country in maternal health because of the inclusion of
modern equipment and highly specialized group of
obstetricians, nurses, perinatologists and pediatricians.
2. Fertility Control and Culture (Abortion)
3. Cultural Beliefs Related to Activity During Pregnancy
COUNTRIES WHO PERMITS ABORTION
1. Poland 9. Kuwait
2. Algeria 10.Morocco
3. Bolivia 11.Pakistan
4. Botswana 12.Peru
5. Burundi 13.Saudi Arabia
6. Cameroon 14.Togo
7. Consta Rica 15.Zimbabwe
8. Ecuador
COUNTRIES WHO PERMITS ABORTION
1. Ethiopia 9. Ireland
2. Finland 10.South Korea
3. India 11.New Zealand
4. Rwanda
5. Taiwan
6. Zambia
7. Colombia
8. Argentina
COUNTRIES WHO PERMITS ABORTION
1. Ethiopia 9. Ireland
2. Finland 10.South Korea
3. India 11.New Zealand
4. Rwanda
5. Taiwan
6. Zambia
7. Colombia
8. Argentina
Cultural Beliefs Related to Activity During Pregnancy
1. Prescriptive Beliefs vs Restrictive Beliefs
2. Orthodox Jewish people avoids baby showers before the
infant’s official naming ceremony
3. Hispanics also believes that early baby showers will invite
bad luck.
4. Food taboos and cravings
Cultural Beliefs Related to Activity During Pregnancy
Birth and Culture
1. Traditional Home Birth-different cultures have different
approaches to childbirth
2. Support During Childbirth-spouses are encouraged to make
contributions during childbirth
3. Cultural Meaning Attached to Infant Gender-male s are being
preferred in the Philippines & United States
4. Postpartum Depression- Muslim cultures considered this as
spirit possesion with negative effect on the body
5. Hot/Cold Theory- Pregnancy is considered as “hot” state and
should avoid cold food & water
6. Postpartum Rituals- placental burials are practice in native
America
1. Leininger’s Sunrise Model
2. Narayanasamy’s ACCESS Model
3. Campinha-Bacote’s Cultural Competence Model
Summary of Knowledge
1. Human caring with a transcultural care is essential for health, healing, and
well-being of individuals, families, groups, and institutions.
2. Every culture has a specific beliefs, values & patterns that need to be
discovered, understood and used in the care of people.
3. It is a human right that cultures have their cultural care values, beliefs, &
practices respected and thoughtfully incorporated in the health services.
4. Culturally based care & health beliefs and health practices can change
overtime.
5. Transcultural healthcare necessitates co-participation of client and
healthcare provider for effective transcultural decisions & outcomes.
6. Observations, participation, and reflection are essential modalities to
discover and respond to clients of diverse cultures with their care and
needs and expectations.
7. Culture care therapy may be needed for people who have been deeply
hurt, insulted or dehumanized because of cultural ignorance and non-caring
modes of healthcare providers.
 Some Criticisms of Transcultural Nursing
1. Stereo-typed images may emerged and that particular attention
may be paid to certain individuals in the caring process.
2. Given the presence of 3,000 cultures around the world, it is
impossible for healthcare professionals to have knowledge of all
cultures.
3. Paying particular attention to the patient of a specific culture
and focusing on that side can cause limitations in to other
aspects of care.
4. Concerns about transcultural care in the field of health will only
lead to formation of specialization in transcultural healthcare
that could increase the responsibilities of nurses, which in turn
will put a additional burden on them.
Get in Touch
With Us
Send us a message or
visit us
City of Batac, Ilocos Norte,
Philippines
(63) 77-600-0459
op@mmsu.edu.ph

Follow us for updates

facebook.com/MMSUofficial
www.mmsu.edu.ph