TRANSCULTURAL

FRAMEWORK

Redelita G.Haboc RM,RN,MAN

INTRODUCTION
 “
"That the culture care needs of people
in the world will be met by nurses
prepared in transcultural nursing."

M. Leininger, Ph.D.

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TRANSCULTURAL NURSING
● Humanistic and scientific area of formal study and
practice which is focused upon differences and
similarities among cultures with respect to human
care, health or well-being, and illness based upon the
people’s cultural values, beliefs and practices.”

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Ultimate goal of Transcultural Nursing
● “to use relevant knowledge to provide culturally
specific and culturally congruent nursing care to
people.”

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CULTURE
● Patterned behavioral response that develops over
time as a result of imprinting the mind through
social and religious structures and intellectual and
artistic manifestations.
● Culture is shaped by values, beliefs, norms, and
practices that are shared by members of the same
cultural group.

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CULTURE
● common lifestyles ● languages
● knowledge ● symbols,
● Beliefs ● ritual and ceremonies
● behavior patterns, ● practices that are
● attitudes, values, unique to a particular
● habits, customs, group of people.

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CHARACTERISTICS OF CULTURE
CULTURE is:
1. learned and taught
2. shared
3. social in nature
4. dynamic, adaptive, and ever-changing

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COMPREHENSIVE APPROACH TO
HEALTH CARE
● Culturally sensitive
● Culturally appropriate
● Culturally competent.

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CULTURALLY
SENSITIVE

https://study.com/academy/
lesson/what-is-cultural-
sensitivity-definition-examples-
importance.html

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 Culturally appropriate
● Nurse applies the underlying background knowledge
that must be possessed to provide a given client with
the best possible health care.

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 Cultural Competence
● “Developing an awareness of one’s own existence, sensations,
thoughts, and environment without letting it have an undue
influence on those from other backgrounds; demonstrating
knowledge and understanding of the client’s culture; accepting
and respecting cultural differences; adapting care to be congruent
with the client’s culture,” according to Larry Purnell in his book
Transcultural Health Care: A Culturally Competent Approach
(1998).

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 Culturally competent
● Implies that within the delivered care the nurse
understands and attends to the total context of the
client’s situation and uses a complex combination of
knowledge, attitudes, and skills.

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ELEMENTS OF CULTURAL
COMPETENCE
1. Cultural awareness - a cognitive process in which the
nurse becomes aware of and sensitive to the clients
cultural values, beliefs, and practices.

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ELEMENTS OF CULTURAL
COMPETENCE
2. Cultural knowledge – The nurse seeks a sound
educational base about different cultures.
3. Cultural skill –cultural assessment
4. Cultural encounters – The nurse interacts with clients
from diverse cultural backgrounds.
5. Cultural desire –motivation to become culturally
competent.

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CULTURAL CONCEPTS AND ESSENTIAL
TERMINOLOGY
 Subculture – smaller groups within a culture
 Bicultural - a person who crosses two cultural,
lifestyles, and sets of values.

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CULTURAL CONCEPTS AND ESSENTIAL
TERMINOLOGY
 Acculturation -adapt to or borrow traits from another
culture.

 Assimilation - process by which an individual

develops a new cultural identity.

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FORMS OF ASSIMILATION
1.Cultural- ex. Ability to speak American English
2.Marital – intermarriage with members of another group.
3.Primary structural-– the relationships between people are
warm, personal interactions between group members in the home,
the church, and social groups
4.Secondary structural –nondiscriminatory sharing, often of a
cold interpersonal nature between different groups in settings such
as school and workplaces

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 MAJOR ASSUMPTIONS TO SUPPORT
LEININGER’S CULTURE CARE
DIVERSITY AND UNIVERSALITY THEORY
.

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 MAJOR ASSUMPTIONS TO SUPPORT LEININGER’S CULTURE CARE
DIVERSITY AND UNIVERSALITY THEORY

● 1. Care is the essence of nursing and is a distinct

dominant, central, and unifying focus.
● 2. Care (caring) is essential for well-being, health,
healing, growth, survival, and face handicaps or
death

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 MAJOR ASSUMPTIONS TO SUPPORT LEININGER’S CULTURE CARE
DIVERSITY AND UNIVERSALITY THEORY

● 3. Culture care is the broadest holistic means to know,

explain, interpret, and predict nursing care phenomena
to guide nursing care practices.
● 4. Nursing is a transcultural humanistic and scientific
care discipline and profession with the central purpose
to serve human beings worldwide.
● 5. Care (caring) is essential to curing and healing, or
there can be no curing without caring.

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 MAJOR ASSUMPTIONS TO SUPPORT LEININGER’S CULTURE CARE
DIVERSITY AND UNIVERSALITY THEORY

● 6. Culture care concepts, meanings, expressions, patterns,

processes, and structural forms of care are different and
similar among all cultures of the world.
● 7. Every human culture has lay care knowledge and
practices and usually some professional care knowledge
and practices which vary transculturally.

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 MAJOR ASSUMPTIONS TO SUPPORT LEININGER’S CULTURE CARE
DIVERSITY AND UNIVERSALITY THEORY

● 8. Culture care values, beliefs, and practices are influenced in the

context of a particular culture. They tend to be embedded in such
things as worldview, language, spirituality, kinship, politics and
economics, education, technology, and environment.
● 9. Beneficial, healthy, and satisfying culturally-based nursing care
contributes to the well-being of individuals, families, and
communities within their environmental context.

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 MAJOR ASSUMPTIONS TO SUPPORT LEININGER’S CULTURE CARE
DIVERSITY AND UNIVERSALITY THEORY

● 10. Culturally congruent nursing care can only happen

when the patient, family, or community values, expressions,
or patterns are known and used appropriately, and in
meaningful ways by the nurse with the people.
● 11. Culture care differences and similarities between the
nurse and patient exist in any human culture worldwide.

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 MAJOR ASSUMPTIONS TO SUPPORT LEININGER’S CULTURE CARE
DIVERSITY AND UNIVERSALITY THEORY

● 12. Clients who experience nursing care that fails to be

reasonably congruent with their beliefs, values, and caring
lifeways will show signs of cultural conflicts,
noncompliance, stresses and ethical or moral concerns.
● 13. The qualitative paradigm provides new ways of knowing
and different ways to discover the epistemic and ontological
dimensions of human care.

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 History of Transcultural Nursing
● 1950’s, Dr. Madeleine M. Leininger noted cultural differences between patients
and nurses when working with emotionally disturbed children.
● in 1954, and in 1965 she earned a doctorate in cultural anthropology from the
University of Washington.
● Leininger recognizes that anthropology’s most important contribution to
nursing was the realization that health and illness are strongly influenced by
culture.
● In 1991, Leininger already a well-known nurse anthropologist, published
her book Cultural Care Diversity and Universality: A Theory of Nursing.
● Leininger produced the Sunrise model to depict her theory of culture care
diversity and universality.
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FACTORS INFLUENCING
TRANSCULTURAL NURSING
1.The marked increase in immigration and the
migration of people within and between countries
worldwide.
2. An implicit societal moral and professional
expectation that nurses and other health care providers
need to know, understand, respect, and respond
appropriately to care for people
of diverse cultures.
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FACTORS AND RATIONALE INFLUENCING
TRANSCULTURAL NURSING
3. The rapid increase in the use of high technologies in caring or
curing with different responses and effects on clients of diverse
cultures.
4. Increased signs of cultural conflicts, cultural clashes, and
cultural imposition practices between nurses and clients of
diverse cultures.

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FACTORS AND RATIONALE INFLUENCING
TRANSCULTURAL NURSING
5. The marked increase in the number of nurses who
travel and work in different places in the world.
6. Anticipated legal defense suits
against nurses resulting from cultural negligence, cultural
ignorance, and cultural imposition practices in working with
diverse cultures.

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FACTORS AND RATIONALE INFLUENCING
TRANSCULTURAL NURSING
7. The rise in gender and special groups issues and rights.
8. The growing trend to care with and for people whether well or
ill in their familiar or particular living and working environment.

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REFERENCES
● Delaune, Sue C. and Patricia K. Landner
. Fundamentals of Nursing. 3rd ed. Thomson, Asian ed. 2006. p. 389.
● Data from Campinha-Bacote, J. (1999). A model and instrument for
addressing cultural competence in health care. Journal of Nursing Education,
38 (5), 204-205), Quoted in Ethical Issues in Contemporary Nursing, p. 342
• Taylor, Lillis and LeMone, op. cit. pp. 53-54.

• Leininger, Madeleine. (1991). Culture care diversity and universality: A theory of nursing.
New York: National League for Nursing Press. 16:44-45.
• https://nursing-theory.org/theories-and-models/leininger-culture-care-theory.php
• https://online.ahu.edu/blog/infographic/guide-to-cultural-sensitivity-in-nursing/
• Leininger,Madeleine and McFarland,Marilyn R. ( 2002).Transcultural Nursing
Concepts,Theories, Research and Practice.(3rd ed.).Medical Publishing Division, New
York.

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Thank you!
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