THEORETICAL FOUNDATIONS OF

TRANSCULTURAL NURSING
 The Importance of
Transcultural Nursing
 Marked increase in the migration of people within and
between countries worldwide.
 A rise in multicultural identities, with people expecting
their cultural beliefs, values, and life ways to be
understood and respected by nurses and other health
care providers.
 Increased used of health care technology sometimes
conflicts with cultural values of clients.
 Worldwide, there are cultural conflicts, clashes, and
violence, that have an impact health care as more
cultures interact with one another.
 Increase in the number of people traveling and working
in many different parts of the world.
 Increase in legal suits resulting from cultural conflicts,
negligence, ignorance, and imposition of health care
practices.
 A rise in feminism and gender issues, with new
demands on health care systems to meet the needs of
women and children.
 Increased demand for community and culturally based
health care services in diverse environmental contexts.

LEININGER, 1995
 History of
Transcultural Nursing
 Critical Analysis of
Transcultural Nursing
 Transcultural nursing contains ambiguous terminology and lacks
clarity in describing key concepts (Habayeb, Mulholland, 1995).
 Nurses have struggled to achieve clarity in concepts, such as
cultural awareness, cultural sensitivity, cultural competence, and
cultural congruence.
 Color, religion, and geographic location are most often used to
narrowly define culture and highlight cultural diversity, which is
often portrayed as a minority/majority issue.
 Talabere (1996) suggests that cultural diversity is itself an
ethnocentric term because it focuses on “how different the other
person is from me” rather than “how different I am from the
other”.
 Transcultural nursing model fails to recognize the
relationship between knowledge and power and their
inattention to the complexities associated with
prejudice, discrimination and racism (Price & Cortis,
2000).
 Although Leininger and other transcultural nurses
address the need to consider the political, economic,
and social dimensions in their theoretical formulations,
transcultural nursing has been criticized for doing too
little to encourage nurses to be actively involved in
setting political, economic, and social policy agendas.
 Culley (1996) criticizeds transcultural nursing for failing
to recognize the power relations that exist between
groups.
 Complex sociocultural phenomena are often reduced
to overgeneralized stereotypes.
 The same criticism might be applied to nursing failure
to address other forms of bias, prejudice,
discrimination, and social injustice.
 Juntunen (2007) has criticized Leininger for
generalizing her research by creating lists of the
culture care values, meanings, and action modes of
each of the cultures that she and her disciples have
studied.
 Transcultural nursing has been criticized for embracing
models based on the assumption that understanding
one’s own culture and the culture of others creates
tolerance and respect for people from diverse
backgrounds.
Selected Resources for
Transcultural Nursing
Leininger’s Sunrise Model
 Leininger’s Theory of Culture Care
Diversity and Universality

 It focuses on describing, explaining, and

predicting nursing similarities and differences
focused primarily on human care and caring in
human cultures.
 She uses worldview, social structure, language,
ethnohistory, environmental context, and the
generic (folk) and professional systems to
provide a comprehensive and holistic view of
influences in culture care.
 Culturally based care factors are recognized as
major influences on human expressions and
experiences related to health, illness, and well-
being or on facing disabilities or death.
 The three modes of nursing decisions and actions
(culture care preservation and/or maintenance,
culture care accommodation and/or negotiation,
and culture care repatterning and/or
restructuring) are presented to demonstrate ways
to provide culturally congruent nursing care.

LEININGER & McFARLAND (2002)