Culture, Health and Society

Program: Post RN BSN

Unit 3: Transcultural Nursing
Presented by: Mrs. Zahida Saboor

1
Transcultural Nursing

Transcultural nursing is a comparative study of

cultures to understand similarities (culture
universal) and difference (culture-specific) across
human groups (Leininger, 1991).
Transcultural Care Concepts

 Cultural awareness.
Self examination of one’s own background, recognizing
biases and prejudices and assumptions about other
people

 Culturally congruent care.

care that fits the peoples 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 practioner to bridge cultural gaps in
caring, work with cultural differences and enable clients
and families to achieve meaningful and supportive care .
Key Concepts Related To Trans-
cultural Nursing
 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 perception 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-specifies
Values, beliefs, and patterns of behavior that tend to be unique to
a selected culture.
 Material culture
Refers to objects (dress, art, religious art)
 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 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 .
 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.
Care:
which assists others with real or estimated needs in an
effort to improve a human condition of concern, or to
face death.
Caring:
Is an action or activity directed towards providing care.
Culture:
Set of values, beliefs and traditions, that are held by a
specific group of people and handed down from
generation to generation.
Culture Care:
Is the multiple aspects of culture that influence and
help a person or group to improve their human
condition or deal with illness or death.
 Nursing
Nursing is defined as a learned humanistic and scientific profession
and discipline which is focused on human care phenomena and
activities in order to assist, support, facilitate, or enable individuals or
groups to maintain or regain their well-being (or health) in culturally
meaningful and beneficial ways, or to help people face handicaps or
death.
 Worldview
Worldview is the way in which people look at the world, or at the
universe, and form a “picture or value stance” about the world and
their lives.
 Emic
Knowledge gained from direct experience or directly from those who
have experienced. It is a common knowledge.
 Etic
Knowledge which describes the professional perspective. It is
professional care knowledge.
 TRANSCULTURAL COMPETENCE
 Caring
 Ongoing
 Multidimensional
 Proactive
 Ethics
 Trust
 Education
 Confidence
 Evaluation
 Madeleine Leininger
One of the first nursing theorist and transcultural global
nursing consultant.
MSN - Catholic University in Washington .
PhD in anthropology - University of Washington.
She developed the concept of transcultural nursing and the
ethno nursing research model.
Trans-cultural Nursing Theory

 Madeleine Leininger is considered as the founder of the theory of

transcultural nursing.
 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)
 Transcultural nursing theory is also known as Culture Care theory.
 Theoretical framework is depicted in her model called the Sunrise
Model (1997).
 Cultural Care Preservation or Maintenance
Refers to nursing care activities that help people from
particular cultures to retain and use core cultural care
values related to healthcare concerns or conditions.
 Cultural Care Accommodation or Negotiation
Refers to creative nursing actions that help people of
a particular culture adapt or negotiate with others in
the healthcare community in an effort to attain the
shared goal of an optimal health outcome for patients
of a designated culture.
 Cultural Care Re-Patterning or Restructuring
Refers to therapeutic actions taken by culturally
competent nurses. These actions help a patient to
modify personal health behaviors towards beneficial
outcomes while respecting the patient's cultural
values.
MAJOR CONCEPTS (Leininger -1991)

 Illness and wellness are shaped by a 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
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 to background,
effective Intercultural communication must take
place
Nursing Process And Role Of Nurse
 Determine the client's cultural heritage and language skills.
 Determine if any of his health beliefs relate to the cause of the
illness or to the problem.
 Collect information that any home remedies the person is
taking to treat the symptoms.
 Nurses should evaluate their attitudes toward ethnic nursing
care.
 Self-evaluation helps the nurse to become more comfortable
when providing care to clients from diverse backgrounds
 Understand the influence of culture, race &ethnicity on the
development of social emotional relationship, child rearing
practices & attitude toward health.
 Collect information about the socioeconomic status of the
family and its influence on their health promotion and
wellness
 Identify the religious practices of the family and their influence on
health promotion belief in families.
 Understanding of the general characteristics of the major ethnic
groups, but always individualizes care.
 The nursing diagnosis for clients should include potential problems in
their interaction with the health care system.
 The planning and implementation of nursing interventions should be
adapted as much as possible to the client's cultural background
 Evaluation should include the nurse's self-evaluation of attitudes and
emotions toward providing nursing care to clients from diverse
sociocultural backgrounds.
 Self-evaluation by the nurse is crucial as he or she increases skills for
interaction. .
CONCLUSION
Nurses need to be aware of and sensitive to the
cultural needs of clients.
The practice of nursing today demands that the
nurse identify and meet the cultural needs of
diverse groups, understand the social and cultural
reality of the client, family, and community,
develop expertise to implement culturally
acceptable strategies to provide nursing care, and
identify and use resources acceptable to the client
(Andrews & Boyle, 2002)
Transcultural Assessment Model

 The Transcultural Assessment Model of Giger and Davidhizars is

a tool developed to assess cultural values of patients about
health and disease behaviors and their effects. The model
contains six cultural dimensions: Communication, Space, Social
Organizations, Time, Environmental Control, and Biological
Variations.
Transcultural nursing care of childbearing women and
children
 Culturally competent care for women and children are
growing increasingly diverse, there is a developing
need for cultural competency among nurses and
throughout healthcare organizations. Cultural
competence includes both culture-specific and culture-
generic knowledge, attitudes, and skills.
 The call to prayer is recited in the Muslims newborn ear
.
 Male offspring are preferred.
 Male circumcision is almost a universal practice and for
Muslims it is religious requirement.
 Mothers may be reluctant to bath postpartum because
of believe that air gets into the mother and Causes
illness
Health Practices In Different Cultures
 Use of Protective Objects
Protective objects can be hanged in the home or chain
around the neck, wrist, or waist to protect the wearer
from the evil eye or evil spirits.
 Use of Substances .
It is believed that certain food substances can be
ingested to prevent illness.E.g. eating raw garlic or onion
to prevent illness or wear them on the body or hang them
in the home.
 Religious Practices
Burning of candles, rituals Practices .
 Traditional Remedies
The use of folk or traditional medicine is seen among
people from all walks of life and cultural ethnic back
ground.
 Gender Roles
In many cultures, the male is dominant figure and
often they take decisions related to health practices and
treatment. In some other cultures females are
dominant.
In some cultures, women are discriminated in
providing proper treatment for illness.
 Healers
Within a given community, specific people are known
to have the power to heal.
 Beliefs about mental health
Mental illnesses are caused by a lack of harmony of
emotions or by evil spirits.
 Economic Factors
Factors such as unemployment, underemployment,
homelessness, lack of health insurance poverty prevent
people from entering the health care system.
 Standard of Practice In The
Delivery Of Transcultural Nursing
Care

1. Social justice
2. Critical reflection
3. Transcultural nursing knowledge
4. Cross-cultural practice
5. Health care system and organization
6. Patient advocacy and empowerment
7. Multicultural workforce
8. Education and training
9. Cross-cultural communication
10. Cross cultural leadership
11. Policy development
12. Evidence based practice and research