DEFINITIONS
Transcultural Nursing
- Transcultural nursing is a comparative study of cultures to
understand similarities (culture universal) and difference
(culture-specific) across human groups (Leininger, 1991).
Culture
- Set of values, beliefs and traditions, that are held by a
specific group of people and handed down from generation to
generation.
- Culture is also beliefs, habits, likes, dislikes, customs and
rituals learn from one’s family.
- Culture is the learned, shared and transmitted values, beliefs,
norms and life way practices of a particular group that guide
thinking, decisions, and actions in patterned ways.
- Culture is learned by each generation through both formal and
informal life experiences.
- Language is primary through means of transmitting culture.
- The practices of particular culture often arise because of the
group's social and physical environment.
- Culture practice and beliefs are adapted over time but they
mainly remain constant as long as they satisfy needs.
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.
Culturally competent care
- is the ability of the practitioner to bridge cultural gaps in
caring, work with cultural differences and enable clients and
families to achieve meaningful and supportive caring.
Nursing Decisions
Leininger (1991) identified three nursing decision and action
modes to achieve culturally congruent care.
- Cultural preservation or maintenance.
- Cultural care accommodation or negotiation.
- Cultural care repatterning or restructuring.
INTRODUCTION
- Madeleine Leininger is considered as the founder of the theory
of transcultural nursing.
- Her theory has now developed as a discipline in nursing.
- Transcultural nursing theory is also known as Culture Care
theory.
- Theoretical framework is depicted in her model called the
Sunrise Model (1997).
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.
- Most cases of lay illness have multiple causalities and may
require several different approaches to diagnosis, treatment, and
cure including folk and Western medical interventions..
- The use of traditional or alternate models of health care
delivery is widely varied and may come into conflict with Western
models of health care practice.
- 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.
APPLICATION TO NURSING
- To develop understanding, respect and appreciation for the
individuality and diversity of patients beliefs, values,
spirituality and culture regarding illness, its meaning, cause,
treatment, and outcome.
- To encourage in developing and maintaining a program of
physical, emotional and spiritual self-care introduce therapies
such as ayurveda and pancha karma.
HEALTH PRACTICES IN DIFFERENT CULTURES
Use of Protective Objects
- Protective objects can be worn or carried or hung in the home-
charms worn on a string 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 certian 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 of redemption etc..
Traditional Remedies
- The use of folk or traditional medicine is seen among people
from all walks of life and cultural ethnic back ground.
Healers
- Within a given community, specific people are known to have the
power to heal.
Immigration
- Immigrant groups have their own cultural attitudes ranging
beliefs and practices regarding these areas.
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.
Beliefs about mental health
- Mental illnesses are caused by a lack of harmony of emotions or
by evil spirits.
- Problems in this life are most likely related to transgressions
committed in a past life.
Economic Factors
- Factors such as unemployment, underemployment, homelessness,
lack of health insurance poverty prevent people from entering the
health care system.
Time orientation
- It is varies for different cultures groups.
Personal Space
- Respect the client's personal space when performing nursing
procedures.
- The nurse should also welcome visiting members of the family
and extended family.
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 ðnicity on the
development of social emotional relationship, child rearing
practices & attitude toward health.
- Collect informationabout the socioeconomic status of the family
and its influence on their health promotion and wellness
- Identifiy 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 individualize care.
- The nursing diagnosis for clients should include potential
problems in their interaction with the health care system and
problems involving the effects of culture.
- 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).