1. The Nursing Process and the Transcultural Model
• Cross-cultural considerations
– Especially applicable to the multiethnic society such as ours
– In 1990 Leininger proposed the need of reevaluation of the
NANDA to be relevant, meaningful, and useful in transcultural
perspectives (Geissler 1992).

2. The Nursing Process and the Cultural Considerations
Western Cultures Non-Western-Cultures
Cause of illness
(Assessment)
Biomedical causes Imbalances between humans and
nature
Supranatural
Magico-religious
Method of
diagnosis
(Diagnosis)
Scientific, high-tech
Specially focused
Organ-specific manifestations
NANDA
Naturalistic, magico-religious
Holistic
Mixed
Global, non-specific symptomatology
Treatment
(Nursing care
plan)
Specialty specific
Pharmacological
Surgery
Holistic
Mixed (magico-religious, supernatural
herbal, biomedical, etc.)
Practitioners/
healers
(Implementation)
Uniform standards and
qualifications for the practice
May be learned through
apprenticeship
Criteria for practice not uniform
Reputation established in community
Caring pattern
(Implementation)
Self-care
Self-determination
Caring provided by others
Group reliance and interdependence
Evaluation Scientific, based on the
expected outcomes met
Naturalistic, global, non-specific
symptomatology improvement

3. The Cultural Considerations in the Nursing Process
ASSESS
Gather information
about the client’s
problem with the
consideration of the
client’s cultural
beliefs
DIAGNOSE
Identify the client’s
problem taking into
consideration
culture-bound
syndromes
PLAN
Set goals of care &
desired outcomes &
identify nursing actions
taking transcultural
perspective
IMPLEMENT
Perform the nursing
actions identified in
planning with
consideration that
these actions do not
violate cultural
boundaries and patient
value system
EVALUATE
Determine if the
goals are met &
outcomes achieved.
Determine if the
client’s expectations
are met

4. Recent current activities related to the model
• Settings the model currently being used:
– http://www.culturediversity.org/assesmnt.htm
– Leininger believed that NANDA has to be transculturally relevant
(Geissler 1992).
– Especially applicable to the U.S. multiethnic society
– By 2050, white Americans are estimated to represent less than
50% of the population. To care for this increasingly diversified
nation, nurses must embrace the concept of culturally congruent
care.
• Specific situations the model is useful:
– The goal of the health care system is to provide specific care to
each individual taking into account the needs and concerns of a
multicultural population.

5. References
• Geissler, E. M., (1992). Nursing diagnoses: a study of
cultural relevance. Journal of Professional Nursing, 8(5),
301-307
• Kulwicki, A. (2009). Culture and ethnicity. In A. Hall & P.
Stockert (Eds.), Fundamentals of nursing (pp. 107-119).
St. Louis, MO: Mosby.
• Leininger, M. (2002). Culture care theory: a major
contribution to advance transcultural nursing knowledge
and practices.