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1. NURSING MODELS for
Cultural competent care

2. Intended Learning Outcomes (ILOs)
Knowledge and Understanding
• Define the concept of cultural competence and its significance in global
nursing practice.
• Describe the key elements, goals, and assumptions of Leininger’s Sunrise
Model, Giger & Davidhizar’s Assessment Model, Campinha-Bacote’s
Model, Purnell’s Model, and Andrews & Boyle’s TIP Model.
• Explain how these models provide frameworks for understanding cultural
diversity and guiding culturally congruent care.
• Identify the stages of intercultural sensitivity and discuss their relevance
to developing cultural competence in nursing.

3. Cont.’
Intellectual Skills
• Compare and contrast the major transcultural nursing models regarding their focus,
application, and theoretical foundation.
• Analyze cultural and contextual factors (social, economic, religious, environmental) that
influence nursing care in different healthcare settings.
• Interpret how the integration of various cultural models supports evidence-based and person-
centered nursing practice.
Professional and Practical Skills
• Apply selected cultural competence models (e.g., Purnell or Campinha-Bacote) to assess
patient needs and plan culturally appropriate care.
• Demonstrate the use of communication skills—both verbal and non-verbal—to promote
culturally safe interactions within interprofessional teams.
• Utilize the problem-solving process of the TIP Model to plan, implement, and evaluate
culturally congruent nursing interventions.

4. Cont.’
General and Transferable Skills
• Collaborate effectively with interprofessional healthcare teams to
provide culturally responsive care.
• Reflect on personal attitudes, biases, and behaviors that may affect
cultural competence and professional practice.

5. NURSING MODELS for Cultural competent care

6. TRANSCULTURAL CARE NURSING
MODELS
1. Leininger’s Sunrise Model
2. Giger and Davidhizar’s

8. 1. Leininger’s Sunrise Model To Depict
Theory Of Cultural Care
DIVERSITY AND UNIVERSALITY
Focuses on describing, explaining, and
predicting nursing similarities and
differences primarily on human care and
caring in human cultures.

9. In order for nurses to assist people of diverse
cultures, Leininger presents three intervention
modes to demonstrate ways to provide culturally
congruent nursing care. These modes are
assistive, supportive, facilitative, or enabling
professional actions and decisions that help
people of a designated culture in:

10. a. Culture care preservation and maintenance
b. Culture care accommodation or negotiation
c. Culture care restructuring and re-patterning.

11. 3. THE GIGER AND DAVIDHIZAR’S TRANSCULTURAL ASSESSMENT MODEL

12. 2- THE GIGER AND DAVIDHIZAR’S TRANSCULTURAL
ASSESSMENT MODEL
Culturally diverse nursing must take into account six
cultural phenomena:
(1)environmental control,
(2)biological variations,
(3)social organization
(4)Communication,
(5)space.
(6)time orientation.

13. The Six Cultural Organizing Phenomena

15. Cultural Competent models
Campinha-Bacote’s

16. 14
Cultural Competence Model
Campinha-Bacote’s
• Cultural awareness
• Cultural skill
• Cultural knowledge
• Cultural encounters
• Cultural desire

17. 3-THE PURNELL MODEL FOR CULTURAL
COMPETENCE
Macro Aspects of the Model
Global society – phenomena related to global society include world
communication and politics; conflicts and warfare; natural disasters and famines;
international exchanges in education, advances in health sciences, etc.
Community – physical, social, and symbolic characteristics that cause people
to connect
Family – is two or more people who are emotionally connected.
Family structure and roles change according to age, generation, marital status,
relocation, etc.
Person – is a bio psych cultural being who is constantly adapting to
his or her environment.

18. The 12 domains essential for assessing the
ethno cultural attributes of an individual,
family, or group are as follows:
1. Overview, inhabited localities, and topography
2. Communication
3. Family roles and organization
4. Workforce Issues
5. Bio cultural ecology

19. Cont.
• 6-High-risk behaviors 7-Nutrition
• 8-Pregnancy and child-bearing 9-Practices
• 10-Death rituals 11-Spirituality
•12-Health-care practices Health-care practitioners

20. Intercultural Sensitivity
Intercultural competence:
The ability to think and act in intercultural appropriate ways
Intercultural sensitivity:
The ability to have an experience and understand relevant
cultural differences and edit other discrimination concept.

21. Stages of Intercultural Sensitivity
1.Denial: Does not recognize cultural differences
2Defense: Recognizes some differences, but sees them as
negative
3Minimization: Unaware of projection of own
cultural values; sees own values as superior

22. Stages of Intercultural
Sensitivity
4Acceptance: Shifts perspectives to understand that the
same "ordinary" behavior can have different meanings in
different cultures.
5Adaptation: Can evaluate other's behavior from their
frame of reference and can adapt behavior to fit the
norms of a different culture.
6Integration: Can shift frame of reference and also deal
with resulting identity issues.

23. The importance of transcultural
nursing

24. Leininger (1995) cites 8 factors:
1ST: Transcultural nursing is needed because of the
growing diversity that characterizes our national
and global populations.
2ND:There has been a rise in multicultural
identities, with people expecting their cultural
beliefs, values, and lifeways to be understood and
respected by nurses and other health care
providers.

25. 3RD: The increased use of health care
technology sometimes conflicts with cultural
values of clients.
4TH: Worldwide, there are cultural conflicts,
clashes and violence that have an impact on
healthcare as more cultures interact with one
another.

26. 5TH: There was an increase in the number of
people traveling and working in many different
parts of the world.
6TH: There was an increase in legal suits resulting
from cultural conflict, negligence, ignorance, and
imposition of health care practices.

27. 7TH: There has been a rise in feminism and gender
issues, with new demands on health care systems
to meet the needs of women and children.
8TH: There has been increased demand for
community and culturally based health care
services in diverse environmental contexts.

28. Andrews/Boyle
Transcultural Inter-professional
Practice (TIP) Model

29. Transcultural Inter-professional Practice (TIP) Model:
This model enable nurses and other health care team to :
▪ Organize and understand what happens in practice.
▪ Critically analyze situations for clinical decision making.
▪ Develop a plan of care.
▪ Propose appropriate nursing interventions.
▪ Predict the outcomes from the care.
▪ Evaluate the effectiveness of the care provided.
Accordingly to the patient cultural context and background.

30. Major concepts and components:
▪ Cultural context.
▪ Inter-professional health care team.
▪ Communication.
▪ Problem solving process.

31. ▪ Cultural context:
Components of the model; the context from environmental, social, economic,
religious, moral, legal, educational, genetic and technological factors which
people's health-related values, attitudes, beliefs and practices of human
emerge, including clients and other inter-professional health care team.

32. ▪ Inter-professional health care team.
• Client at its core.
• May also include: Family and support persons, other
healthcare personnel, traditional, folk and religious healers.
• All providers working together to deliver the highest
quality of care.
• A partnership among client and providers that establishes
trust, collaboration, cooperation, and communication.

33. ▪ Communication
• Verbal—spoken word, language (over 6,000 worldwide), tone of
voice, abbreviations, idioms.
• Nonverbal—how people convey meaning without words. Facial
expressions, gestures, posture, physical distance, silence, eye
contact.
• Mixed—modesty, technology assisted.

34. ▪ Problem solving process.
–Guides health care teams in determining what the
client needs to obtain optimal well-being and health.
• Comprehensive assessment skills.
• Mutual goal setting.
• Planning care.
• Implementing care.
• Evaluation of care to achieve the goals of:
• Culturally congruent, competent, quality care
based on evidence and best practice.

35. ▪ Problem solving process:
• Proficiency in using the problem-solving process requires time and
repeated simulated and/or clinical experiences.
• Developing competence is uneven and nonlinear, as is the process of
developing cultural competence.

36. Communication skills (verbal and non verbal)

37. Summary
▪ Transcultural inter-professional practice model that serves as a framework
for nurses seeking to collaborate with clients and other members of the
health care that is beneficial, meaningful, relevant, culturally congruent,
culturally competent and consistent with the cultural believes and
practices of client from diverse backgrounds.

38. ▪ The goals and assumptions of the model:
provides a systematic, logically, orderly, scientific process for delivering cultural
congruent ,competent, safe, affordable, and provide quality care to people from
diverse backgrounds across the life span.
Facilitates the delivery of nursing and health care consistent with cultural beliefs
and practices of clients from diverse backgrounds
Provides a conceptual framework to guide nurses in the delivery of culturally
congruent care that is theoretically sound

39. CULTURAL BELIEF SYSTEMS
Cultural meanings and cultural belief systems develop from the
shared experiences of a group in society and are expressed
symbolically.
The use of symbols to define, describe, and relate to the world
around us is one of the basic
characteristics of being human.
One of the most common expressions of symbolism is the
metaphor.
In metaphor, one aspect of life is connected to another through a
shared symbol.