This document provides information on transcultural nursing concepts and models. It discusses Madeleine Leininger's theory of transcultural nursing, which introduced the concepts of cultural care preservation, accommodation, and repatterning. It also describes Joyce Geiger and Ruth Davidhizer's transcultural assessment model, which identifies six cultural phenomena to assess: communication, space, social organization, time, environmental control, and biological variations. Finally, it examines cultural values and care meanings and actions for several cultures including Anglo-American, Mexican American, Haitian American, African American, and North American Indian cultures.

1. ~ ANTONIO, Jevid Mirriam G.
NCM 120
Basic Concepts
 Transcultural Nursing — the study of the lifeways
and patterns of persons of various cultures
including their healthcare practices and nursing’s
role in that culture. = sensitive to their culture
differences; ex, food preferences, self-care
preferences
 Cross Cultural Nursing — the study of the
lifeways and patterns of persons of various
cultures from an anthropological perspective that
is being applied to nursing. = purpose: to observe
on how they live
 International Nursing — the exchange of nurses
between 2 or more nations/cultures.
 Culture — the patterns and lifeways that guide a
group of people’s worldviews and decision
making.
 Cultural Imposition — a situation where one
culture forces their values and beliefs on another
culture or subculture.
 Acculturation — the process of adapting or
modifying the patterns and lifeways of an adopted
culture as a result of contact with another group
or individual. = ex. Tshirt to sleeveless
 Assimilation — the process of accepting some of
the cultural practices or traits of the prevailing
culture into one’s own daily activities. =
kinalimutan/pinalitan mo na lahat
 Refugee — a person who flees from persecution,
invasion, or political danger. = people who force
to live for their culture because of political invasion
 Values — something regarded as desirable,
worthy, or right, as a belief, standard, or moral
precept.
 Beliefs — a tenet or body of tenets; doctrine; creed.
 Ethnocentrism — the universal tendency of
human beings to think that their ways of thinking,
acting, and believing are the only right, proper, and
natural ways. It can be a major barrier to providing
culturally conscious care.
 Prejudice — Negative attitudes toward a specific
group of people (e.g., race, religion) (Pincus, 2006).
 Discrimination — Actions that deny equal
treatment to persons perceived to be members of
some social category or group (Pincus, 2006).
 Generalization — usually an oversimplification
made about behaviors of an individual or large
group.
 Stereotyping — An oversimplified conception,
opinion, or belief about some aspect of an
individual or group of people (Purnell, 2005).
 Bias — A preference or an inclination, especially
one that inhibits impartial judgment; or an unfair
act or policy stemming from prejudice (IOM, 2003).
 Assumption — A basic underlying assumption is
an unconscious, taken-for-granted belief and
value that helps determine behavior, perception,
thought, and feeling (Schein, 2010).
Cultural Competence in Nursing
 Developing an awareness of one’s own existence,
sensations, thoughts, and environment without
letting it have an undue influence on those from
other backgrounds.
 Demonstrating knowledge and understanding of
the client’s culture.
 Accepting and respecting cultural differences.
 Adapting care to be congruent with the client’s
culture.
4 Levels of Cultural Competence
 Unconscious incompetence — not being aware
that one is lacking knowledge about another
culture.
 Conscious incompetence — being aware that
one is lacking knowledge about another culture. ~
alam mo kasi pinag aralan pero hindi mo na
maalala or nakalimutan
 Conscious competence — learning about the
client’s culture, verifying generalizations about the
client’s culture, and providing culturally specific
interventions. ~ individual and cultural differences
 Unconscious competence — automatically
providing culturally congruent care to clients of a
diverse culture. ~ giving congruent care in
different races
What is YOUR goal re: Cultural Competence?
Through this course we hope that you will desire to
strive for CONSCIOUS COMPETENCE regarding your
client’s culture when you practice.
CULTURAL ICEBERG

2. ~ ANTONIO, Jevid Mirriam G.
 Surface Culture ~ observable; you have
background
 Deep Culture ~ not observable; dig deeper to
their culture and it explains the story of their
culture
NURSING THEORISTS IN TRANSCULTURAL
NURSING
Madeleine Leininger — the founder of Transcultural
Nursing.
Dr. Leininger studied anthropology in the
1950’s and early 60’s. She earned her PhD in Cultural
Anthropology. She then decided that nursing was
constantly dealing with the lifeways and patterns of
peoples of many backgrounds and that in caring for
these persons, nurses needed to be sensitive to the
unique needs of all peoples. She felt strongly that we
should NOT impose our views on others whenever
possible.
LEININGER’S THEORY
 She developed the “SUNRISE MODEL” as a basis
for assessment and research in nursing.
 This model remains as a standard in Transcultural
Nursing Theory.
 Dr. Leininger also developed the
ETHNONURSING Method for conducting
Transcultural Research. While it is considered by
Dr. Leininger to be Qualitative, it has certain
attributes that make it somewhat Quantitative as
well.
 Note that the model looks like a Sunrise and the
Worldview encompasses everything that makes
people who they are.
 The 7 Cultural and Social Structure Dimensions
are the large areas that nurses need to learn about
through interview and living among the people of
different cultures.
 Below the Individuals, Families, Groups,
Communities, & Institutions are the Diverse
Health Systems that all persons deal with in
various ways.

3. ~ ANTONIO, Jevid Mirriam G.
 Generic or Folk Systems are the everyday
remedies an individual, family or group may use to
promote wellness and healing.
Some examples might include:
 Chicken Soup
 Chamomile Tea or other Herbal teas
 Voodoo
 Sacrifices of birds or animals to the spirits
 Prayer
 Curandero
Nurses need to assess in all these areas to plan safe,
effective care.
 Professional Systems are different depending
upon the Health Care Delivery System of that
culture. Whether is socialized medicine, private
insurance, communal healthcare, poor economic
support vs. great wealth, all contribute to the
influence of the utilization of Professionals to
prevent illness, heal illness, and promote health
and wellness.
 Nursing must collaborate within the healthcare
delivery system to plan and implement safe,
effective, culturally competent care.
How to Provide Culturally Congruent Care:
Leininger suggests 3 approaches to plan and
implement Culturally Congruent Care.
 The first is Cultural Care
Preservation/Maintenance where we look at
what we as nurses can do to preserve and maintain
the cultural practices of an individual or family
while receiving safe, holistic care somewhere in the
Healthcare Delivery System.
 The second approach is Cultural Care
Accommodation/Negotiation where we look at
what we as nurses can do to accommodate the
patient and negotiate with the patient within the
healthcare environment in order to provide
culturally congruent care while he/she is in the
Healthcare Delivery System.
 The third approach is Cultural Care
Repatterning/Restructuring where we look at
what we as nurses need to do with the patient and
family to repattern or restructure their lifeways in
order to promote healing and wellness, always
being cognizant of the cultural influences that
affect why they do what they do in their life
experience.
GEIGER AND DAVIDHIZER MODEL
 Joyce Newman Geiger and Ruth Davidhizer
were inspired to develop a culturally competent
assessment tool by their nursing students at Bethel
College in Mishawaka, IN. Dr. Davidhizer just
passed away in 2007.
 The Transcultural Assessment Model was
developed and researched in 1990.
IMPORTANCE OF TRANSCULTURAL NURSING
 Increase the migration of people within and
between countries worldwide.
 Rise in multicultural identifies, with people
expecting their cultural belief, values and lifeways
to be understood and respected by nurses and
other health care providers.
 Cultural conflicts, clashes and violence that have
impact in the health care.
 Increase legal suits resulting from cultural conflict,
negligence, ignorance and imposition of heath
care provider.
 Increase in travelling and working in many
different parts of world.
CULTURAL ASSESSMENT

4. ~ ANTONIO, Jevid Mirriam G.
CULTURAL ASSESSMENT
 A cultural nursing assessment is a systematic way
to identify the beliefs, values, meanings, and
behaviors of people while considering their
history, life experiences, and social and physical
environments.
GIGER AND DAVIDHIZAR'S TRANSCULTURAL
ASSESSMENT MODEL
 Is viewed as a culturally competent practice field
that is client centered and research focused.
 To deliver culturally sensitive care, the nurse must
remember that everyone is unique and a product of
past experiences, beliefs, and values that have been
learned and passed down from one generation to
the next
SIX CULTURAL PHENOMENA
1. Communication
 Communication is the means by which culture
is transmitted and preserved. Both verbal and
nonverbal communications are learned in one's
culture.
 Verbal and nonverbal patterns of
communication vary across cultures, and if
nurses do not understand the client's cultural
rules in communication, the client's acceptance
of a treatment regimen may be jeopardized.
 Accurate diagnosis and treatment is impossible
if the health-care professional cannot
understand the patient.
 Culture not only determines the
appropriateness of the message but also
influences all the components of
communication.
Thus, an assessment of communication should
consider:
 dialect,
 style,
 volume, including silence,
 touch,
 context of speech or emotional tone, and
 kinesics, including gestures, stances, and eye
behavior
2. Space
 Space refers to the distance between
individuals when they interact. All
communication occurs in the context of space.
There are four distinct zones of interpersonal space:
 inmate zone (extends up to 1 ½ feet),
 personal distance (extends from 1 ½ to 4 feet),
 social distance (extends from 4 to 12 feet) and
 public distance (extends 12 feet or more)
3. Social Organization
 Social organization refers to the social group
organizations with which clients and families
may identify.
4. Time
 Time is an important aspect of interpersonal
communication. Some cultures are considered
future oriented, others present oriented, and
still others past oriented
 These differences in time orientation may
become important in health-care measures
such as long- term planning and explanations
of medication schedules.
eg: Latin Americans, Native Americans, and Middle
Easterners are present oriented cultures and may
neglect preventive health care measures. They may
show-up late or not at all for appointments
5. Environmental Control
 Environmental control refers to the ability of
the person to control nature and to plan and
direct factors in the environment.
 Some groups perceive man as having mastery
over nature; others perceive humans to be
dominated by nature, while others see
harmonious relationships between humans
and nature
 For example, Asians and Native Americans
may perceive that illness is a disharmony with
other forces and that medicine is only capable
of relieving the symptoms rather than curing
the disease. These groups are likely to look for
naturalistic solutions, such as herbs and hot
and cold treatments to resolve or cure a
cancerous condition
6. Biological variations
 body structure,

5. ~ ANTONIO, Jevid Mirriam G.
 skin colour,
 other visible physical characteristics,
 enzymatic and genetic variations,
 electrocardiographic patterns,
 susceptibility to disease,
 nutritional preferences and deficiencies, and
 psychological characteristics
CULTURAL VALUES AND CARE MEANINGS AND
ACTIONS
ANGLO AMERICAN CULTURE (MAINLY US MIDDLE
AND UPPER CLASS)
Countries belongs to Anglo American culture:
 USA
 CANADA
 NEW ZEALAND
 UNITED KINGDOM
 AUSTRALIA
A. CULTURE VALUES
 Individualism – independent
 Independence and freedom – values of
not wearing mask
 Competition and achievement
 Materialism – they really like material
things then appreciate it
 Technology dependent – high tech
 Instant time and actions – on the spot
presentation
 Youth and beauty
 Equal sex rights – equality of both genders
 Leisure time highly valued possible – ex.
Bar
 Reliance on scientific facts and numbers
– kapag meron kang sinabi wag na wag
kang papasok or magr’receive ng pasyente
kung wala kayong alam kasi matanong sila
 Less respect for authority and the elderly
– ex. send to my mother to nursing home
 Generosity in time of crisis – they love
you and they give something or appreciate
you
B. CULTURE CARE MEANINGS AND ACTIONS
MODES
 Stress alleviation by/ affected by their:
i. Physical means
ii. Emotional means
 Personalized acts
i. Doing special things
ii. Giving individual attention
 Self-reliance by:
i. Reliance on self
ii. Becoming as independent
iii. Reliance on technology
 Health instruction
i. Teach us hot “to do” this care
for self
ii. Give us the “medical” facts
MEXICAN AMERICAN CULTURE
A. CULTURAL VALUES
 Extended family valued – lolo, lola, titas,
titos
 Interdependence with kin and social
activities
 Patriarchal (machismo) – sense of
masculine pride
 Exact time less valued
 High respect for authority and the
elderly

6. ~ ANTONIO, Jevid Mirriam G.
 Religion valued (many roman Catholics)
 Native foods for well being
 Traditional folk-care healers for folk
illnesses
 Belief in hot-cold theory – yin & yang
regimen or system. cold: gives strength &
nourishment to the body; hot: gives better
digestion and circulation
B. CULTURAL CARE MEANINGS AND ACTION
MODES
 Succorance (direct family aid) – seeking
for affectionate, care, support
 Involvement with extended family
 Filial love/loving – love coming from the
family
 Respect for authority
 Mother as care decision maker
 Protective male care
 Acceptance of god’s will
 Use of folk-care practices
 Healing with foods
 Touching – form of communication
HAITIAN AMERICAN CULTURE
A. CULTURAL VALUES
 Extended family as support system
 Religion – god’s will must prevail
 Reliance on folk foods and treatments
 Belief in hot-cold theory
 Male decision maker and direct caregivers
 Reliance on native languages
B. CULTURAL CARE MEANING AND ACTIONS
MODES
 Involve family or support
 Respect
 Trust
 Succorance
 Touching
 Reassurance
 Spiritual healing
 Use of folk food, care rituals
 Avoid evil eye and witches
 Speak the language
AFRICAN AMERICAN CULTURE
A. CULTURAL VALUES
 Extended family networks
 Religion valued (many are Baptists,
Methodists,)
 Interdependence with “blacks” – ex.
Nigerian
 Daily survival
 Technology valued e.g. radio, car
 Folk foods
 Folk healing modes
 Music and physical activities
B. CULTURAL CARE MEANING AND ACTIONS
MODES
 Concerns for my “brothers and sisters”
 Being involve
 Giving presence (physical)
 Family support and “get together”
 Touching appropriately
 Reliance on folk home remedies
 Rely on “Jesus to save us” with prayers and
songs
NORTH-AMERICAN INDIAN CULTURE
A. CULTURAL VALUES
 Harmony between land, people, and
environment
 Reciprocity with “mother earth”
 Spiritual inspiration (spirit guidance)
 Folk healers (shamans)
 Practice culture of life and taboos
 Rhythmicity of life with nature
 Authority of tribal elders
 Pride in culture heritage and “nations”
 Respect and value for children
B. CULTURAL CARE MEANING AND ACTIONS
MODES
 Establishing harmony between people and
environment with reciprocity
 Actively listening
 Using periods of silence (great spirit
guidance)
 Rhythmic timing (nature, land and people)
in harmony
 Respect for native folk healers, carers, and
curers
 Maintaining reciprocity (replenish what is
taken from mother earth)
 Preserving cultural rituals and taboos
 Respect for elders and children

7. ~ ANTONIO, Jevid Mirriam G.
HEALERS AND THEIR SCOPE OF PRACTICE
CULTURE/FOLK PRACTITIONER
A. HISPANIC (countries: Ecuador, Mexico,
Venezuela, Guatemala, El Salvador)
 Family member
 Curandero – medicine man; shaman
 Espiritualista or spiritualist
 Yerbero – witch doctors; herbalist
 Sabador
B. BLACK (countries: Nigeria, Ethiopia, Egypt)
 Old lady – hear sayers
 Spiritualist
 Voodoo priest or priestess or hougan –
performing rituals
C. CHINESE
 Herbalist - herbal
 Acupuncturist
D. AMISH (countries: canada, us, argentina
bolevia)
 Braucher or Baruch - dactor
 Lay midwives
E. GREEK
 Magissa, “magician”, bonesetters - hilot
 Priest (orthodox)
F. NATIVE AMERICANS
 Shaman
 Crystal gazer and trembler (Navajo) –
evolution of doctor w/o certificate
BIOCULTURAL DIFFERENCE IN THE PHYSICAL
EXAMINATION
A. GENERAL APPEARANCE
a. Physical appearance
(age, gender, level of consciousness, facial
features, and skin color)
b. Body fracture (stature, nutrition, symmetry,
posture, position, and overall body fluid or
comfort.
c. Assessment of mobility (gait and ROM)
d. Behavior (facial expression, mood and
effect, fluency of speech, ability to
communicate ideas, grooming)
Client’s dress for the following groups:
1. Amish (solid color, use of snaps or pins instead
of buttons, bonnets over the head of the
women
2. India wear saris
3. Arab – Muslim men – wear kafias (cloth
headdress and long robes
4. Church of Jesus Christ of latter-day saints
(Mormons). Wear special white underwear
called temple garments
B. SKIN
 Mongolian spots
 Jaunice
 Pallor
 Erythema
 Petechiae
C. SECRETIONS
 Most Asians and native americans have
mild to absent body odor
D. HAIR
 African americans – fragile and long and
straight, thick and kinky
 Asians – straight and skill hair
E. EYES
 African americans – brown eyes
 Scandinavian – blue eyes
F. MUSCULOSKETAL SYSTEM
 African americans – long bones narrower
and denser
 Asians – is below than white Americans
CLINICAL DECISION MAKING AND NURSING
ACTIONS
According to Leininger suggest 3 major modalities to
guide nursing judgement
1. CULTURAL PRESERVATION – refers to
“assistive supporting, facilitative or enabling
professional actions and decisions that help
people of culture to retain or preserve relevant
care values.
2. CULTURAL CARE ACCOMMODATION
AND/OR NEGOTIATION - refers to "those
assistive, supporting, facilitative or enabling
creative professional actions and decisions that
help people of a designated culture to adapt to
or negotiate to, or satisfying health outcome
with professional care providers.

8. ~ ANTONIO, Jevid Mirriam G.
3. CULTURAL CARE REPATTERNING AND/OR
RESTRUCTURING - refers to "those assistive,
supporting, facilitative or enabling creative
professional actions and decisions that help
people of a designated culture to reorder,
change or greatly modify their lifeways for new
while respecting the clients’ cultural values and
beliefs.
MULTICULTURAL HEALTH
INFLUENCES OF CULTURE ON HEALTH
Multicultural health is the phrase used to reflect
the need to provide health care services in a sensitive,
knowledgeable and non-judgmental manner with
respect for people’s health beliefs and practices when
they are different than your own.
INFLUENCES OF CULTURE ON HEALTH
Health in general is influenced by
 The environment
 Your genetics
 Socioeconomic and
 Social and cultural factors
Everyone has a cultural background. Culture defines
what we think, what we say and what we do.
Culture impacts on
 An individual’s perception of health and illness
 Their health behaviour
 beliefs of what is a health issue
 why they have the illness and
 influences how people perceive they should
talk about the illness.
Being able to recognize accept and respect cultural
similarities and differences is an important in the
 delivery of effective health care services and
 ability to provide this service within a cultural
context.
This is the focus of Multicultural Health.
FACTORS IMPACTING ON HEALTH CARE
 Language barriers and accents
 Communication
 Universal cultural patterns /norms
 Contextual factors e.g housing, educational
level, socio-economic status
 Health beliefs n Acculturation continuum
factors or level of cultural adaptation
 Alternativete treatments
 Religious and spiritual perception
 Dietary and food requirements
 Medication requirements
 Birthing /end of life and death rituals n. Access
to and knowledge of services
 Client support knowledge
 Staff knowledge / competence/ support
INFLUENCE OF CULTURAL AND HEALTH BELIEF
SYSTEMS ON HEALTH CARE PRACTICES
HEALTH AND ILLNESS IN AMERICA
 Conventional system of health care is
biomedicine
o Based on scientific findings
o Treat disease using latest technologies
 Is pluralistic
 70 -90% of sickness managed outside the
biomedical system
o Home remedies
o Popular therapies
o Complementary and alternative
medicine (CAM)
 Biomedical care often in conjunction with these
other systems
TRADITIONAL HEALTH BELIEFS AND PRACTICES
 Culture determines how a person
o Defines health
o Recognizes illness
o Seeks treatment
 Characterized in variety of ways
o Etiology of illness
 Personal
 Natural
 Social
 Supernatural
 Therapies that are employed
o Use of therapeutic substances
o Physical forces
o Magico-religious interventions
CULTURAL OUTLOOK

9. ~ ANTONIO, Jevid Mirriam G.
 Each group has a unique outlook on life
 Common understanding
 Ranking of values
 Worldview
o Expectations about personal and public
conduct, assumptions regarding social
interaction and assessments of
individual behavior are determined by
the cultural outlook
MAJORITY AMERICAN
CULTURE
OTHER CULTURAL
GROUPS
Mastery over nature Harmony with nature
Personal control over the
environments
Fate
Doing – activity Being/becoming
Time dominates Personal interaction
dominates
Human equality Hierarchy/rank/status
Individualism/privacy Group welfare
Youth Elders
Self-help Birthright inheritance
Competition Cooperation
Future orientation Past or present
orientation
Informality Formality
Directness/openness/hone
sty
Indirectness,/ritual/
“face”
Practicality/efficiency Idealism
Materialism Spiritualism/detachme
nt
WORLD VIEW EVIDENT IN HEALTH CARE
DECISIONS
 May appear indifferent in terminal illness due
to belief in reincarnation
 Belief in faith healing may contradict health
care recommendations
 Preservation of life vs denial of sustaining care
 Practitioner decision rather than family
decision
WORLDVIEW EVIDENT IN HEALTH CARE
DECISIONS
Relationship to
nature
Mastery over
nature
Diagnosis
dependent on
technology, lab
values, etc.
Personal
control or Fate?
Personal
responsibility
Cure
dependent on
personal
behavior
State of being Emphasis is on
doing, not
being
Clients are
recipients of
healing
Human Equality all patients
deserve equal
access to
healthcare
Client inferior
to the
professionals
Aging Values
youthfulness
Wisdom that
comes with
aging
and elders not
as highly valued
Perceptions of
time
Future oriented Prevention,
long-term
management of
disease
Degree of
formality and
directness
Very informal
and very direct
Honest, open
communication
valued
Materialism or
spirituality
Diseases have
physiological
characteristics
and the body is
not look at as a
whole
Emotional and
social issues are
generally not
considered
relevant.
WHAT IS HEALTH?
 "A state of complete physical, mental, and
social well-being, not merely an absence of
disease or infirmity. -World Health
Organization (WHO)
 Other cultures include natural, spiritual and
supernatural dimensions of health.
 Health may be less dependent on symptoms
than on the ability to accomplish daily
responsibilities.
MEANING OF HEALTH IN OTHER CULTURES
 Harmony with nature
 Absence of malevolent environmental forces
 Living according to God's will
 Avoidance of pollution

10. ~ ANTONIO, Jevid Mirriam G.
 Dependent on relationship with universe
 Pleasing ancestor spirits
 Mind-body-soul
 Can accomplish daily responsibilities
HEALTH ATTRIBUTES
 Physical
o Skin color
o Wt maintenance
o Hair sheen
 Normal body functions
o Bowel function
o Menstruation
 Undisturbed sleep
 Appropriate energy levels
 Behavioral norms
BODY IMAGE
 Perceptions of wt, health, and beauty differ
worldwide
 Thinness important in the US
o Historically associated with poor diet
and disease
o Overweight seen as a character flaw
o Many cultures value overweight
o Africans, Caribbean Islanders, Filipinos,
Mexicans
o Middle Easterners, American indians.
Pacific Islanders
 Values often change with immigration
HEALTH MAINTENANCE
• 3 broad areas of intercultural agreement on
health habits
• Diet
• Sufficient rest
• Cleanliness
• The definition of each varies within cultures
American Health Habits
• 3 Meals a Day
• Daily shower/bath
• Alcohol
• Smoking
• Fat
• Fiber
• Calcium
• Fresh fruits/vegs
o cruciferous vegs
• Exercise
• Regular health
• Checkups
Health Habits Worldwide
• Dressing warmly
• Avoiding going outdoors with wet hair
• Daily doses of cod liver oil
• Molasses
• Natural amulets
o Camphor bags
o or garlic cloves
• Faith
o Blessings of the
o throat
o Wearing holy medals
Health Promoting Food Habits
• Strength
• Vigor
• Mental acuity
• Equilibrium of
• body and soul
Food Habits:
• Balance and moderation
• Quantity of food
• Strength and vitality
• Sympathetic quality
Balance: Yin/Yang
• Often practiced in Asian nations
• Keeping the body in harmony by use of yin and
yang
• Avoid extremes in both
• Staples are neutral/balanced
• Yin
o Raw
o Soothing
o Cooked at low temps
o White/light green in color
• Yang
o High caloric
o High heat
o Spicy
o Red-orange-yellow in color

11. ~ ANTONIO, Jevid Mirriam G.
Balance: Hot/Cold
• From the ancient Greek humoral medicine
o Air: cold
o Earth: dry
o Fire: hot
o Water: moist
• Four Body humors
o Hot and moist: blood
o Cold and moist: phlegm
o Hot and dry: yellow/green bile
o Cold and dry: black bile
• Used in the Middle East, parts of Latin America,
the Philippines, and India
• Based on hot/cold aspects of food
o Taste
o Preparation method
o Proximity to the sun
o Balanced to account for personal
constitution and weather
• Body must adjust to hot food before cold can
be eaten
• May be natural world balance or spiritual
harmony
QUANTITY OF FOOD
 In good health
 Heavy meals
o Ample food
o Overweight
 In illness or poor health
o Poor appetite
Strength & vitality
 Milk builds strong bones
 Carrots improve eyesight
 Candy for quick energy
 Chicken soup is a cure-all
 Strong foods/weak foods
 Strengthening foods
Sympathetic quality of food
• Looks like human body part or organ
• "You are what you eat
• Properties of food incorporated into physical
traits
• Italians drink red wine to improve blood
• American women use gelatin to strengthen
fingernails
• Ginseng increase strength and stamina
• Americans eat cabbage-family veggies to
reduce risk of cancer
• Oatmeal and fish to prevent heart disease
• Belief that fresh or local foods are healthiest
Disease, Illness, and Sickness
• Illness
o Perceptions of and reactions to a
physical or psychological condition
• Disease
o Abnormalities or malfunctioning of
body organs and systems
• Sickness
o Entire disease-illness process
Becoming sick
• Who is consulted when one becomes sick?
• Social legitimization of the illness
• Sick person is excused from daily obligations
• Temporary condition
Causes of illness in Biomedicine
• Immediate causes
o Bacterial/vital infections, toxins,
tumors, injury
• Underlying causes
o Smoking, high cholesterol, glucose
intolerance, nutritional deficiencies
• Ultimate causes
o Hereditary predisposition,
environment, obesity
Other Theories: Sickness Due to the Patient
• Attributable to constitution
• Lifestyle choices
• Genetic or Psychological vulnerability to illness
or disease
• Responsibility falls on patient
Other Theories: Sickness Due to the Natural World
 Environmental
o Weather, allergens
 Wind or bad air
o Enters body through pores, orifices

12. ~ ANTONIO, Jevid Mirriam G.
 Humoral
o Disharmony with environment
 Astrology
o Determines fate
 Natural forces
o Lightning, falling rocks
Other Theories: Sickness Due to the Social World
 Evil Eve
o Common belief
o Children most vulnerable
o Can project harm on another person
 Conjury
o Illness directed towards a person by
someone with imputed powers
Other Theories: Sickness Due to the Supernatural
World
 Caused by the actions of gods, spirits, or ghosts
of ancestors
 Spirit possession
 Malevolent spirits
 Soul loss
FOLK ILLNESSES: CULTURE BOUND SYNDROMES
 Soul loss
o Susto, espanto
 Muso
o Mental illness
 SUNDS
o Sudden unexpected nocturnal death
syndrome
 From strong emotions
o Bilis, Colera (stroke)
o Ceeb (cooling of blood and organs
o Wabyung (stomach and chest pain)
 Somatic complaints
o Dhat (loss of seman)
FOLK ILLNESSES: DIET RELATED
 High blood/low blood
 Imbalance in digestive system
o Numbness of extremities
 Si zhi ma mu
o Wad of food stuck
 Empacho
o Paralysis
 Pasmo
 Anorexia nervosa and bulimia nervosa
HEALING PRACTICES
• Biomedicine
o Diagnose and cure
• Healing
o Addresses the experience of illness
o Alleviates infirmities even when disease
is not evident
o Responds to personal, familial, and
social issues surrounding sickness
SEEKING CARE
• Biomedicine
o Emergency situations
o May be rejected due to cost,
impersonal, inconvenient or
inaccessible
• Home remedies
• Professional advice
• Depends on
o Cost
o Availability
o Previous care experience
o Referrals
o How the patient perceives the problem
FOLK HEALERS AND OTHER ALTERNATIVE
PRACTITIONERS
• May provide an understanding of illness within
the context of the patient's worldview
• Offer care beyond the cure of disease
o Sincere sympathy
o Renewed hope
o See Controversial Practices: Botanical
o Remedies
HEALING THERAPIES
• Home remedies
o Herbal teas
o Megavitamins
• Popular Therapies
o Chiropractic
o Homeopathy

13. ~ ANTONIO, Jevid Mirriam G.
o Hypnosis
o Massage
• Professional
• Therapies
• Biomedicine
• Traditional Chinese Medicine
• Ayurvedic medicine
o Ancient Asian
o Indian system of healing
3 BROAD CATEGORIES
• Administration of therapeutic substances
• Application of physical forces or devices
• Magicoreligious interventions
ADMINISTRATION OF THERAPEUTIC SUBSTANCES
• Pharmaceutical
• Diet prescriptions
• Botanical medicine
• Homeopathy
o Symptoms in illness are evidence that
the body is curing itself and
acceleration or exaggeration of the
symptoms speeds healing
o Like cures like
• Naturopathy
o Aids the body in healing itself usually
through noninvasive, natural
treatments
APPLICATION OF PHYSICAL FORCES OR DEVICES
• Chiropractic
o Misalignments of the spine
• Osteopathic
o Blood/lymph flow/nerve function
improve through manipulation of the
musculoskeletal system
• Massage therapy
• Acupressure
• Pinching
• Scratching techniques
• Coining
• Acupuncture
• Moxibustion
• Cupping
• Electrotherapies
• Biofeedback
• Hydrotherapy
MAGICORELIGIOUS INTERVENTIONS
 Spiritual healing practices
o Appeals to the saints
o Pilgrimages
o Correct conduct in this and past lives
o Virtuous behavior of ancestors
o Religious offerings
 Healing occurs through restoration of balance
 Actions by an individual
o Meditation
o Yoga
o Visualization or
o guided imagery
o Hypnotherapy
• Sacred healer
o Faith Healers
o Cajun traiteurs
o Powwowing
o Voodoo
o Shamans
o Medicine men