3. Outlines
Definition of Key terms
Transcultural nursing theory
Purpose of knowing transcultural nursing theory
The nursing process and LEININGER'S theory of culture care diversity and
universality
Role of nurse in transcultural nursing
Example of scenario according LEININGER'S Theory
4. Culture: is a way of life of a group of people-the behaviors, beliefs, values,
and symbols that they accept, and that are passed along by communication
and imitation from one generation to the next.
Ethnography: is the study and systematic recording of human culture.
Transcultural Nursing: is a comparative study of cultures to understand
similarities (culture universal) and differences (culture - specific) across
human groups.
6. Founder
As the initiator of and the leader in the field of transcultural nursing, Madeleine Leininger in the
early 1970's during her tenure as Dean of the School of Nursing at the University of Washington,
she was the first professional nurse who finished a doctorate degree in anthropology.
Initiation
During the 1950s, Leininger worked in a child guidance home and while she recognized the
importance of focusing on “care” early on, she was also surprised to observe stark differences in
child behavioral patterns based on differing cultural backgrounds.
Transcultural Nursing Theory
7. Cont…
Idea
The ideas sparked by her conclusion paved the way for Leininger to expand nurses’ knowledge and
understanding of diverse cultures that were lacking in healthcare at this time.
8. Objective
Leininger’s objective is for nurses to immerse themselves in cultural education and to implement a
style of care parallel to what the patient deems suitable according to his or her cultural expectations.
Transcultural nurse
The nurse who recognizes and respects culture diversity has culture sensitivity and provides nursing
care that accepts the culture factors in health and illness.
9. Purpose of knowing transcultural nursing Theory:
1. To heighten awareness for health care providers.
2. Nurses as the direct care providers must be prepared to function with transcultural nursing
knowledge and practices to ensure beneficial outcomes to people of different cultures
3. To prepare a new generation of nurses who would be knowledgble, sensitive, competent and
safe to care for people with different or similar lifeways, values, beliefs and practices in
meaningful, explicit and beneficial ways.
10. Cont…
4. To strengthen in their commitment to relationship-centered nursing that emphasizes care of
the suffering person rather than attention simply more to the pathophysiology of disease.
5. Increase in migration of people within and between countries world wide.
6. The increased of technology used sometimes conflicts with cultural values of clients.
7. Improve communication
8. Decrease patient length of stay
9. Decrease cost
12. The nursing process and LEININGER'S Theory
of Culture Care Diversity and Universality:
The nurse using Leininger's theory plans and makes decisions with clients with respect. the
nurse and the patient, who work together to identify, plan, implement, and evaluate nursing
care with respect to the cultural congruence of the care.
13. The nursing process and LEININGER'S Theory of Culture Care
Diversity and Universality:
1. Assessment
2. Planning
3. Implementation
4. Evaluation
14. Role of Nurse in Transcultural Nursing
1. Determine the client's cultural heritage and language skills.
2. Determine if any of his health beliefs relate to the cause of the illness or to the problem.
3. Collect information that any home remedies the person is taking to treat the symptoms.
4. Nurses should evaluate their attitudes toward ethnic nursing care.
5. Self-evaluation helps the nurse to become more comfortable when providing care to clients
from diverse backgrounds
6. Understand the influence of culture, race ðnicity on the development of social emotional
relationship & attitude toward health..
15. 7- Collect information about the socioeconomic status of the family and its influence on their
health promotion and wellness.
8. Identify the religious practices of the family and their influence on health promotion belief in
families48
16. 9. Understanding of the general characteristics of the major ethnic groups, but always
individualizes care.
10. The nursing diagnosis for clients should include potential problems in their interaction
with the health care system and problems involving the effects of culture.
11. The planning and implementation of nursing interventions should be adapted as much as
possible to the client's cultural background.
12. Evaluation should include the nurse's self-evaluation of attitudes and emotions toward
providing nursing care to clients from diverse sociocultural backgrounds.
13. Self-evaluation by the nurse is crucial as he or she increases skills for interaction.
17. Situation:
Mrs. N. and her family had recently immigrated from Cambodian. Mrs. N. had suffered
from severe rheumatoid arthritis and was receiving Methotrexate injections at home. Home
health staff couldn’t communicate directly with her because of language barrier, but they could
and they rely on Mrs. N.'s son to translate. However, his command of English was limited and
he was not knowledgeable about medical terminology or procedures. Over time, it was
determined that Mrs. N. needed a hip replacement, and should come into the clinic for
preoperative visits and teaching. For reasons that were unclear at the time, Mrs. N. failed to
keep her appointments.
18. Cross-Cultural Assessment Findings:
In an effort to understand more about this patient and why she was failing to
keep clinic appointments, with the help of her son, the cross-cultural assessment
questions were asked. It was learned that because Mrs. N. was such a recent
immigrant, having come from a very isolated, rural Cambodian farming
community, she had no knowledge of surgery being used to treat a problem such as
hers. She distrusted what the physicians wanted to do because she understood
nothing about hip replacement surgery. In her rural community, surgery was
performed only under dire, life-threatening circumstances.
19. Nursing diagnosis:
Impaired verbal communication related to speak Khmer language and
interpreter unavailable as evidenced by failing to keep clinic appointments.
Impaired social interaction related to recent move away from neighborhood
and friends of same ethnic group.
Ineffective management of therapeutic regimen related to impaired social
interaction.
20. Interventions:
When this information became known, a meeting was held with Mrs. N. her
son, key clinic staff, and the home health nurse. Mrs. N. and her son were
helped to understand that while surgery of this nature was unknown to them,
the procedure was frequently used to help arthritic patients and that staff
anticipated a successful postsurgical outcome. Staff worked with the son to
help him understand the necessary technical information so that he could
properly translate information.
21. Evaluation:
Within a short time, the surgery was agreed to and scheduled. The home health
nurse made a pre-operative visit and later followed through with Mrs. N.'s home
care. Mrs. N.'s progress and outcomes were significantly different the staff
asked the right questions and were sensitive to cross-cultural needs. The Sunrise
Enabler will be a useful tool for the nurse as she continues to systematically the
components of the patient's culture during the process of planning care. During
the planning phase, the nurse develops a plan of care
22. Cont …
• based on the data gathered and presents the plan of N. and her son for review and modification. This
process should result in culture care preservation or maintenance and accommodation because the
nurse implements the plan to
• promote health and well-being of Mrs. N. and her son in a way that is both Congruent with the life
ways of the congruent with current best practices.
• Evaluation is based on the nurse's observation that the process has resulted in culturally congruent
nursing care for Mrs. N. and her son. Throughout this process, the model may be applied
simultaneously to other problems as they are identified by Mrs. N. and the nurse. Culturally
congruent strategies will be planned to address those issues that are also compatible with current
best clinical practices.
