Transcultural nursing

Transcultural nursing
• Madeleine Leininger is regarded as the creator of the theory of transcultural nursing.

• Her theory has now evolved into a nursing discipline.

Her books explain the evolution of her theory:
• Transcultural nursing (1995) • Transcultural nursing diversity and universality (1991) (2002)
• Transcultural nursing theory is also known as culture care theory. • Her sunrise model depicts the theoretical framework (1997).
Concerning the theorist
• One of the first nursing theorists and global transcultural nursing consultants.
• MSN – Catholic University of Washington, D.C. • Ph.D. – University of Washington

For more information, visit leininger.
• Transcultural nursing is the comparative study of cultures in order to understand similarities (culture universal) and differences (culture specific) across human groups (leininger, 1991).
• Culture is the learned, shared, and transmitted values, beliefs, norms, and life way practices of a specific group that guide thinking, decisions, and actions in patterned ways.
• Each generation learns culture through both formal and informal life experiences.
• Language is the primary means of transmitting culture, and cultural practices frequently emerge as a result of the group’s social and physical environment.
• Cultural practices and beliefs evolve over time, but they largely remain constant as long as they meet needs.
• Religion is a set of beliefs in a divine or superhuman power (or powers) that must be obeyed and worshiped as the creator and ruler of the universe.
• An ethnic group is a group of people who share a common and distinct culture and who belong to a specific group.
Ethnicity is a sense of belonging to a group.
• The sense of belonging to a particular ethnic group or culture.
Culture-universals are values, behavioral norms, and life patterns that are shared by people from different cultures.
• Values, beliefs, and patterns of behavior that are distinctive to a specific culture.
• Objects are referred to as material culture (dress, art, religious arti1acts)
• Beliefs, customs, languages, and social institutions are examples of non-material culture.
• A subculture is made up of people who have their own identity but are related to a larger cultural group.
• A person who combines two cultures, lifestyles, and sets of values.
• Refers to the fact or state of being distinct. Diversity can exist between cultures as well as within cultural groups.
Acculturation occurs when members of a minority group adopt the dominant society’s attitudes, values, beliefs, and practices, resulting in a blended cultural pattern. I need writing help with my dissertation – cheap thesis writing services

• The state of being disoriented or unable to respond to a different cultural environment due to its sudden strangeness, unfamiliarity, and incompatibility with the stranger’s perceptions and expectations, which is distinguished from others by symbolic markers (cultures, biology, territory, religion).
• Ethnic groups have a shared social and cultural heritage that is passed down through generations.
• Refers to a person’s subjective view of their ancestors as well as a sense of belonging to a distinct group from other groups.
• The classification of people based on shared biologic characteristics, genetic markers, or characteristics. People of the same race do not all share the same culture.
• It is a thorough self-examination of one’s own background, recognizing biases, prejudices, and assumptions about other people.
• Care that fits the people’s valued life patterns and set of meanings – generated by the people themselves rather than based on predetermined criteria.
• Is the practitioner’s ability to bridge cultural gaps in caring, work with cultural differences, and enable clients and families to receive meaningful and supportive care.
Nursing decisions
Leininger (1991) identified three nursing decision and action modes to achieve culturally congruent care.
1. Cultural preservation or maintenance.
2. Cultural care accommodation or negotiation.
3. Cultural care repatterning or restructuring.
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.s• 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.s• 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.
Healerss• Within a given community, specific people are known to have the power to heal.
Immigrations• Immigrant groups have their own cultural attitudes ranging beliefs and practices regarding these areas.
Gender roless• 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 healths• Mental illnesses are caused by a lack of harmony of emotions or by evil spirits.s• 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 orientations• It is varies for different cultures groups.
Personal spaces• Respect the client’s personal space when performing nursing procedures.s• 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 information about 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. .
• 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). (andrews & boyle, 2002).

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