TRANSCULTURAL NURSING

PRESENTED BY : MUZAMIL QADIR

MSC NURSING I YEAR

INTRODUCTION:
⚫ Transcultural Nursing is a specialty with in Nursing
focused on the comparative study and analysis of
different cultures and sub- cultures. Various groups are
examined with respect to their caring behaviour,
nursing care, health and illness values, beliefs and
patterns of behaviour.
Culture:
⚫ Norms and practices of a particular group that are learned
and shared and guide thinking, decisions, and actions.
Cultural values:
⚫ The individual's desirable or preferred way of acting or
knowing something that is sustained over a period of time
and which governs actions or decisions.
DEFINITION:
Leininger defined transcultural nursing as: "A
legitimate and formal area of study, research, and
practice focused on culturally based care, values, and
practices to help cultures and sub-cultures maintain or
regain their health and face difficulties or death in a
culturally congruent and beneficial caring ways"
 Cont..

"Transcultural Nursing is a comparitive study of cultures to

understand similarities(cuture universal) and
differences(culture-specific) across human group."
HISTORY OF TRANSCULTURAL
NURSING
⚫ In 1950's Medeleine M. Leininger, known as the
foundress of Transcultural Nursing, noted cultural
differences between patients and nurses while working
with emotionally disturbed children. This experience
led to study clinical difference in perception of the
care. She recognized that health and illness states are
strongly influenced by culture and formulated the
theory of Transcultural Nursing.
⚫ In 1991, she published 'Culture Care Diversity And
Universality: A Theory Of Nursing'
⚫ Her theory has now developed into a discipline in nursing.
⚫ In 1988 Transcultural Nursing Society initiated
certification examinations: certified Transcultural Nurse
(CTN)
 GOAL
⚫ The goals of transcultural nursing is to give culturally
congruent nursing care, and to provide culture specific and
universal nursing care practices for the health and well-
being.
GUIDELINES FOR
TRANSCULTURAL NURSING

■ Become aware about the role of cultural influences.

■ Learn as much as possible about the belief system and
practices.
 CONT..

⚫ Practice techniques of observation and listening to acquire

knowledge of beliefs and values

⚫ "Keep in mind that health practices are part of the overall

culture and that changing them may have widespread
implications for the person
CONT...
■ Do not force the client to participate in care that
conflicts with his or her value.
■ Accommodate the cultural dietary practices of the
clients as much as possible.
■ Take into consideration the cultural role of the family
member who makes most of the important decisions.
CONT...
⚫ Seek assistance of a respected family
member.
⚫ Modify care to include folk practices.
⚫ Learn from your mistakes and do not
repeat them.
BARRIERS IN TRANSCULTURAL
■ No knowledge expansion
■ Racism Bias
■ Language
■ Difference in expectations
■ Fear and disgust
■ Difference in perception
■ Mistrust of health care
 IMPORTANCE OF
TRANSCULTURAL NURSING
1) There is a marked increase in the migration of people
within and between countries world wide.
2) There has been a 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.
3) The increased use of health care technology sometimes
conflicts with cultural values of clients.
⚫ World wide there are cultural conflicts, clashes, and
violence that have an impact health care as more cultures
interact with one another.
⚫ There was an increase in legal suits resulting from cultural
conflict, negligence, ignorance, and imposition of health
care practices.
⚫ There is an increase in the number of people travelling and
working in many different parts of the world.
⚫ There has been a rise in feminism and gender issues, with
new demands on health care systems to meet the needs of
woman and children
Cntd...,
⚫ There has been an increased demand for community
and culture based health care services in diverse
environmental contexts.
 MODELS OF TRANSCULTURAL
NURSING:
To help develop, test and organize the emerging body of
knowledge in Transcultural Nursing, it is necessary to
have a conceptual framework from which various
theoritical statements can emerge.
⚫ There are two popular models widely used in the field
⚫ Leininger's Sunrise Model
⚫ The Giger and Davidhizar: 'Transcultural Assessment
Model'
LEININGER'S SUNRISE MODEL
The model is based on the concept of culture care and
shows 3 major nursing modalities that guide nursing
judgments and activities to provide 'Culturally
Congruent Care'
3 major modalities are
⚫ Cultural care preservation/ Maintainance
⚫ Cultural care Accommodation/Negotiation
⚫ Cultural care Repatterning /Reconstructing.
Culturally Congruent Care: The care that
is beneficial and meaningful to the people
being served.
Culturally Diverse Nursing Care: An optimal
mode of health care delivery; It refers to the
variability of nursing approaches needed to
provide culturally appropriate care that
incorporates an individuals cultural values,
beliefs and practices including sensitivity to
the environment from which the individual
comes and to which the individual ultimately
return.
 The Giger and Davidhizar-
Transcultural Assessment Model

⚫ This model was developed in 1988 in response to the need

for nursing students in an undergraduate program to assess
and provide care for patients that were culturally diverse.
Giger and Davidhizar have identified six cultural
phenomena that vary among cultural groups and affect
health care.
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:
⚫ 1) dialect,
⚫ 2) style,
⚫ 3) volume, including silence,
⚫ 4) touch,
⚫ 5) context of speech or emotional tone, and
⚫ 6) kinesics, including gestures, stances, and eye behaviour
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 1/2 feet),
⚫ personal distance (extends from 1 1/2 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 ORIENTATION

⚫ Time is an important aspect of interpersonal communication.

Some cultures are considered future oriented, others present
oriented, and still others past oriented
Cntd..,
⚫ 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
Cntd...,

⚫ 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:

Biological variations are:

⚫ body structure,
⚫ skin colour,
⚫ other visible physical characteristics,
⚫ enzymatic and genetic variations,
⚫ electrocardiographic patterns,
⚫ susceptibility to disease,
⚫ nutritional preferences and deficiencies, and
⚫ psychological characteristics
 NURSING PROCESS AND ROLE OF
NURSE

⚫ Determine the client's cultural heritage and

⚫ language skills
⚫ Determine if any of his health beliefs
⚫ Collect information that any home remedies
 CONT...
⚫ Nurses should evaluate their attitudes toward ethnic nursing
care.
⚫ Self-evaluation
⚫ Understand the influence of culture, race & ethnicity
⚫ Identify the religious practices of the family
⚫ The planning of nursing care should be adapted as much as
possible to the client's cultural background.
 CONCLUSION

⚫ 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