Theoretical Foundations of Transcultural Nursing Chapter 1: Theoretical Foundations of Transcultural Nursing

Transcultural Nursing The blending of nursing and anthropology into an area of specialization within the discipline of nursing Conceptualized by Dr. Leininger A formal area of study that uses the concepts of culture and caring

Transcultural Nursing (cont.) Transcultural nursing (TCN) is a nursing specialty focused on the comparative study and analysis of cultures and subcultures. It examines these groups with respect to their: Caring behavior Nursing care Health–illness values and beliefs Patterns of behavior

Transcultural Nursing (cont.) Transcultural nursing’s goal is to: Develop a scientific and humanistic body of knowledge in order to provide nursing care that is both Culture specific Culture universal

Transcultural Nursing (cont.) Culture-specific refers to: Particular values, beliefs, and patterns of behavior that tend to be special or unique to a group and do not tend to be shared with members of other cultures Culture-universal refers to: The commonly shared values, norms of behavior, and life patterns that are similarly held among cultures about human behavior and lifestyles

Question Is the following statement true or false? Methods, rules, guidelines, and patterns of behavior about food practices can be described as culture-specific.

Answer True Rationale: The need for food is a culture-universal. Culture-specific determines methods, rules, guidelines, and patterns of behavior. For example, items that are considered to be edible; acceptable methods used to prepare and eat meals; rules concerning who eats with whom, the frequency of meals, etc.

Transcultural Nursing (cont.) Anthropology: The study of humans including their: Origins Behavior Social relationships Physical and mental characteristics Customs Development through time and in all places in the world

Transcultural Nursing (cont.) Culture (as defined by Leininger) the “learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group of people that guide thinking, decisions, and actions in a patterned way… Culture is the blueprint that provides the broadest and most comprehensive means to know, explain, and predict people’s lifeways over time and in different geographic locations.”

Transcultural Nursing (cont.) Influences a person’s definition of health and illness Oftentimes connotes a person’s racial or ethnic background. Culture also encompasses: Socioeconomic status Ability or disability Sexual orientation Age Occupation or profession

Transcultural Nursing (cont.) Ethnicity The perception of oneself and a sense of belonging to a particular ethnic group or groups. It can also mean feeling that one does not belong to any group because of multiethnicity. Currently five classifications; however, some people may identify with more than one ethnicity/race.

Transcultural Nursing (cont.) Race Refers to a group of people who share such genetically transmitted traits as skin color, hair texture, and eye shape or color. Races are arbitrary classifications that lack definitional clarity; all cultures have their own ways of categorizing or classifying their members.

Historical and Theoretical Foundations of Transcultural Nursing Dr. Madeleine M. Leininger, nurse anthropologist Initial conception in the 1950s Formal creation as a specialty and new discipline within the profession in the 1960s−1970s Nurse scholars have generated a substantial and important body of theoretical, research, and evidence- based knowledge in TCN, which is ongoing.

Question Is the following statement true or false? Transcultural nursing has been formally considered a nursing specialty since 2000.

Answer False Rationale: Transcultural nursing was formally considered as a specialty and new discipline within the profession in the 1960s and 1970s.

Leininger’s Contribution to Transcultural Nursing Theory of Culture Care Diversity and Universality Focuses on describing, explaining, and predicting nursing similarities and differences focused primarily on human care and caring in human cultures Sunrise Enabler Visual representation of the concepts of her theory. Based on the concept of cultural care that guides nursing judgments and activities to provide culturally congruent care

Leininger’s Sunrise Enabler

Leininger’s Contribution to Transcultural Nursing (cont.) Established the Transcultural Nursing Society (TCNS) TCNS Newsletter Created the Journal of Transcultural Nursing (JTN) and served as founding editor Established the first master’s and doctoral programs in nursing with a theoretical and research focus in TCN Created a new qualitative research method called enthnonursing research to investigate phenomena of interest in TCN

Question Is the following statement true or false? Dr. Madeleine M. Leininger authored both conceptual frameworks, the Theory of Culture Care Diversity and Universality and the Sunrise Model.

Answer True Rationale: Dr. Madeleine M. Leininger is credited with authoring both of these conceptual frameworks related to transcultural nursing.

Advancements in Transcultural Nursing Expanded models by nursing scholars: Giger and Davidhizar Transcultural Assessment Model Purnell Model for Cultural Competence Campinha-Bacote Model of Cultural Competence in the Delivery of Healthcare Services

Advancements in Transcultural Nursing (cont.) The Core Curriculum has been established to support TCN practice with a core base of knowledge. Used in a variety of practice settings. Two certifications offered in TCN, basic and advanced.

Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model A new model, uses the scientific process for delivering culturally congruent, 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

TIP Model (cont.) Components of the model; the context from which people's health-related values, attitudes, beliefs, and practices emerge: Interprofessional Health Care Team Communication Problem Solving

TIP Model (cont.) Interprofessional 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

TIP Model (cont.) 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

TIP Model (cont.) Problem solving 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

TIP Model (cont.)

TIP Model (cont.) 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.

Question Which of the following is an example of verbal communication? Avoiding eye contact Nodding to convey understanding Speaking another language Arms folded and legs crossed

Answer C. Speaking another language Rationale: Speaking another language is a verbal communication method. This is an example of the spoken word versus nonverbal communication, which is conveying meaning without words.