1. Transcultural Nursing Theory: Sunrise Model
Madeleine Leininger
Transcultural Nursing Theory:
Sunrise Model

2. What is Transcultural Nursing?
"a discipline of study and practice focused on comparative culture care differences and similarities among and between cultures in order to assist human beings to attain and maintain meaningful and therapeutic health care practices that are culturally based" (Leininger, 2008, p.9).

3. Motivation for theory development
In the 1950's working as a clinical nurse specialist with disturbed children in the Midwest United States, Leininger noticed recurrent behavioral differences among the children and hypothesized the differences had a cultural base.
This experience led Leininger to becoming the first nurse to earn a doctorate in anthropology and precipitated the development of Transcultural nursing. (

4. Cont...
Through interactions with patients and conversations with peers  Leininger identified "two major missing dimensions in nursing, namely knowledge of diverse cultures and the meaning and practices of care in diverse cultures" (Leininger, 2008, para 4).

5. Philosophical Roots of Leininger's Theory
Leininger states that the philosophical roots of her theory are:
  extensive and diverse nursing experiences
  anthropological insights
  life experiences and values
  reflection upon spiritual insights and beliefs
The theorist created a theory to develop "new practices for nursing to meet diverse cultural needs and to provide therapeutic care with comprehensive and holistic care practices in a caring discipline" Leininger, 2008, p.10)
    

6. Transcultural Nursing Theory Concepts
Transcultural nursing theory incorporates research from numerous scientific disciplines: 
    1.  Nursing
    2.  Medicine
    3.  Education
    4.  Psychology
    5.  Public Health
    6.  Epidemiology
(Murphy, S. C., 2006)    

7. INTERRELATIONSHIP Culturally Competent Nursing Care
-promote human rights and 
    quality health care through 
    cultural awareness
-centered on universal aspect
    of human caring as 
    defined within each culture
-assess cultural needs  and
    integrate nursing care that 
    is congruent with cultural 
    values  
    
Transcultural Nursing Research
-address cultural conflicts 
    within healthcare beliefs
-nursing care that is beneficial
    and meaningful to all cultures
-increase knowledge base to 
    improve cultural competence
-impact global healthcare 
    policy and practices
(Transcultural Nursing Society, 2012)

8. Culturally Congruent Nursing Care
Culturally congruent nursing care occurs when nurses integrate information from individuals, family, community, or institution based on cultural:
 beliefs
 values
 norms
 patterns/lifeways
 practices
to provide appropriate and meaningful nursing care.
(Leininger, M. M., 1997)

9. Metaparadigm Concepts
CARING (not Nursing)
essence of nursing
universal concept within all cultures 
assisting, supporting, or enabling behaviors to improve a person's condition
essential for survival, development, ability to deal with life's events
greater level of wellness is achieved when caring is in line with patient's cultural values and beliefs
(Andrews, M. M., Boyles, J. S., 2002)

10. Metaparadigm Concepts
PERSON
 Some cultures  do not recognize the concept of "person".  Leininger's definition includes:
individuals
families
groups
communities
(Andrews, M. M., Boyles, J. S., 2002)

11. Metaparadigm Concepts
ENVIRONMENT
 The environmental context includes any events
physical
ecological
sociopolitical
cultural

12. Diversity and Universality Theory:  The Origins of Leininger's Transcultural Nursing Theory
"During the 1950's, while working in a child guidance home, Leininger
experienced what she describes as a culture shock when she realized that 
recurrent behavioral patterns in children appeared to have a cultural basis.  
Leininger identified a lack of cultural and care knowledge as the missing link to 
nursing's understanding of the many variations required in patient care to 
support compliance, healing, and wellness.  These insights were the 
beginnings of a new construct and phenomenon related to nursing care called  
transcultural nursing".
                                                                                    (Jones & Bartlett, 2012)

13. Evaluation of Transcultural Nursing Theory
Clarification of Origin
Originally developed in 1950s
Leininger's 1st book, Cultural Care Diversity and Universality - Published 1991
Transcultural Nursing (2nd ed.) - Published 1995
Transcultural Nursing (3rd ed.) - Published 2002
    
 Though the transcultural nursing theory model is applicable to nursing, its principals can be thought to be important in most professional circumstances.
To achieve the highest degree of patient compliance, healing, and wellness, the theory accounts for the cultural aspects of the patient.                      (
                                                                       

14. Evaluation of Transcultural Nursing Theory
Content
Human being- Nurses need humanistic and scientific transcultural knowledge in order to adequately care for patients in the 21st century.
Environment-  Care values are influenced by many things including worldview, spirituality, and environment.
Health- Care specific to one's culture promotes health, as valued and defined by each culture.
Nursing- Since 1989 nurses have been able to receive global certification in transcultural nursing, gaining knowledge and awareness of the cultural needs of patients, making them able to provide culturally congruent, responsible and compassionate care.                         (Leinninger, M. M., 1997)

15. Evaluation of Transcultural Nursing Theory
View
The transcultural nursing model can be used in  all aspects of nursing care, but proper use of the    model can only be achieved 
      if the patient's values are        known and meaningfully       used in an appropriate way       by the nurse with the patient.
   
       
                                                                                                                (

16. Evaluation of Transcultural Nursing Theory
                    Practice situations
Transcultural Nursing Theory should be
      practiced in all professional situations.
Examples:
Dietary restriction (kosher) for people of Jewish faith. 
Providing vegetarian meal options for Catholics
          on Fridays.
Direct eye contact for Asian/Vietnamese means a challenge and should be avoided.
It is customary to address elder Americans as well as people of Arabic and Muslim faith formally. 

17. Weblinks

18. References
Leininger, M. (1997, Winter). Transcultural nursing research to tranform nursing education  
        and practice: 40 years. Image:  Journal of Nursing Scholarship, 29(4), 341+.Retrieved
        from
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