The Transcultural Theory Addressing Cultural Dynamics

The increasing population of immigrants in the United States has contributed to health disparities in the health care system. Cultural competence can remove health disparities by eliminating personal biases, and treating every person with respect. Simply recognizing and accepting different cultures is not enough, one must be able to consistently recognize and understand the differences in order to be culturally competent. Knowledge and culturally competent practices are a must for nurses to deliver quality care in our rapidly changing multicultural world (Edelman, 2014 p. 25).

“Health is influenced by culture and beliefs” (NRS-429V, 2011, p. 1). In order for the nurse to properly care for the patient, she must know and understand the patient’s culture. “Cultural care is a comprehensive model that includes the assessment of a client’s cultural needs, beliefs, and health care practices” (NRS-429V, 2011, p. 1). It is not enough to just know where the patient lives or where he came from. The nurse must embrace the concept of cultural competence and cultural awareness. This requires not only the awareness of the cultural beliefs and values of their patients, but also

Utilizing the culture care theory, nurses become knowledgeable of what constitutes health in understanding the meanings and symbols of the ways of culture. Care, caring knowledge, and actions are core components that will ensure the health or wellbeing of people in various cultures. Kaakinen et al (2015) asserts that clients may not be prone to nurse’s suggestions for health promotion because of cultural conflicts with the client’s belief and value systems.

Madeliene Leininger was one of the first people to recognize that cultural differences influence an individual’s response to health care activities and that these cultural differences also affect experiences of well-being, health, illness, disability and death. During her career, Leininger noticed eight factors occurring in the world around her that directly impacted people of different cultures. She used these factors to frame the theory of transcultural nursing, and today, they are still relevant. She observed a sharp increase in population migration between countries across the globe. She experienced people who

Leininger (1988) defined nursing as a transcultural phenomenon requiring knowledge of different cultures to provide care that is congruent with the clients’ life ways, social structure, and environmental context. This definition from the founder of transcultural care would support applying a cultural sensitive nursing care in the clinical setting, and highly linked to her definition of transcultural nursing as a legitimate and formal area of study focused on culturally based care beliefs, values, and practices to help cultures or subcultures maintain or regain their health (wellbeing) and face disabilities or death in culturally congruent and beneficial caring ways (Leininger, 1970, 1978, 1995). Moreover Leininger summarized the process of applying transcultural care as providing care that fits with cultural beliefs and life ways. From a professional perspective, it refers to the use of emic (local cultural knowledge and life ways) in meaningful and tailored ways that fit with etic (largely professional outsiders’ knowledge), in other words care should be individualized according to patient’s culture to promote holistic and effective nursing care.

The term culture is defined as “the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups” (Potter & Perry, 2013). With the increase of culturally diverse populations in the United States, it is important for nurses to practice cultural competence. Cultural competence is the ability to acquire specific behaviors, skills, attitudes, and policies in a system that permits “effective work in a cross-cultural setting” (OMH, 2013). Being culturally competent is essential because nurses who acknowledges and respects a patient’s health beliefs and practices are more likely to have positive health outcomes (OMH, 2012). Every culture has certain views and attitudes concerning

I have learned that it is important that educators  and health providers be trained on cultural competency to understand the population they are serving. Marks, Sims, and Osher (King, Sims, & Osher, n.d.) define cultural competency  as a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross–cultural situations" ( as cited in Cross et al., 1989; Isaacs & Benjamin, 1991). Health providers and educators should investigate demographic patterns or trends in the place where they live and work. This brings awareness of the types of cultures that they might come across when they are working with people. Organizations should integrate and implement policies that promote the value of  diversity, self-assessment, manage the dynamics of difference, acquire and institutionalize cultural knowledge, and adapt to diversity and the cultural contexts of communities they serve (Georgetown  University, 2004). Georgetown University (2004) also stresses that culture competency grows gradually and is always open for improvement.

Cultural competence can be defined as using the ability of one’s awareness, attitude, knowledge and skill to effectively interact with a patient’s many cultural differences. Madeline Leininger, a pioneer on transcultural nursing describes it this way; “a formal area of study and practice focused on comparative human-care differences and similarities of the beliefs, values and patterned lifeways of cultures to provide culturally congruent, meaningful, and beneficial health care to people” (Barker, 2009, p. 498). The importance of cultural diversity in healthcare allows for the delivery of appropriate cultural autonomy. Showing respect for others will lead to trust between nurse and

In order to deliver nursing care to different cultures, nurses are expected to understand and provide culturally competent health care to diverse individuals. Culturally competent care is tailored to the specific needs of each client, while incorporating the individual’s beliefs and values (Stanhope & Lancaster, 2006, p. 90). By being culturally competent, nurses are able to help improve health outcomes by using cultural knowledge and specific skills in selecting interventions that are specific to each client (Stanhope & Lancaster). Therefore, nurses “should perform a cultural assessment on every client with whom they interact with” (Stanhope &

Adapting to different cultural beliefs and practices requires flexibility and a respect for others view points. Cultural competence means to really listen to the patient, to find out and learn about the patient's beliefs of health and illness. To provide culturally appropriate care we need to know and to understand culturally influenced health behaviors. However, becoming culturally competent is a much more daunting task. Culture (and ethnicity) often influences a patient’s perceptions of health and illness. Therefore, if healthcare providers appear insensitive to cultural diversity, their actions may negatively affect the quality of the healthcare that they provide.

Cultural competence in health care describes the ability to provide care to patients with diverse values, beliefs and behaviors, including tailoring health care delivery to meet patients’ social, cultural and linguistic needs. The need for healthcare systems to increase cultural competence and personalize care for ethnic patient minorities should not be ignored. Healthcare systems should promote better understanding and communication between diverse ethnic patients and caregivers. Hospitals should design a system that caters to the needs of all the populations they serve and not just apply a one-size-fits-all approach. Becoming a culturally competent health care organization is a critical component in reducing health care disparities.

The development of the Giger and Davidhizar Transcultural Assessment Model (GDTAM) came about because of nursing students’ need to provide culturally diverse care for patients. The model acknowledges that each culture is individually unique and assesses them according to six phenomena: communication, space, social organization, time, environmental control, and biological variations. In this model “nurses must use transcultural nursing knowledge as a skill and an art to provide care to diverse populations in a culturally appropriate and competent manner” (Sagar, 2012, p. 57). It goes on to discuss how the model sees cultural competence as “a dynamic process implemented by an individual or health care agency by using significant interventions based on the client’s ‘cultural

Throughout this paper I will be pulling information from the Giger and Davidhizar Transcultural Assessment Model. It is pertinent for health care workers to be familiar with this model because of the growing affects that culture has on a patient’s view of disease prevention and health restoration. This model focuses on six cultural phenomena: communication, time, space, social organization, environmental control, and biological variations. It is important for nurses to utilize this tool while performing assessments on patients because of the substantial effects that each one has on a patient’s perspective. Every person is unique and knowing that no one perspective is universal will aid the nurse in treating each patient with culturally competent care.

The purpose of this paper is to discuss the eight reasons why transcultural nursing (TCN) is a necessary specialty, according to Dr. Madeleine Leininger. Dr. Madeleine Leininger was a pioneer in this field of nursing. I will define the meaning of cultural diversity and relate it to nursing practice. I will explain three ways that I provide culturally sensitive care to my patients. I work in an outpatient obstetrics and gynecology office, where we see many different cultures.

The premise of Madeleine Leininger ‘s Theory of Culture Care Diversity and Universality is that one must regard his or her patient both holistically and with respect to the patient’s given cultural background. Leininger aims to establish a nurse-patient relationship in which communication and collaboration are culturally congruent. Via such interactions, a nurse can hypothetically deliver individualized, culturally competent care. However, while Leininger’s theory has many benefits and clear applicability in a multicultural society, its execution may fall short due to the predominating social norms and values held by larger society.