Chapter 1 Theoretical Foundations of Transcultural Nursing Copyright

Chapter 1: Theoretical Foundations of Transcultural Nursing Copyright © 2016 Wolters Kluwer Health | Lippincott Williams & Wilkins

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

Question • Is the following statement true or false? • Methods, rules, guidelines, and patterns of behavior about food practices can be described as culture-specific. Copyright © 2016 Wolters Kluwer • All Rights Reserved

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. Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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. ” Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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. Copyright © 2016 Wolters Kluwer • All Rights Reserved

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. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Historical and Theoretical Foundations of Transcultural Nursing • Transcultural nursing: – Dr. Madeleine M. Leininger, nurse anthropologist – Initial conception in the 1950 s – Formal creation as a specialty and new discipline within the profession in the 1960 s− 1970 s – Nurse scholars have generated a substantial and important body of theoretical, research, and evidencebased knowledge in TCN, which is ongoing. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Question • Is the following statement true or false? • Transcultural nursing has been formally considered a nursing specialty since 2000. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Answer • False • Rationale: Transcultural nursing was formally considered as a specialty and new discipline within the profession in the 1960 s and 1970 s. Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

Leininger’s Sunrise Enabler Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Answer • True • Rationale: Dr. Madeleine M. Leininger is credited with authoring both of these conceptual frameworks related to transcultural nursing. Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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. Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

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 Copyright © 2016 Wolters Kluwer • All Rights Reserved

TIP Model (cont. ) Copyright © 2016 Wolters Kluwer • All Rights Reserved

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. Copyright © 2016 Wolters Kluwer • All Rights Reserved

Question • Which of the following is an example of verbal communication? A. Avoiding eye contact B. Nodding to convey understanding C. Speaking another language D. Arms folded and legs crossed Copyright © 2016 Wolters Kluwer • All Rights Reserved

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. Copyright © 2016 Wolters Kluwer • All Rights Reserved