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Transcultural nursing is based on the work of Dr. Madeleine M. Leininger who in the 1950s noted differences between nurses and patients when working with emotionally disturbed children. Based on this clinical experience, she studied cultural differences in perceptions of care and earned a doctorate in 1965 (Andres & Bolye, 2016). Based on this study, Leininger realized that anthropology contributed to nursing by helping with the realization that culture strongly influenced illness states. With the need to develop, test and organize the emerging body of knowledge on transcultural nursing, it became necessary to create a specific framework for the emergence of various theoretical states.
The Leininger’s Sunrise model, which shows three major nursing modalities, was the first guide nursing judgment that considers culturally appropriate and congruent care. The Leininger’s Sunrise Enabler for theory of culture care diversity and university is the earliest model for cultural care. Moreover, to foster excellence in transcultural nursing practice, eight standards that give criteria for evaluating transcultural nursing and tools for teaching and learning were developed (Del Grosso, 2019). The eight cultural nursing standards are accompanied process and outcome criteria and a rationale.
Another vital component in the history and theoretical foundations of transcultural nursing was the development of a logo with the message, ‘Many Cultures One world.’ With the logo, nurses were challenged to function in transcultural environments (Del Grosso, 2019). Every person in the world would be met through the new mantra.
With the ever-increasing multicultural environment in most parts of the world, transcultural nursing continues to become an essential part of healthcare. The world is continuously becoming a global village which requires nurses to appreciate the differences in cultural values, beliefs and customs of their patients. Nurses are required to acquire the necessary skills and knowledge than ensure they provide culturally competent care. The ability to comprehend cultural diversity and use this understanding in delivery of care promotes the quality of outcomes.
Transcultural nursing helps ensure positive patient care outcomes and satisfaction of healthcare clients. According to Edwards (2019), transcultural perspectives are vital in shaping patient’s beliefs about their own health and the healthcare system. As the representative of the healthcare system, the nurse is vested with the responsibility of providing the best care for patients. By taking into considerations the cultural backgrounds of the patients, the nurse is able to provide tailor-made patient care that ensure the satisfaction of individual patients and overall quality of health.
In the ever increasingly dynamic world, transcultural nursing ensures that nurses give the best care and increases the quality and outcomes. Transcultural nursing considers the sensitivity, concerns and risk factors of a variety of cultures (Edwards, 2019). It hence ensure that the nurse understands and overcome potential barriers in delivering care. Having an understanding of the needs and requirements of a patient creates a positive attitude towards a healthcare system and promotes quick recovery.
Dr. Madeleine Leininger is credited as the developer of the transcultural nursing concept. She developed the cultural care theory that promotes the provision of culturally congruent nursing care. Based on the theory, culturally congruent nursing care is based on cognitively based assistance, supportive, and tailor-made to meet the needs of individuals or groups based on their lifeways and cultural values and beliefs (Andres & Bolye, 2016). The care under Leininger’s theory fits and has beneficial meaning for people who are differently and similarly cultured.
Leininger developed the Sunrise model and coined the eight factors that guide on the transcultural care. She holds that for nurses to provide appropriate, comprehensive and appropriate care, nurses need to expand their worldview and incorporate new dimensions including social structures, language, environmental contexts, generic care and other areas (Andres & Bolye, 2016). The sunrise model is the theoretical framework that guides the creation of other transcultural nursing theories.
Leininger proposed three modes of guiding nursing care judgments, actions and decision that are beneficial and meaningful. These include preservation and maintenance, accommodation and negotiation and repatterning and restructuring. These three modes of care have significantly impacted how nurses provide congruent nursing care and fostered the creation of nurses that are culturally competent. In summary, Leininger can be considered the original creator of the concept of transcultural nursing (Andres & Bolye, 2016). She developed the processes that are vital in the provision of competent nursing care.
Andrew/Boyle’s Transcultural Interprofessional Practice (TIP) model is one of the most important nursing tools that can be applied in teaching, learning, consultation, research and practice by nurses in transcultural environments (Andrews & Boyle, 2019). There are key components of the Transcultural Interprofessional Practice (TIP) model. The model aims at providing patient centered care, based on logical and orderly decision making for safe culturally competent and congruent, evidence based affordable and quality for individuals from a variety of backgrounds and across different lifespans.
The first one is the context from which the health related values, practices, believes and attitudes emerge. The context may be based on religion, ethnicity, geographical location or other factors in the environment of the client or patient (Andrews & Boyle, 2019). Under this component, the nurse is expected to transform their thinking to suit the religious, ethnical and cultural believes, attitudes and practices of their patient so that they offer appropriate healthcare services.
The second component of the TIP model is the interprofessional healthcare team. Interprofessional collaboration is necessary in the provision of transcultural patient centered care. Based on this component, a healthcare team composed of a cadre of health professionals that include nurses, physicians, laboratory technicians, pharmacists, nutritionists, social workers and other workers should collaborate in providing quality and patient centered care to patients (Andrews & Boyle, 2019). A healthcare team comprised of people with complementary skills committed to a common purpose and performing goals aimed at the welfare of a patient or a group of patient is advocated by Andrew and Boyle.
The third component of the TIP model is effective verbal and non-verbal communication among members of a team. In an interprofessional team, effective communication is necessary for the promotional of continuity and clarity in the patient care team. Poor communication creates room for medical errors (Andrews & Boyle, 2019). With clarity of orders, proper interpretation of information, and timely communication, quality and safety of patient care is assured.
The fourth component is a scientific problem solving process of five systematic steps, scientific problem solving, mutual goal setting, implementation, evaluation and planning to ensure the effectiveness of therapeutic interventions and care. This component encourage the use of evidence based care. It requires that nurses and other healthcare personnel learn how to use evidence from research to provide the best possible care for their clients.
Andres, A.M. & Bolye, J.S. (2016). Transcultural Concepts in Nursing Care (7th ed.).
Andrews, M. M., & Boyle, J. S. (2019). The Andrews/Boyle Transcultural Interprofessional Practice (TIP) Model. Journal of Transcultural Nursing, 30(4), 323-330.
Del Grosso, A. (2019). Application of Leininger’s Culture Care Theory in Family Medical History.
Edwards, A. M. E. (2019). Implementation of a Transcultural Nursing Education Program to Improve Nurses' Cultural Competence.
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