1. UNIT 5: INTRODUCTION TO TRANSCULTURAL
NURSING
MRS. ANA LOKI KOTOIMATUKU
PERSONAL PROFESSIONAL DEVELOPMENT/RESEARCH
UPDATED 28TH FEBRUARY, 2023

2. LEARNING OUTCOMES:
At the end of the lecture, the student will be able to:
1. Express the need for Transcultural Nursing.
2. Apply Madeleine Leininger's transcultural theory
to nursing care in Fiji today.
3. Explain the importance of self awareness in health
professionals.
4. Examine the ethical considerations in transcultural
nursing.

3. LEARNING OUTCOMES:
5. Discuss the twelve(12) cultural competency standards.
6. Discuss the individual nurses expected cultural
competencies.
7. Discuss the two(2) main health care organization
expected cultural competencies with regards to:
Governance & Administration and Language.

4. INTRODUCTION
 Transcultural nursing is an essential aspect of
healthcare today.
 The ever increasing multicultural population in
different countries poses a significant challenge to
nurses providing individualize and holistic care to
the patients.
 This requires the nurses to recognize and appreciate
cultural differences in healthcare values, beliefs and
customs.

5. INTRODUCTION
 Nurses must acquire the necessary knowledge
and skills in cultural competency.
 Culturally competent nursing care helps ensure
patient satisfaction and positive outcomes.
 Transcultural nursing shows how professional
nursing interacts with the concept of culture

6. DEFINITION: TRANSCULTURAL NURSING
 According to Madeleine Leininger, transcultural
nursing is a substantive area of study and practice that
focuses on the comparative cultural values of caring,
the belief and practices of individuals or groups of
similar or different cultures.

7. EXPRESS THE NEED FOR TRANSCULTURAL
NURSING IN HEALTH CARE
 According to Giger, 2017, states that
providing culturally and competency
care in the 21st century will be a
difficult task for many nurses.
 The need for transcultural nursing
will continue to be an important
aspect in health-care. (Maier-Lorentz
et al, 2008)
We are now at the crossroads
either we do nothing or do
something to help others.

8. EXPRESS THE NEED FOR TRANSCULTURAL
NURSING IN HEALTH CARE
 Studies reveal that “all health care providers need
to be prepared to meet the cultural needs of all
clients and patients.
 Be prepared to avoid cultural shocks.
 Minimize Ethnocentrism, cultural imposition,
cultural blindness, imposing cultural pains on
others.
 Let us not judge others by the color of their skin
but let us improve to communicate with them to
learn from them. (John Richardson, DON)

9. EXPRESS THE NEED FOR TRANSCULTURAL
NURSING IN HEALTH CARE
The need for Transcultural health care has
risen due to travel nurses, language barriers
and rise in human rights and expectations,
cultural conflicts, violence, and law suits.
We need to help others through assisting,
supporting them to improve their condition or
face death and disability with dignity.
We need to be caring and understand the
cultural values and cultural practices of our
clients or patients.((John Richardson, DON)

10. EXPRESS THE NEED FOR TRANSCULTURAL
NURSING IN HEALTH CARE
 Transcultural Nursing ensures that as professionals
we need to consider seriously that:“ No one choose to
be born, to the Race they are, the disability they may
have, the country they live, the socioeconomic status
they are brought up, or the skin color they have.
 Each individual person deserves to be respected for
who they have become.
 We need to respect how they respond to the different
environment and environmental influences.
 We only provide guidance to them if that influence is
harmful to their health and well being” and their
environment. …(JRSHOU-2013

11. EXPRESS THE NEED FOR TRANSCULTURAL
NURSING IN HEALTH CARE
 Nurses must acquire the necessary knowledge and
skills in cultural competency.
 Culturally competent nursing care helps ensure
patient satisfaction and positive outcomes.
 It identifies factors that define transcultural nursing
and analyses methods to promote culturally
competent nursing care.
 Culturally competent nurses have knowledge of other
cultural ways and are skilled in identifying particular
cultural patterns so that an individualized care plan is
formulated that will help meet the established
healthcare goals for that patient (Gustafson, 2005).

12. MADELEINE LEININGER TRANSCULTURAL
THEORY
Introduced the concept of Transcultural
Nursing in 1978 to explain cultural
competency.
The Transcultural Nursing
Theory or Culture Care Theory by
Madeleine Leininger involves knowing
and understanding different cultures.
 Concerning nursing and health-illness
caring practices, beliefs, and values to
provide meaningful and efficacious
nursing care services to people’s cultural
values health-illness context.

13. MADELEINE LEININGER TRANSCULTURAL
THEORY
 It focuses on the fact that different cultures have
different caring behaviors and different health and
illness values, beliefs, and patterns of behaviors.
 The cultural care worldview flows into knowledge
about individuals, families, groups, communities,
and institutions in diverse health care systems.
 This knowledge provides culturally specific
meanings and expressions about care and health.
 The next focus is on the generic or folk system,
professional care system(s), and nursing care.

14. MADELEINE LEININGER TRANSCULTURAL
THEORY
Leininger visited and studied more
than a dozen cultures worldwide.
 Information about these systems includes the
characteristics and the specific care features of
each.
 This information allows for the identification of
similarities and differences or cultural care
universality and cultural care diversity.
 Next are nursing care decisions and actions which
involve cultural care preservation/maintenance,
cultural care accommodation/negotiation, and
cultural care re-patterning or restructuring.
 It is here that nursing care is delivered.

15. MADELEINE LEININGER TRANSCULTURAL
THEORY
Sunrise Model of Madeleine
Leininger’s Theory
 The Sunrise Model is
relevant because it enables
nurses to develop critical and
complex thoughts about
nursing practice.
 These thoughts should
consider and integrate
cultural and social structure
dimensions in each specific
context, besides nursing
care’s biological and
psychological aspects.

16. IMPORTANCE OF SELF AWARENESS IN
HEALTH PROFESSIONALS
 Caring, the basis of good nursing, depends on you
knowing more about who you are.
 We cannot help others unless we have a clear idea
about who we are and what we value.
 Self-awareness is the ability to, and process of
consciously looking at oneself objectively.
 To identify and process information important to
one’s well-being.

17. IMPORTANCE OF SELF AWARENESS IN HEALTH
PROFESSIONALS
 Development of self is affected by biological,
psychological, social, and cultural factors.
 Awareness of self includes the ability to
recognize and evaluate the effects of internal and
external stimuli.
 These stimuli include behavior, needs, motives,
attitudes, values, feelings, perceptions,
assumptions, thoughts, beliefs, and interactions
with one’s environment.

18. IMPORTANCE OF SELF AWARENESS IN
HEALTH PROFESSIONALS
The ongoing process of self-awareness can be organized as
follows:
• Intrapersonal: focuses on exploring the nurses’ personal self and
examining personal thoughts
• Relational: allows oneself to analyze oneself in relation to other
people and connect personal thoughts and feelings with that of
others
• Extra-personal: continuously expands beyond personal self and
focuses on the analysis of the environment
• Contextual: focuses on intrapersonal, interpersonal and extra-
personal analysis within a given context or situation
• A cognitive activity

19. IMPORTANCE OF SELF AWARENESS IN
HEALTH PROFESSIONALS
Possessing a clear sense of self-awareness will help nurses engage
professionally with a diverse patient population and modify
behavior as needed.
The self-aware nurse is able to:
• Better assess one’s ability to provide care and assess patient needs
• Pivot when needed in evolving situations
• Prevent situations from getting out of control
• Maintain self-esteem and self-efficacy
• Be confident in difficult situations
• Build strong skills in the area of resilience, decision-making, and
communication
• Improve interpersonal and professional relationships

20. IMPORTANCE OF SELF AWARENESS IN
HEALTH PROFESSIONALS
Culture in health care settings are very challenging in
the sense that:
 Each person has a culture.
 Each health care provider has a culture that may be
different from that of the patient .
 Each profession and discipline within the health care
setting has a culture.

21. ETHICAL CONSIDERATIONS IN
TRANSCULTURAL NURSING
Ethics in cultures are affected by the following due to cultural diversity.
 Multiculturalism: no common moral principles are shared by all
cultures.
 Postmodernism: holds the stance that everything is social construction.
 Humanism : all human beings are equal in worth have common
resources and problems that they are alike in fundamental ways.
 Cultural imperialism: practice of extending the policies and practices
of one group to the minority groups.
 Cultural relativism: belief that the behavior and practices of people
should be judged only from the context of their cultural system.
 Cultural imposition: is the intrusive application of the minority groups
cultural view upon individuals and families.

22. TWELVE CULTURAL COMPETENCY
STANDARDS
TUTOTRIAL ACTIVITY
GROUP 1: STANDARD 1 & 2
GROUP 2: STANDARD 3 & 4
GROUP 3: STANDARD 5 & 6
GROUP 4 : STANDARD 7 & 8
GROUP 5 : STANDARD 9 & 10
GROUP 6 : STANDARD 11 & 12

23. THE INDIVIDUAL NURSE’S CULTURAL
COMPETENCIES
 Developing a self awareness without influencing other people’
backgrounds.
 Continue to learn clients culture under your care.
 Demonstrating knowledge and understanding of client’s culture,
health related needs, and meaning of health and illness.
 Accepting and respecting cultural differences in a manner that
facilitates the clients and the family’s ability to make decisions to
meet their needs and beliefs.
 Recognizing that the health care providers beliefs and values
may not be the same as the clients.

24. THE INDIVIDUAL NURSE CULTURAL
COMPETENCIES
 Resisting judgmental attitudes such as “different
is not as good”.
 Being open to new cultural encounters.
 Recognizing that the primary and secondary
characteristics of culture determine the degree to
which clients adhere to the beliefs, values, and
practices of their dominant culture.

25. THE INDIVIDUAL NURSE CULTURAL
COMPETENCIES
 Having contact and experience with the
communities from which clients come.
 Being willing to work with clients of diverse
cultures and subcultures.
Accepting responsibility for one’s own
education in cultural competence by
attending conferences, reading literature
and observing cultural practices

26. THE INDIVIDUAL NURSES CULTURAL
COMPETENCIES
 Promoting respect for individuals by
discouraging racial and ethnic slurs among co
workers.
 Intervening with staff behavior that is
insensitive, lacks cultural understanding or
reflects prejudice.
 Having a cultural general framework for
assessment plus cultural specific knowledge
about client.

27. GOVERNANCE AND ADMINISTARTION
 The organization must have a mission
statement and policies that address diversity.
 The board of Governance must include
members of the ethnicity of the community it
serves.
 A committee for cultural competencies exists
and includes the staff, managers,
administrators, chaplains , and members who
representative of the community.

28. GOVERNANCE AND ADMINISTARTION
The organization engages in community
diversity fairs.
The organization seeks resources from
federal state, and private agencies to
continually upgrade and integrate cultural
competence into care.
 The organization partners with diverse
community agencies.
 The organization networks with diverse
community leaders.

29. GOVERNANCE AND ADMINISTARTION
 Administrators, managers and staffs are
encouraged to be active in public policy for the
client base to whom they deliver.
 Policy statements include efforts to eliminate the
bias and prejudice of clients and staff.
 Programs reflect the needs of the diversity of the
community.
 The organization’s programs are advertised in
community newspapers , on the radio and
television in the languages of the community.

30. GOVERNANCE AND ADMINISTARTION
 The organization is willing to support a
mentoring program to entice recruitment into
the health professions.
 Data collected includes the race, ethnicity,
culture and language preferences of the staff
and client base.
 Patients right documents are in the major
languages served by the community.

31. GOVERNANCE AND ADMINISTARTION
 Fiscal resources are available for interpretation.
 The strategic plan reflects the needs of the
community.
 Pain scales are in diverse languages of the
population served.
HR recruitment and hiring activities reflect
the needs of the community.
Position descriptions and evaluation
practices reflect cultural competence.

32. GOVERNANCE AND ADMINISTRATION
 Conflict an grieving procedures reflects the
language of the staffs.
 Food choices are reflective of the client and
staff.
 The holiday calendar that is reflective of the
client population base
 Intake form reflects cultural assessment.

33. Language
 Developing skills and using interpreters ( includes
sign language) with patients and families who have
limited English proficiency.
 Providing patients with educational documents that
are translated into their preferred language.
 Providing discharge instructions at a level the patient
and the family prefer.
 Providing medication and treatment instructions in
the language the patient prefers.
 Using pain scales in the preferred language of the
patient.

34. END OF LECTURE!!!!
ANY QUESTIONS????????

35. REFERENCE
Andrews, M.M. (2003). Culturally competent nursing care. In M.M. Andrews,
J.S. Boyle, & T.J.Carr (Eds.), Transcultural concepts in nursing care (pp 18-
23). Philadelphia: Lippincott Williams & Wilkins.
Giger, N. J., & Davidhizar, E.R.(2004).Transcultural Nursing: Assessment and
Intervention(4th ed). St. Louis, Missouri: Mosby.
Giger, N.J.(2017). Transcultural Nursing Assessment and Intervention(7th ed). St
Louis, Missouri: Elsevier.