TRANSCULTURAL NURSING

Nursing has developed several models of care delivery to help explain relationships
between the nurse and culturally diverse clients and their families. Transcultural nursing
incorporates concepts found in nursing, sociology, anthropology, and psychiatry. Perhaps the
best known model and theory come from Madeleine Leininger, identified as the founder of
transcultural nursing theory, who began her research of transcultural nursing in the 1960’s.

Madeleine Leininger
• A nurse scientist and anthropologist, has developed the Cultural Care Diversity and
Universality theory over the past three decades. She developed this theory in response to
her growing conviction that culture dictates the way that individuals should receive care,
based on the different ways that cultures meet their basic needs and respond to human
interaction (Leininger, 1991). According to her theory "Cultural care involves those
facets of culture that deal with individual and group health and well being, including
efforts to improve upon the human condition or to deal with illness, handicaps, or death"
(Frisch & Frisch, 1998). Leininger (1991) theorized that every culture had access to some
form of folk or indigenous health care system and that some, but not all, had access to a
professional health care system.
• She saw the urgent need for transcultural nursing in the mid 1950's. She also felt that
transcultural nursing was an essential nursing and healthcare need worldwide.

Transcultural Nursing
• Was defined as "a humanistic and scientific area of formal study and practice in nursing
which is focused upon differences and similarities among cultures with respect to human
care, health, and illness based upon the people's cultural values, beliefs, and practices,
and to use this knowledge to provide cultural specific or culturally congruent nursing care
to people" (Fernandez, 1997-2001). Essentially, transcultural nursing has focused on
understanding cultures and their specific care needs and how to provide care that fits their
lifeways rather than assuming professional nurses always know what is best for them.
• When establishing transcultural nursing more then four decades ago, Leininger (1998)
held that "Care is the heart of nursing; Care is power; Care is essential to healing (or
 well-being); Care is curing; and Care is (or should be) the central and dominant focus of
nursing and transcultural nursing decisions and actions". Transcultural nursing promotes
and upholds these ideas because human beings are born, live, work and die within a
culture care context and viewpoint. To neglect cultural factors such as one's religion,
family ties, and economical, political, educational and technological factors can lead to
non-caring and cultural negligence with often non-beneficial outcomes (Leininger, 1998).
• Defined as a humanistic and scientific area of formal study and practice in nursing which
is focused upon differences and similarities among cultures with respect to human care,
health, and illness based upon the people's cultural values, beliefs, and practices, and to
use this knowledge to provide cultural specific or culturally congruent nursing care to
people.
• Leininger (1991) notes the main goal of transcultural nursing is to provide culturally
specific care. But before transcultural nursing can be adequately understood, there must
be a basic knowledge of key terminology such as culture, cultural values, culturally
diverse nursing care, ethnocentrism, race, and ethnography.

Definition of Terms:
1. Culture refers to norms and practices of a particular group that are learned and
shared and guide thinking, decisions, and actions.
2. Cultural values are the individual's desirable or preferred way of acting or
knowing something that is sustained over a period of time and which governs actions or
decisions.
3. Culturally diverse nursing care is an optimal mode of health care delivery,
refers to the variability of nursing approaches needed to provide culturally appropriate care
that incorporates an individual’s cultural values, beliefs, and practices including sensitivity to
the environment from which the individual comes and to which the individual may ultimately
return. (Leininger, 1985).

SPECIALIZATION
In the early 1900s, Max Weber, one of the pioneers of modern sociology, designed a
perfectly rational organizational form, called a bureaucracy. Among the characteristics of this
"ideal" organization were specialization, division of labor, and a hierarchical organizational
design.
Division of labor is a form of specialization in which the production of a product or
service is divided into several separate tasks, each performed by one person. According to
Weber's design, inherent within the specialization and division of labor is knowledge of the
precise limit of each worker's "sphere of competence," and the authority to perform individual
tasks without overlapping others.
Adam Smith, an early economist, suggested that productivity would rise significantly
when the division of labor principle was used. Output per worker would be raised while costs per
unit produced would be reduced. Division of labor was applied, for example, in manufacturing
plants that incorporated mass production techniques. In organizations that used mass production,
each worker specialized in completing one specialized task; the combined work of several
specialized workers produced the final product. For example, in manufacturing an automobile,
one worker would assemble the dashboard, an other would assemble the wheels, and yet another
would paint the exterior.
Since the time of Adam Smith, division of labor has been perceived as a central feature of
economic progress. Two aspects of labor exist. First is the division of labor within firms; this
concerns the range of tasks performed by workers within a particular firm. Second is the division
of labor between firms; this concerns the range of products or services the firm produces.