A.

Practice Leininger identifies several factors related to the slowness of nurses to recognizes and value transcultural nursing and cultural factors in nursing practices and education. 1) The theory was conceptualized during 1950s when virtually no nurses were prepared in anthropology or cultural knowledge to understand transcultural concepts, models, or theory. 2) Although people had longstanding and inherent cultural needs, many clients were reluctant to push health personnel to meet their cultural needs and therefore did not demand that their cultural and social needs be recognized or met. 3) Until the past decade, transcultural nursing articles submitted for publication were often rejected because editors did not understand the relevance of cultural knowledge to transcultural nursing or as essential to nursing. 4) The concept of care was limited interest to nurses until the late 1970s when Leininger began promoting the importance of nurses studying human care, obtaining background knowledge in anthropology, and obtaining graduate preparation in transcultural nursing, research, and practice. 5) Contends that nursing that nursing tends to remain too ethnocentric and far too involved in following medicines interest and directions. 6) Nursing has been slow to make substantive progress in the development of a distinct body of knowledge, because many nurses researchers have been far too dependent on quantitative research methods to obtain measureable. Nurses are now gradually realizing the importance of cultural nursing and the need to understand cultures. Nursing is in a new phase of health emphasis where there is an increased display of cultural identity, accompanied by increased demands for culture specific care and general health services. The world is strongly multicultural and that we, as health personnel are anticipated to respond to our clients diverse cultural needs. Practice guides the nurse to provide holistic and culturally based care. In effective practice nurses help the client to care for themselves and others with a familiar, supportive, and meaningful context.

B. Education The inclusion of culture and comparative care in nursing curricula began in 1966 at University of Coloardo, where Leininger was professor of nursing and anthropology. Awareness of the importance of culture care to nursing gradually began to appear during the late 1960s, but very few nurse educators were prepared adequately to teach courses about transcultural nursing. This gave rise to the first doctoral program in transcultural nursing in 1977 at the University of Utah. Despite the encouraging outcomes, using care as the central theme in nursing curriculum needs further research on validation of its usefulness and effectiveness. Transcultural nurses are taught, guided, and mentored in ways to withhold and deal with their own biases and prejudices through formal courses and clinical experiences in transcultural nursing. Knowing the patient's cultural background would help the nurse to heighten his

or her awareness with his own beliefs, values, morals and prejudices. This would also foster understanding, respect and appreciation for the individuality and diversity of patients beliefs, values, spirituality and culture regarding illness, its meaning, cause, treatment, and outcome. It will also strengthen the nurses' commitment to relationship-centered nursing that emphasizes care of the suffering person rather than attention simply more to the pathophysiology of disease, and recognizes the essentiality of the nurse as a dynamic component of that relationship.

C. Research Basic and advanced research studies are being done and tested by nurses globally. Approximately 100 cultures and subcultures have been studied as of 1995 and more are in progress. There is a heightened interest on the part of consumers who are funding to continue research in transcultural nursing care. Nurse anthropologists and other nurses have contributed to international and regional/local workshops, conferences and instructional programs on transcultural nursing. Researchers in the field of transcultural nursing are expected to enhance theoretical development and will continue to identify culture-specific and universal care constructs. Researchers use sunrise model a conceptual visual guide depicting multiple factors predicted to influence culturally congruent care with people of different cultures. It severs as a cognitive guide for the researcher to visualize and reflect on different factors predicted to influence culturally based care in the discovery process. Transcultural nurses have stimulated many other nurses to pursue research and to discover some entirely new knowledge in nursing. This knowledge will greatly reshape and transform nursing in the future.

Due to the upturned needs for international understanding and nursing care, it is reasonable to predict that transcultural nurse specialists will be tomorrows leaders in education, research and service programs.

D. Administration Culturally competent care can only occur when clients beliefs and values are thoughtfully and skillfully incorporated into nursing care. The sunrise model valuable in curlturalogic health care assessments of client heath care needs. As researcher uses the model the different factors depicted in the model are kept in mind in relations to discovering cultural care phenomenon.

Analysis of its value and utility in extending nursing knowledge Transcultural nursing theory is really a broad, holistic, comprehensive perspective of human groups, populations, and species. According to Tomey and Alligood, 2006, this theory continues to generate

many domains of inquiry for nurse researchers to pursue for scientific and humanistic knowledge. The theory challenges nurses to seek both universal and diverse culturally based care phenomena by diverse cultures, the culture of nursing, and the cultures of social unsteadiness worldwide. Leiningers culture care theory is relevant worldwide to help guide nurse researchers in conceptualizing the theory and research approaches and to guide practice. Practicing nurses now have holistic, culturally based research findings for use in caring for clients of diverse and similar cultures or subcultures in different countries. The theory is not difficult to use once the researcher understands it and method and has mentor guidance. Newcomers to the theory and method can benefit from experienced, expert mentors in addition to studying transcultural research conducted using the theory and method. Most importantly, nurses often express that this theory and method are the only ones that it makes sense to use in nursing. They contend it is very natural to nursing and helps one to gain fresh new insights about care, health, and well being. Unquestionably, it is the theory of today and tomorrow and one which will grow in use in the future in our growing and increasingly multicultural world. The research and theory provide a new pathway to advance the profession of nursing and the body of transcultural knowledge for application in nursing practice, education, research, and clinical consultation worldwide. Tomey, A. & Alligood, M. (2006). Nursing Theorists and their Works. Mosby, Inc.

Handouts? http://www.asha.org/uploadedFiles/Cultural-Competence-Checklist-Service-Delivery.pdf