L6 Leininger, Travelbee, Pender
non-traditional, such as spiritually based
MADELEINE LEININGER
Culture Care Theory
Transcultural Nursing
● That the culture care needs of people in
the world will be met by nurses prepared
in Transcultural Nursing.
● Defined as a formal area of study and
practice focused on comparative human
care (caring) differences and similarities of
the beliefs, values, and patterned lifeways
of cultures to provide culturally congruent,
meaningful, and beneficial health care to
people.
● is a study of cultures to understand both
similarities and differences in patient
groups.
● nurses practice according to the patient’s
cultural considerations
CULTURE
● is a set of beliefs held by a certain group
of people, handed down from generation
to generation.
● is the learned, shared and transmitted
values, beliefs, norms and life way
practices of a particular group that guide
thinking, decisions, and actions in
patterned ways.
Why is it beneficial for nurses to use cultural
knowledge to treat patients?
● It helps nurses to be aware of ways in
which the patient’s culture and faith
system provide resources for their
experiences with illness, suffering, and
even death.
● It helps nurses to be understanding and
respectful of the diversity.
● It helps strengthen a nurse’s commitment
to nursing based on nurse-patient
relationships and emphasizing the whole
person rather than viewing the patient as
simply a set of symptoms or an illness.
● It helps a nurse to be open minded to
treatments that can be considered
therapies like meditation and anointing.
Transcultural Nursing Theory
● Nurses have a responsibility to understand
the role of culture in the health of the
patient. Not only can a cultural
background influence a patient’s health,
but the patient may be taking home
remedies that can affect his or her health,
as well.
CULTURALOGICAL ASSESSMENT
● Which takes the patient’s cultural
background into consideration in
assessing the patient and his or her
health.
● Once the assessment is complete, the
nurse should use the culturalogical
assessment to create a nursing care plan
that takes the patient’s cultural
background into consideration.
CULTURAL AWARENESS
● It is an in-depth self-examination of one's
own background, recognizing biases and
prejudices and assumptions about other
people.
CULTURALLY CONGRUENT CARE
● Care that fits the people's valued life
patterns and set of meanings which is
generated from the people themselves,
rather than based on predetermined
criteria.
CULTURALLY COMPETENT CARE
● Is the ability of the practitioner to bridge
cultural gaps in caring, work with cultural
differences and enable clients and families
to achieve meaningful and supportive
caring.
CULTURAL SHOCK
● The state of being disoriented or unable to
respond to a different cultural environment
because of its
○ sudden strangeness
○ Unfamiliarity
L6 Leininger, Travelbee, Pender
○ incompatibility to the stranger's
perceptions and expectations and
is differentiated from others by
symbolic markers
(cultures, biology, territory,
religion).
CULTURAL CARE
● Refers to the subjectively and objectively
learned and transmitted values, beliefs
and patterned lifeways that assist,
support, facilitate, or enable another
individual or group to maintain their
well-being, health, to improve their human
condition and lifeway, or to deal with
illness, handicaps, or death
CULTURAL CARE DIVERSITY
● Refers to the variabilities and / or
differences in meanings, patterns, values,
lifeways, or symbols of care within or
between collectivities that are related to
assistive, supportive or enabling human
care expressions
ETHNOHISTORY
● Refers to those past facts, events,
instances and experiences of individual,
groups, cultures and institutions that are
primarily people-centered (ethno) and that
describe, explain, and interpret human
lifeways within particular cultural contexts
and over short or long periods of time
GENERIC (FOLK OR LAY) CARE SYSTEM
“EMIC”
● Refer to culturally learned and transmitted,
indigenous (or traditional ), folk (home
based) knowledge and skills used to
provide assistive, supportive, enabling or
facilitative acts toward or for another
individual, group or institution with evident
or anticipated needs to ameliorate or
improve a human lifeway or health
condition (or well-being) or to deal with
handicaps and death situations
PROFESSIONAL CARE SYSTEM “ETIC”
● Refers to formally taught, learned and
transmitted professional care, health,
illness, wellness and related knowledge
and practice skills that prevail in
professional institutions usually with
multidisciplinary personnel to serve
consumers
THREE NURSING DECISIONS AND
ACTIONS TO ACHIEVE CULTURALLY
FRIENDLY CARE FOR THE PATIENT
1. CULTURAL PRESERVATION OR
MAINTENANCE
● Deals on the nursing care aspect with the
goal of helping in the preservation or
maintenance of favorable health and
caring lifestyle. This entails that in
maintaining homeostasis, the nurse or the
healthcare provider must be sensitive in
the idiosyncrasies and uniqueness of the
patient.
● Paying special attention to cultural beliefs
and traditions will aid in a more efficient
facilitation of caring for the individual.
2. CULTURAL CARE ACCOMMODATION OR
NEGOTIATION
● The nurse must be able to adapt or
negotiate with the client by taking into
account the particular culture the client
belongs to.
● The nurse must recognize that in order to
be effective, he/she must take into
account the possible differences of the
client’s beliefs from his/her own. By
acknowledging this fact, the nurse will not
come across too strong and will not
appear as imposing.
● The nurse must accept the differences
and manage to reach into a compromise
can eventually lead to a more sustainable
healthcare plan for the client because
encroachment on beliefs is minimized.
3. CULTURAL CARE REPATTERNING OR
RESTRUCTURING
● Dwells on idea that people are capable of
modifying their lifestyles to accommodate
new healthcare ways or patterns. It further
expounds that individuals have the
capacity to change and are open to try
L6 Leininger, Travelbee, Pender
new practices as long as they think that
the results are culturally meaningful and
satisfying.
● For the nursing practice, the repatterning
aspect of this model is a useful tool in
trying to “bend” or flex some of the
stringent beliefs or habits of the client by
including them in their own healthcare
plan. This further implies that considering
the cultural background of an individual
does not necessarily mean being certain
practices are better left alone.
JOYCE TRAVELBEE
Human to Human Relationship Model of Nursing
ASSUMPTION
the concepts of existentialism by Kierkegaard and
logotherapy by Frankl.
EXISTENTIALISM
● believes that humans constantly face
choices and conflicts and are accountable
to the choices they make in life.
LOGOTHERAPY
● is meaning-centered psychotherapy based
on the assumption that meaning fulfilment
in life is the best protection against
emotional instability.
METAPARADIGMS
PERSON
● "a unique irreplaceable individual—a
one-time being in this world, like yet unlike
any person who ever lived or ever will live“
● Human beings are evolving; they are ever
in the present but becoming. As we
understand our own humanness, we grow
and develop more humanness.
HEALTH
● Subjective health: is an individually
defined state of well being in accord with
self-appraisal of the
physical-emotional-spiritual status.
● Objective health: is an absence of
discernible disease, disability of defect as
measured by physical examination,
laboratory tests and assessment by
spiritual director or psychological
counselor.
NURSING
● is defined as “an interpersonal process
whereby the professional nurse
practitioner assists an individual, family or
community to prevent or cope with
experience or illness and suffering, and if
necessary, to find meaning in these
experiences.”
BASIC CONCEPT
SUFFERING
● “an experience that varies in intensity,
duration and depth…a feeling of unease,
ranging from mild, transient mental,
physical or mental discomfort to extreme
pain”
MEANING
● which is the reason attributed to a person
NURSING
● helps a person find meaning in the
experience of illness and suffering;
and the nurse’s spiritual and ethical choices, and
perceptions of illness and suffering, which are
crucial to help patients find meaning.
HOPE
● which is faith that there will be change that
would bring something better.
Six important characteristics of hope are:
1. Dependence on other people.
2. Future orientation.
3. Escape routes.
4. The desire to complete a task or have an
experience.
5. Confidence that others will be there when
needed.
6. The acknowledgment of fears and moving
forward towards its goal.
COMMUNICATION
● “a strict necessity for good nursing care
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SELF-THERAPY
● This refers to the nurse’s presence
physically and psychologically.
● the ability to use one’s own personality
consciously and in full awareness to
establish relatedness and to structure
nursing interventions
TARGETED INTELLECTUAL APPROACH
● by the nurse toward the patient’s situation.
5 PHASES OF
INTERACTION PROCESS
● The initial meeting or original encounter.
● The visibility of personal and emerging
identities.
● EMPATHY.
● SYMPATHY.
● Establishing mutual understanding and
rapport
SYMPATHY
● Refer to “feelings of loyalty" or
"unity or harmony in action or effect”.
implies sharing (or having the capacity to share)
the feelings of another, while
EMPATHY
● tends to be used to mean imagining, or
having the capacity to imagine, feelings
that one does not actually have.
NOLA PENDER
Health Promotion Model (HMP)
METAPARADIGM
PERSON
● is a biophysical organism shaped by the
environment, but also seeks to create an
environment in which human potential can
be fully expressed
ENVIRONMENT
● described as the social, cultural, and
physical context in which life unfolds.
HEALTH
● defined as the actualization of human
potential through goal-directed behavior,
self-care, and relationships with others
with necessary adjustments made to
maintain relevant environments.
ILLNESS
● are discrete events in the life that
can hinder or facilitate the patient’s
continuing quest for health.
NURSING
●
MAJOR CONCEPT
INDIVIDUAL CHARACTERISTIC AND
EXPERIENCE
● Prior related behavior
● Personal factors: biological, psychological,
sociocultural
BEHAVIOR-SPECIFIC COGNITIONS AND
AFFECT
● Perceived benefits of actions
● Perceived barriers to actions
● Perceived self-efficacy
● Activity-related affect
● Interpersonal influence:(family, peers,
providers); norms, support, models
● Situational influences: options, demand
characteristics, aesthetics
BEHAVIORAL OUTCOMES
● Immediate competing demands (low
control) and preferences (high control)
● Commitment to a plan of action
● Health Promotion Behavior
THEORETICAL STATEMENT
1. Prior behavior and inherited and acquired
characteristics influence beliefs, affect,
and enactment of health-promoting
behavior.
2. Persons commit to engaging in behaviors
from which they anticipate deriving
personally valued benefits
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3. Perceived barriers can constrain
commitment to action, a mediator of
behavior as well as actual behavior.
4. Perceived competence or self-efficacy to
execute a given behavior increases the
likelihood of commitment to action and
actual performance of the behavior.
5. Greater perceived self-efficacy results in
fewer perceived barriers to a specific
health behavior.
6. Positive affect toward a behavior results in
greater perceived self-efficacy, which can
in turn, result in increased positive affect.
7. When positive emotions or affect are
associated with a behavior, the probability
of commitment and action is increased.
8. Persons are more likely to commit to and
engage in health-promoting behaviors
when significant others model the
behavior, expect the behavior to occur,
and provide assistance and support to
enable the behavior.
9. Families, peers, and health care providers
are important sources of interpersonal
influence that can increase or decrease
commitment to and engagement in
health-promoting behavior.
10. Situational influences in the external
environment can increase or decrease
commitment to or participation in health
promoting behavior.
11. The greater the commitments to a specific
plan of action, the more likely
health-promoting behaviors are to be
maintained over time.