Madeleine Leininger: Transcultural Nursing also known as Culture Care Theory.

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 in relation to
care and health. The next focus is on the generic or folk system, professional care system(s), and nursing care. This
information allows for the identification of similarities and differences or cultural care universality and cultural care
diversity.

Major concepts:

Transcultural nursing ❏ is defined as a learned subfield or branch of nursing which focuses upon the comparative
study and analysis of cultures with respect to nursing and health-illness caring practices, beliefs, and values.

Professional nursing care (caring) ❏ is defined as formal and cognitively learned professional care knowledge and
practice skills obtained through educational institutions that are used to provide assistive, supportive, enabling, or
facilitative acts to or for another individual or group.

Professional nursing care (caring) ❏ is defined as formal and cognitively learned professional care knowledge and
practice skills obtained through educational institutions that are used to provide assistive, supportive, enabling, or
facilitative acts to or for another individual or group.

Cultural congruent (nursing) care ❏ is defined as those cognitively based assistive, supportive, facilitative, or
enabling acts or decisions that are tailor-made to fit with individual, group, or institutional cultural values, beliefs,
and lifeways in order.

➔ Nursing care will be culturally congruent or beneficial only when the clients are known by the nurse and the
clients’ patterns, expressions, and cultural values are used in appropriate and meaningful ways by the nurse with
the clients.

Nursing ❏ is defined as a learned humanistic and scientific profession and discipline which is focused on human
care phenomena and activities.

Health ❏ is a state of well-being that is culturally defined, valued, and practiced, and which reflects the ability of
individuals (or groups).

Human beings ❏ are believed to be caring and to be capable of being concerned about the needs, well-being, and
survival of others. Society/environment

❏ are not terms that are defined by Leininger; she speaks instead of worldview, social structure, and
environmental context.

❏ Ethnonursing ❏ Worldview ❏ Culture ❏ Emic ❏ Etic ❏ Culture shock ❏ Culture Imposition

Cultural and social structure dimensions ➢ are defined as involving the dynamic patterns and features of
interrelated structural and organizational factors of a particular culture:

➢ (subculture or society) ➢ (social), political (and legal), ➢ economic, educational, technologic ➢ and
cultural values, ethnohistorical factors

Environmental context ➢ is the totality of an event, situation, or particular experience that gives
meaning to human expressions, interpretations, and social interactions in particular physical, ecological,
sociopolitical and/or cultural settings.
Culture care ➢ is defined as the subjectively and objectively learned and transmitted values, beliefs, and
patterned lifeways

Culture care universality ➢ indicates the common, similar, or dominant uniform care meanings, pattern,
values, lifeways or symbols that are manifest among many cultures .

Culture care diversity ➢ indicates the variabilities and/or differences in meanings, patterns, values,
lifeways, or symbols of care within or between collectives .

Generic (folk or lay) care systems are culturally learned and transmitted, indigenous (or traditional), folk
(home-based) knowledge and skills used ➔ To improve a human life way, health condition (or well-
being), or to deal with handicaps and death situations.

Three modes of nursing care decisions and actions

❏ Cultural care preservation is also known as maintenance enabling professional actions and decisions
➔ that help people of a particular culture to retain and/or preserve relevant care values

❏ Cultural care accommodation also known as negotiation ➔ help people of a designated culture to
adapt to or negotiate with others for a beneficial or satisfying health outcome with professional care
providers.

❏ Culture care repatterning, or restructuring ➔ reorder, change, or greatly modify their lifeways for
new, different, and beneficial health care pattern ➔ while respecting the client(s) cultural values and
beliefs and still providing a beneficial or healthier lifeway than before the changes were coestablished
with the client(s). (Leininger, 1991)

Purpose and goal of the theory:

O The central purpose is to discover and explain diverse and universal culturally based care factors
influencing the health, well-being, illness or death of individual or groups

O To use research findings to provide culturally congruent, safe, and meaningful care to clients of diverse
or similar cultures

Theory of Human Becoming (Man-Living-Health) by Rosemarie Rizzo Parse

Parse's Human Becoming Theory guides the practice of nurses to focus on quality of life as it is described
and lived.

❏ The human becoming theory of nursing presents an alternative to both the conventional biomedical
approach as well as the biopsychosocial-spiritual approach of most other theories and models of
nursing.

❏ The theory is structured around three abiding themes: ❏ Meaning ❏ Rhythmicity ❏ Transcendence
Parse synthesized the original nine assumptions about humans and becoming into three assumptions
about human becoming, as follows: 1. Human becoming is freely choosing personal meaning with
situation, intersubjectively living value priorities. 2. Human becoming is configuring rhythmical patterns
of relating with human universe. 3. Human becoming is transcending illimitably with emerging possibles.
❏ Man's reality is given. Meaning through lived experiences. ❏ In addition, man and environment co-
create.

Three concepts: (1) imaging (2) valuing (3) languaging

❏ Imaging is a process of knowing and of coming to know as persons accept and reject ideas, values,
beliefs and practices consistent with their worldview ❏

Valuing –is the process of choosing and embracing what is important. persons are continuously
confirming-not confirming beliefs as they are making choices about how to think, act, and feel. ❏
Languaging – it is about the way persons are with the world and in relationships with others and self

❏ Rhythmicity states that human becoming is co-creating rhythmical patterns of relating in mutual
process with the universe.

❏ Man and environment co-create in rhythmical patterns. ❏ (1) Revealing-concealing (2) Enabling-
limiting (3) Connecting-separating ❏ The paradox linked with revealing-concealing is disclosing-not
disclosing Revealing-concealing is the way persons disclose and keep hidden, all-at-once, the persons
they are becoming ➔ There is always more to tell and more to know about ourselves as well as others.

➔ Some aspects of reality and experience remain concealed.

O linked with the Paradox potentiating-restricting Enabling-limiting represents the potentials and
opportunities that surface with the restrictions and obstacles of everyday living.

O Enabling-limiting is about choosing from the possibilities and living with the consequences of those
choices.

❏ Paradox linked with connecting-separating is attending-distancing. This concept relates to the ways
persons create patterns of connecting and separating with people and projects. Connecting-separating is
about communion-aloneness and the ways people separate from some to join with others.

❏ Transcendence explains that human becoming is co-transcending multidimensionally with emerging

possibilities. It refers to reaching out and beyond the limits a person sets, and that one constantly
transforms.

❏ Three related concepts: 1. Powering 2. Originating 3. Transforming.

1.Powering is the pushing-resisting process that propels people in life. 2.Originating –people strive to be
like others while simultaneously striving to be unique and different from others. 3. Transforming is about
integrating unfamiliar ideas or activities into one’s life. This represents a process of deliberately shifting
one’s patterns of health.

Concepts ❏ Person (referred to as "man" throughout the theory) as an open being who is more than and
different from the sum of the parts.

❏ The Environment is everything in the person and his or her experiences. The environment is
inseparable from the person, as well as complementary to and evolving with the person.

❏ Health is the open process of being and becoming and involves the synthesis of values.
❏ Nursing is described as a human science and art that uses an abstract body of knowledge to help
people.

All cultures have generic or folk health care practices, that professional practices vary across cultures ➔
and that in any culture there will be cultural similarities and differences between the care-receivers
(generic) and the professional caregivers. Care is distinct, dominant, unifying and central focus of nursing
❏ Nursing, as a transcultural care discipline and profession, has a central purpose to serve human beings
in all areas of the world

❏ Nursing care will be culturally congruent or beneficial only when the clients are known by the nurse
and the clients’ patterns, expressions, and cultural values are used in appropriate and meaningful ways
by the nurse with the clients. I

❏ These three themes are permeated by four postulates: illimitability, paradox, freedom, and mystery.
❏ Illimitability is "the indivisible unbounded knowing extended to infinity, the all-at-once remembering
and prospecting with the moment.“

❏ Paradox is "an intricate rhythm expressed as a pattern preference." Paradoxes are not "opposites to
be reconciled or dilemmas to be overcome but, rather, lived rhythms."

❏ Freedom is "contextually construed liberation." People are free to continuously choose ways of being
with their situations.

❏ Mystery is "the unexplainable, that which cannot be completely known."

Composure Model and Retirement and Role Discontinuity Model

.CARMELITA DIVINAGRACIA

The Lived Experiences of Nursing Service Personnel and Nursing Educators on Collaboration

COMPASURE BEHAVIORS

- are sets of behaviors or nursing measures that the nurse demonstrates to selected patients.

COMPOSURE- is acronym which stands for Competence, Presence, and Prayer, Open-mindedness, Stimulation,
understanding, Respect and Relaxation, Empathy.

Wellness Status- a condition being in a state of well being, a coordinated and integrated living pattern that involves
the dimension of wellness.

SISTER LETTY G. KUAN-RETIREMENT AND ROLE DISCONTINUES

It is primary importance to prepare early in life by cultivating other role of options at age 50-60 in order to have a
rewarding retirement period even amidst the presence of role discontinues experienced by this age group.

RETIREMENT- is an inevitable change in one’s life. It is evident in increasing statistics of aging population
accompanied by related disabilities and increased dependence.
-this developmental stage, even later part of life, must be considered desirable and satisfying through the
determination of factors that will help the person enjoy his remaining years of life.
-ROLE DISCONTINUITY-is the interruption in the line of status enjoyed or performed. The interruption may be
brought about by an accident, emergency, and change of position or retirement.
-COPING APPROACHES- refer to the interventions or measures applied to solve a problematic situation or state in
order to restore or maintain equilibrium and normal functioning.
-Change of life- is the period between near retirement and post-retirement years. In medico-physiological terms, this
equates with the climacteric period of adjustment and re adjustment to another tempo of life.
-Retiree- is an individual who has left the position occupied for the past years of productive life because he / she has
reached the prescribed retirement age or has completed the required years of service.