TRANSCULTURAL

NURSING
Ns.Joanggi Wiriatarina Harianto, M.Kep.,PhD (Cand)
Faculty of Nursing Science
Universitas Muhammadiyah Kalimatan Timur
Introduction
TRANSCULTURAL NURSING
• Transcultural nursing has been 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. (Leininger M. and McFarland, M.R. (2002).
ETHNONURSING
• This is the study of nursing care beliefs, values, and
practices as cognitively perceived and known by a
designated culture through their direct experience, beliefs,
and value system (Leininger, 1979).
 Overview
CONCEPT OF TRANSCULTURAL NURSING
GENERIC (LAY AND FOLK) AND PROFESSIONAL CARE
TRANSCULTURAL NURSING CARE PRINCIPLES
SUNRISE MODEL: A CONCEPTUAL RESEARCHER ENABLER
Interesting facts
List some interesting facts about CULTURE. Here are a few
examples:
• Culture is the learned, shared and transmitted values, beliefs, norms, and lifeways of a
particular group that guides their thinking, decisions, and actions in patterned ways.
• Manifest cultural norms or rules of behaviour are the obvious and readily known beliefs
and expressions such as greeting another person by a handshake
• Culture shave traditional ceremonial practices such as religious rituals, food feasts, and
other activities that are transmitted intergenerationally and reaffirm family or group ties
and caring ways.
• Cultures have their local or emic (insider’s) views and knowledge about their culture that
are extremely important for nurses to discover and understand for meaningful care
practices. Emic ideas and beliefs are often viewed as “secrets” and may not be willingly
shared with cultural strangers such as nurses or physicians unless the stranger is trusted.
• All human cultures have some intercultural variations between and within cultures.
Cultural variation is an important concept to keep in mind when studying individuals and
different cultures
Key People

Madeleine Leininger is an an American nurse and Marilyn R. McFarland, Professor, Department

anthropologist, author of transcultural nursing. Born in of Nursing, School of Health Professions and Studies,
Nebraska, she became the first professional nurse to University of Michigan-Flint.
earn a PhD in anthropology, bringing both disciplines
together in her work..
McClosky and Grace (2001)

Nurse Family
Culture Culture

Understanding

Therapeutic Interaction

Healing and Satisfactory Care

CULTURE CARE DIVERSITY
Culture care diversity indicates the variabilities and/or differences in meanings, patterns, values, lifeways, or symbols of care within or
between collectives that are related to assistive, supportive, or enabling human care expressions. Cultural diversity refers to the
variations and differences among and between cultural groups resulting from differences in lifeways, language, values, norms, and other
cultural aspects. Cultural diversity was one of the first concepts emphasized in transcultural nursing.
CULTURE CARE UNIVERSALITY
Culture care universality indicates the common, similar, or dominant uniform care meanings, pattern, values,
lifeways or symbols that are manifest among many cultures and reflect assistive, supportive, facilitative, or
enabling ways to help people. Cultural universals refer to the commonalities among human beings or humanity
that reveal the similarities or dominant features of humans.
 CONCEPT OF TRANSCULTURAL NURSING
Transcultural nursing is a comparative study of cultures to understand similarities (culture universal) and
differences (culture - specific) across human groups (Leininger, 1991). 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 (Leininger and McFarland, 2002).
The goal’s transcultural nursing are:
1)To give cultural congruent nursing care.
2)To provide culture specific and universal nursing care.
3)To aid in facing adverse human conditions, illness or death in culturally meaningful ways
 GENERIC (LAY AND FOLK)AND PROFESSIONAL CARE
In developing the transcultural nursing field two very important ideas were developed to identify different kinds of
care, namely, generic care and professional nursing care, which were based largely on emic and etic care discoveries.

• Generic care(caring) refers to culturally learned and transmitted lay, indigenous (traditional),
and largely emic folk knowledge and skills used by cultures. In contrast,
professional(nursing) care (caring) refers to formally and cognitively learned etic knowledge
and practice skills that have been taught and used by faculty and clinical services to
provide professional care.
• Generic care is derived originally and still today from emic or within the culture.
Professional care is derived ethically from largely outside specific cultures from professional
and institutional sources.
 Cultural Informant’s Views of Comparative Generic and Professional Care/Cure (Leininger & McFarland, 2002)
Generic (Emic) Care/Cure Professional (Ethic) Care/Cure
• Humanistically oriented • Scientifically oriented
• People based with practical and familiar referents • Clients to be acted on with unfamiliar techniques and strangers

• Holistic and integrated approach with focus on social relationship, language, and lifeways • Fragmented and nonintegrated services with focusing on physical body and mind

• Focus is largely on caring • very

In developing the transcultural nursing field two Focus is largely onideas
important curing,were
diagnosis, and treatments
developed to identify different kinds of care, namely, generic care and professional
• nursing and
Largely nontechnological using folk remedies care, whichrelationships
personal were based largely on emic• andLargely
etic care discoveries.
technological with many diagnostic tests and scientific treatments

• Focuses on prevention of illnesses, disability, & maintaining lifeways • Focusesontreatingdiseases,disabilities,andpathologies

• Uses high-context communication modes • Uses low-context communication modes

• Relies on traditional and familiar folk caring and healing • Relies on biophysical and emotional factors to be assessed and treated
• The Sunrise Enabler serves as cognitive
map to discover embedded and multiple
factors related to the theory, tenets, and
assumptions with the specific domain of
inquiry under study. This visual diagram
reminds the researcher to search broadly
for diverse factors influencing care within
any culture under study
• Leininger’s enablers do not neglect
professional or etic medical knowledge
about human beings in illness and health
such ac biophysical, social, and nursing
for medical factors,but focus mainly on
total lifeways and care or caring factors
influencing health and/or wellbeing,
dissabilities, and death
Upper part

Middle Part

Lower part
PENJELASAN LEBIH RINCI
• Upper part meliputi komponen dari struktur sosial & cara pandang yang
mempengaruhi perawatan dan kesehatan, melalui konteks bahasa,
etnohistory, dan lingkungan.
• Faktor-faktor ini juga mempengaruhi sistem perawatan dari perawat,
tenaga profesional, dan pelayanan kesehatan tradisional yang ada di
middle part.
• Sementara lower part merupakan proses/intervensi asuhan keperawatan.

Secara keseluruhan membentuk MATAHARI yang menjadi alur pikir perawat dalam memberikan asuhan keperawatan.
 BRIEFLY EXPLANATION
• The Sunrise Model had some minor revisions from 1955 to 1985 to refine it in relation to the theory and the
multiple holistic factors that could influence culture care. The model shows potential influencers (not causes)
that might explain care phenomena related to historical, cultural, social structure, worldview, environmental, and
other factors.
• It is important to understand that gender, age, class, race, historical, and other features are usually embedded or
related to to social structure factors such as religion, kinship, politics, and economics; cultural values are found
linked to sex, age, etc. for example, gender, age, and race data are generally embedded in family ties, politics,
and specific cultural norms and practices. In some families caring decisions and certain actions are related to male
and female roles and often over generations.
• Likewise, biophysical, emotional, genetic, medical, nursing, and other factors may be bear on generic and
professional health or illness care. Hence, gender, class, age, and race factors are found in their natural cultural
places and have to be discovered by the researcher in their familiar or natural cultural contexts.
HOW TO USE?
• As researchers use the Model, they will discover many hidden, obvious, and unexpected factors influencing
care meanings, patterns, symbols, and practices in different cultures. “Let the sun shine and rise” figuratively
means to have nurses open their minds to informants to discover many different factors influencing care in
their culture with their meanings and the ways they influence the health and well-being of people
• In general, the Sunrise Model is an invaluable guide to discover new knowledge or to confirm knowledge of
cultural informants. Often nurses say, “The Sunrise Model became imprinted on my mind to alert me to
many factors that had never explored been in nursing”; “The Model really helped me to get a holistic view of
cultures and not just nursing diagnoses, symptoms, diseases, and medical views”; “The Model greatly
expanded my view of what needs to be considered in nursing to reach out and help people of diverse
cultures”;
 Conclusion

Transcultural nurse generalists and specialists in lifecycle areas and in prevention and health maintenance will
be greatly needed to provide safe and competent care. It will be a great opportunity for nurses prepared in
transcultural nursing to make health care culture specific, safe, and meaningful to consumers. Hence, for all these
major reasons, transcultural nursing became of critical importance and a necessity for today and the future.
Questions & answers
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