Theoretical Foundation of Transcultural Nursing
MADELEINE LEININGER
(JULY 13, 1925 – AUGUST 10, 2012
- An internationally known educator, author,
theorist, administrator, researcher,
consultant, public speaker, and the
developer of the concept of transcultural
nursing
- She earned a nursing diploma from St.
Anthony’s Hospital School of Nursing,
followed by undergraduate degrees at Mount
St. Scholastica College and Creighton
University.
- While working in a child guidance home
during the 1950s, she experienced what she
described as a cultural shock when she
realized that children’s recurrent behavioral
patterns appeared to have a cultural basis.
She identified a lack of cultural and care
knowledge as the missing link to nursing.
- She was the first in the 1960s to coin the
concept of “culturally congruent care,” which
was the goal of the Theory of Culture Care,
MADELEINE LEININGER (JULY 13, 1925 –
AUGUST 10, 2012) and today the concept is
being used globally.
- As for being a pioneer nurse anthropologist,
she was appointed Dean of the University of
Washington, School of Nursing in 1969 and
remained in that position until 1974. In 1973,
under her leadership, the University of
Washington was recognized as the
outstanding public institutional school of
nursing in the United States.
- Her appointment followed a trip to New
Guinea in the 1960s that opened her eyes to
the need for nurses to understand their
patients’ culture and background to provide
care. She is considered by some to be the
“Margaret Mead of nursing” and is
recognized worldwide as the founder of
transcultural nursing, a program that she
created at the School in 1974.
- Her official certifications read LL (Living
Legend), Ph.D. (Doctor of Philosophy), LHD
(Doctor of Human Sciences), DS (Doctor of
Science), RN (Registered Nurse), FAAN
(Fellow American Academy of Nursing), and
FRCNA (Fellow of the Royal College of
Nursing in Australia).
 The concept of transcultural nursing
appeared less than 30 years ago since
MADELEINE LEININGER first began to
develop a theory of transcultural nursing as
part of a doctoral study in anthropology.
 Transcultural Nursing was developed
because of the need to work with people from
widely divergent cultural atmosphere.
 It is critical that nurses, because of their
direct patient care, understand and work
effectively within this diverse cultural
atmosphere.
 People from various cultures and subcultures
are more common in today’s world and these
people are sensitive to the preservation of
their cultural heritage and customs.
 The most important aspect in developing
cultural competence is understanding the
interrelatedness of cultural concept.
 Transcultural scholars and academics refer
to care as universal phenomenon that
transcends cultural boundaries, and their
aim is to incorporate transcultural
nursing into nursing curricula and clinical
practices through a research-based
knowledge of cultures.
 The term TRANSCULTURAL NURSING is
sometimes used interchangeably with
cross-cultural, intercultural, or
multicultural.
 In analyzing the Latin derivations of the
prefixes associated with these terms, you will
notice that trans means across, inter
means between, and multi means many.
 TRANSCULTURAL NURSING is an area of
study or practice that considers or the
specific values, beliefs, and ways of life of
people of diverse similar cultures, with the
goal of using this knowledge in creative ways
to provide culturally congruent care.
 Transcultural nursing is the blending of
anthropology and nursing in both theory and
practice. Recognizing that nursing is an art
and a science, transcultural nursing enables
us to view our profession from a cultural
perspective.
 Anthropology refers to the study of humans
and humankind, including their origins,
behavior, social relationships, physical and
 mental characteristics, customs, and
development through time and in all places
in the world.
 Transcultural nursing is not just for
immigrants, people of color, or members of
the federally defined pan ethnic minority
groups, i.e., Blacks, Hispanics, Asians/
Pacific Islanders, and American
Indians/Alaska Natives.
 The goal of transcultural nursing is to
develop a scientific and humanistic body
of knowledge to provide culture specific
and culture universal nursing care
practices to individuals, families, groups, and
communities from diverse back grounds.
 Culture specific, refers to values, beliefs,
and patterns of behavior that tend to be
special or unique to a group and that do not
tend to be shared with members of other
cultures.
 Culture universal refers to the commonly
shared values, norms of behavior, and life
patterns that are similarly held among
cultures about human behavior and
lifestyles.
 Transcultural nursing requires sophisticated
assessment and analytic skills and the ability
to plan, design, implement, and evaluate
nursing care for individuals, families,
groups, and communities representing
various cultures.
IMPORTANT IDEAS TO BE UNDERSTOOD
ABOUT TRANS-CULTURAL NURSING SUCH AS
THE FOLLOWING:
1. Care needs to be systematically studied to learn
about human care (caring) in diverse and similar
cultures in the world and environments.
2. Nurses need to be knowledgeable about their own
cultural care heritage and of biases, beliefs, and
prejudices to work effectively with clients.
3. Nurses need to use trans culture-specific and
comparative knowledge to guide caring practices for
culturally congruent care.
4. A focus on cultural care competencies for diverse
cultures and universals (commonalities) is essential.
5. Nurses should seek comprehensive, holistic, and
comparative culture care phenomena.
6. Maintaining an open learning-discovery process
about care and culture is imperative.
7. Nurses need creative ways to provide culturally
congruent care practices
IMPORTANCE OF TRANSCULTURAL NURSING
Leininger (1995) cites eight factors that
influenced her to establish transcultural
nursing:
1. There was a marked increase in the migration of
people within and between countries worldwide.
Transcultural nursing is needed because of the
growing diversity that characterizes our national and
global populations. In its broadest sense, diversity
refers to differences in race, ethnicity, national origin,
religion, age, gender, sexual orientation, ability or
disability, social and economic status or class,
education, and related attributes of groups of people
in society.
2. There has been a rise in multicultural and life ways
identities, with people expecting their cultural beliefs,
values, to be understood and respected by nurses
and other health care providers.
3. The increased use of health care technology
sometimes conflicts with cultural values of clients,
such as Amish prohibitions against using certain
apnea monitors, IV pumps, and other such health
care technologic devices in the home.
4. Worldwide, there are cultural conflicts, clashes,
and violence that have an impact health care as
more cultures interact with one another.
5. There was an increase in the number of people
traveling and working in many worlds. different parts
of the world.
6. There was an increase in legal suits resulting from
cultural conflict, negligence, ignorance, and
imposition of health care practices.
7. There has been a rise in feminism and gender
issues, with new demands on health care systems to
meet the needs of women and children.
8. There has been an increased demand for
community and culturally based health care services
in diverse environmental con texts
HISTORY OF TRANSCULTURAL NURSING
 In the 1950’s Dr. Madeleine M. Leininger
noted cultural differences between patients
and nurses while working with emotionally
disturbed children.
 This clinical experience led her in 1954 to
study cultural differences in the perceptions
of care and in 1965 she earned a doctorate
in cultural anthropology from the University of
Washington.
 She also recognized Washington. that one of
anthropology's most important contributions
to nursing was the realization that health and
illness states are strongly influenced by
culture,
 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 about care and health. The next
focus is on the generic or folk system,
professional care systems, and nursing care.
 In 1995, Leininger defined transcultural
nursing as “a substantive area of study and
practiced focused on comparative cultural
care (caring) values, beliefs, and practices of
individuals or groups of similar or different
cultures to provide culture well specific and
universal nursing care practices in promoting
health or being or to help people to face
unfavorable human conditions, illness, or
death in culturally meaningful ways .”
  The theory first appeared in Leininger’s
Culture Care Diversity and Universality,
published in 1991, but it was developed in
the 1950s. The theory was further developed
in her book Transcultural Nursing, which was
published in 1995. In the third edition of
Transcultural Nursing, published in 2002, the
theory-based research and the Transcultural
theory application are explained.
MAJOR CONCEPTS OF THE TRANSCULTURAL
NURSING THEORY
 TRANSCULTURAL NURSING is defined as
a learned subfield or branch of nursing that
focuses upon the comparative study and
analysis of cultures concerning nursing and
health-illness caring practices, beliefs, and
values to provide meaningful and efficacious
nursing care services to their cultural values
and health-illness context.
 ETHNONURSING 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)
 NURSING is defined as a learned humanistic
and scientific profession and discipline which
is focused on human care phenomena and
activities to assist, support, facilitate, or
enable individuals or groups to maintain or
regain their well-being (or health) in culturally
meaningful and beneficial ways, or to help
people face handicaps or death.
 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 to improve a human health condition
(or well-being), disability, lifeway, or to work
with dying clients.
 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 the individual, group, or institutional,
cultural values, beliefs, and life ways to
provide or support meaningful, beneficial,
and satisfying health care, or well-being
services.
 HEALTH It is a state of well-being that is
culturally defined, valued, and practiced. It
reflects individuals’ (or groups) ‘ability to
perform their daily role activities in culturally
expressed, beneficial, and patterned
lifeways.
 HUMAN BEINGS Such are believed to be
caring and capable of being concerned about
others’ needs, well-being, and survival.
Leininger also indicates that nursing as a
caring science should focus beyond
traditional nurse-patient interactions and
dyads to include families, groups,
communities, total cultures, and institutions.
 SOCIETY AND ENVIRONMENT Leininger
did not define these terms; she speaks
instead of worldview, social structure, and
environmental context.
 WORLDVIEW is how people look at the
world, or the universe, and form a “picture or
value stance” about the world and their lives.
 SOCIETY AND ENVIRONMENT Leininger
did not define these terms; she speaks
instead of worldview, social structure, and
environmental context.
CULTURAL AND SOCIAL STRUCTURE
DIMENSIONS
- defined as involving the DYNAMIC
PATTERNS and features of interrelated
structural and organizational factors of a
particular culture (subculture or society)
which includes religious, kinship (social),
political (and legal). Economic, educational,
technological, and cultural value, ethno-
historical factors, and how these factors may
be interrelated and function to influence
human behavior in different environmental
contexts.
 ENVIRONMENTAL CONTEXT is the totality
of an event, situation, or experience that
gives meaning to human expressions,
interpretations, and social interactions in
particular physical, ecological, sociopolitical,
and/or cultural settings.
 CULTURE is learned, shared, and
transmitted values, beliefs, norms, and
lifeways of a particular group that guides their
thinking, decisions, and actions in patterned
ways.
 CULTURE CARE is defined as 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, improve
their human condition lifeway, or deal with
illness, handicaps, or death.
 CULTURE CARE DIVERSITY indicates the
variabilities and/or differences in meanings,
patterns, values, life ways, or symbols of
care within or between collectives related to
assistive, supportive, or enabling human
care expressions.
 CULTURE CARE UNIVERSALITY
indicates the common, similar, or dominant
uniform care meanings, patterns, values,
lifeways, or symbols manifest among many
cultures and reflect assistive, supportive,
facilitative, or enabling ways to help people.
 GENERIC (FOLK OR LAY ) CARE
SYSTEMS are 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 life way, health condition (or well-
being), or to deal with handicaps and death
situations.
 EMIC Knowledge gained from direct
experience or directly from those who have
experienced it. It is generic or folk
knowledge.
 PROFESSIONAL CARE SYSTEMS are
defined as 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.
 ETIC The knowledge that describes the
professional perspective. It is professional
care knowledge.
 ETHNOHISTORY includes those past facts,
events, instances, experiences of
individuals, groups, cultures, and instructions
that are primarily people centered (ethno)
and describe, explain, and interpret human
lifeways within cultural contexts over short or
long periods of time.
 CARE as a noun is defined as those abstract
and concrete phenomena related to
assisting, supporting, or enabling
experiences or behaviors toward or for
others with evident or anticipated needs to
ameliorate or improve a human condition or
lifeway.
 CARE as a verb is defined as actions and
activities directed toward assisting,
supporting, or enabling another individual or
group with evident or anticipated needs to
ameliorate or improve a human condition or
lifeway or face death.
 CULTURE SHOCK may result when an
outsider attempts to comprehend or adapt
effectively to a different cultural group. The
outsider is likely to experience feelings of
discomfort and helplessness and some
degree of disorientation because of the
differences in cultural values, beliefs, and
practices.
 CULTURAL IMPOSITION refers to the
outsider’s efforts, both subtle and not so
subtle, to impose their own cultural values,
beliefs, behaviors upon an individual, family,
or group from another culture.
MADELEINE LEININGER’S
SUNRISE MODEL THEORY
The SUNRISE MODEL is relevant because it
enables nurses to develop critical and complex
thoughts about nursing practice. These thoughts
should consider and integrate cultural and social
structure dimensions in each specific context,
besides nursing care’s biological and psychological
aspects.
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 concerning care and
health.
The next focus is on the generic or folk
system, professional care systems, and nursing
care. Information about these systems includes the
characteristics and the specific care features of
each. This information allows for the identification of
similarities and differences or cultural care
universality and cultural care diversity.
Next are nursing care decisions and actions
which involve cultural care preservation or
maintenance, cultural care accommodation or
negotiation, and cultural care repatterning or
restructuring. It is here that nursing care is delivered.
THREE MODES OF NURSING CARE DECISIONS
AND ACTIONS
 CULTURAL CARE PRESERVATION is also
known as maintenance. It includes those
assistive, supporting, facilitative, or enabling
professional actions and decisions that help
people of a particular culture to retain and/or
preserve relevant care values so that they
can maintain their well-being, recover from
illness, or face handicaps and/or death.
 CULTURAL CARE ACCOMMODATION,
also known as NEGOTIATION, includes
those assistive, supportive, facilitative, or
enabling creative professional actions and
decisions that 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 Includes those assistive,
supporting, facilitative, or enabling
professional actions and decisions that help
clients reorder, change, or greatly modify
their life ways for new, different, and
beneficial health care pattern while
respecting the clients’ cultural values and
beliefs and still providing a beneficial or
healthier lifeway than before the changes
were established with the clients.

ASSUMPTIONS:
- Different cultures perceive, know, and
practice care differently, yet there are some
commonalities about care among all world
cultures.
- Values, beliefs, and practices for culturally
related care are shaped by, and often
embedded in, “the worldview, language,
religious (or spiritual), kinship (social),
political (or legal), educational, economic,
technological, ethnohistorical, and
environmental context of the culture.
- While human care is universal across
cultures, caring may be demonstrated
through diverse expressions, actions,
patterns, lifestyles, and meanings.
- Cultural care is the broadest holistic means
to know, explain, interpret, and predict
nursing care phenomena to guide nursing
care practices.
- All cultures have generic or folk health care
practices, that professional practices vary
across cultures, and that there will be cultural
similarities and differences between the
care-receivers (generic) and the professional
caregivers in any culture.
- Care is the distinct, dominant, unifying, and
central focus of nursing, and while curing and
healing cannot occur effectively without care,
care may occur without a cure.
- Care and caring are essential for humans’
survival and their growth, health, well-being,
healing, and ability to deal with handicaps
and death.
- Nursing, as a transcultural care discipline
and profession, has a central purpose of
serving human beings in all areas of the
world; that when culturally based nursing
care is beneficial and healthy, it contributes
to the wellbeing of the client(s) –whether
individuals, groups, families, communities, or
institutions –as they function within the
context of their environments.
- Nursing care will be culturally congruent or
beneficial only when the nurse knows the
clients. The clients’ patterns, expressions,
and cultural values are used in appropriate
and meaningful ways by the nurse with the
clients.
- If clients receive nursing care that is not at
least reasonably culturally congruent (that is,
compatible with and respectful of the clients’
lifeways, beliefs, and values), the client will
demonstrate signs of stress, noncompliance,
cultural conflicts, and/or ethical or moral
concerns.
ANALYSIS:
- In Leininger’s nursing theory, it was stated
that the nurse would help the client move
towards amelioration or improvement of their
health practice or condition. This statement
would be of great difficulty for the nurse
because instilling new ideas in a different
culture might present an intrusive intent for
the “insiders.” Culture is a strong set of
practices developed over generations that
would make it difficult to penetrate.
- The whole activity of immersing yourself
within a different culture is time consuming to
understand their beliefs and practices fully.
Another is that it would be costly on the part
of the nurse.
- It is highly commendable that Leininger
formulated a theory that is specified to a
multicultural aspect of care. On the other
side, too much was given to the culture
concept per se that Leininger failed to
discuss the functions or roles of nurses
comprehensively. It was not stated how to
assist, support, or enable the client to be
attuning them to an improved lifeway.
- Because of the intrusive nature, resistance
from the “insiders” might impose a risk to the
nurse’s safety, especially for cultures with
highly taboo practices.
- Because of its financial constraints and
unclear ways of being financially
compensated, it can be the reason why
nurses do not engage much with this kind of
nursing approach.
STRENGTHS:
 Leininger has developed the Sunrise Model
in a logical order to demonstrate the
interrelationships of the concepts in her
theory of Culture Care Diversity and
Universality.
 Leininger’s theory is essentially
parsimonious in that the necessary concepts
are incorporated in such a manner that the
 theory and its model can be applied in many
different settings.
 It is highly generalizable. The concepts and
relationships presented are at a level of
abstraction, which allows them to be applied
in many different situations.
 Though not simple in terms, it can be easily
understood upon the first contact.
WEAKNESS:
- The theory and model are not simple in
terms.
CONCLUSION:
According to transcultural nursing, nursing
care aims to provide care congruent with cultural
values, beliefs, and practices. Cultural knowledge
plays a vital role for nurses on how to deal with the
patients. To start, it helps nurses to be aware of how
the patient’s culture and faith system provide
resources for their experiences with illness,
suffering, and even death. It helps nurses
understand and respect the diversity that is often
present in a nurse’s patient load.
It also 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 illness. Finally, using cultural
knowledge to treat a patient also helps a nurse be
open-minded to treatments that can be considered
non-traditional, such as spiritually based therapies
like meditation and anointing.
CULTURAL RESPECT
Cultural respect is vital to reduce health disparities
and improve access to high-quality healthcare that is
responsive to patients' needs, according to the
National Institutes of Health (NIH). Nurses must
respond to changing patient demographics to
provide culturally sensitive care. This need is
strikingly evident in critical care units.
Cultural Competence, a journey not a destination.
 Cultural Awareness
 Cultural knowledge and skill
 Cultural encounter
CULTURAL COMPETENCE
The understanding of diverse attitudes, beliefs,
behaviors, practices, and communication patterns
attributable to a variety of factors. Factors race,
ethnicity, religion, historical and social context,
physical or mental ability, age, gender, sexual
orientation, generational acculturation status.
CULTURAL COMPETENCE IN HEALTHCARE
According to health policy institute, cultural
competence is the ongoing process of capacity of
healthcare system, organizations, and professionals
to provide for diverse patient population high quality
care that is safe, patient and family centered,
evidence-based, and equitable. (The National
Quality Forum)
The goal is to provide the highest quality of
care to every patient, regardless of race, ethnicity,
cultural background, English proficiency, or literacy.
A health care provider is culturally competent
when: He /she can deliver culturally appropriate and
specifically tailored care to patients with diverse
values, beliefs, and behaviors.
Why do we need cultural competence in 21st
century?
 Everyone has a right to healthcare that
meets their needs.
 Immigration will impact demographics.
 Growth of minority population.
FRAMEWORK FOR DELIVERING CULTURALLY
COMPETENT SERVICES
Compinha Bacote and Munoz (2001) proposed a live
component model for developing cultural
competence.
1. Cultural awareness involves self-
examination of in-depth exploration of one's
cultural and professional background. This
component begins with insight into one's
cultural healthcare beliefs and values. A
cultural awareness assessment tool can
be used to assess a person's level of cultural
awareness.
2. Cultural knowledge involves seeking and
obtaining an information base on different
cultural and ethnic groups. This component
is expanded by an easing information offered
through sources such as journal articles,
seminars, textbooks, internet resources,
workshop presentations and university
courses.
3. Cultural skill involves the nurse's ability to
collect relevant cultural date regarding the
patient's presenting problem and accurately
perform a culturally specific assessment The
Giger and Davidhizar model offers a
framework for assessing cultural, racial, and
ethnic Difference in patients.
4. Cultural encounter is defined as the
process that encourages nurses to directly
engage in cross-cultural interactions with
patients from culturally diverse backgrounds.
Nurses increase cultural competence by
directly interacting with patients from
different cultural backgrounds. This is an
ongoing process, developing cultural
competence cannot be mastered.
5. Cultural desire refers to the motivation to
become culturally aware and to seek cultural
encounters. This component involves the
willingness to be open to others, to accept
and respect cultural differences and to be
willing to learn from others.
CULTURE IS CENTRAL TO THE DELIVERY OF
HEALTHCARE
  it influences patients’ healthcare beliefs,
practices, attitudes towards care, and trust in
the system and in the individual providers.
 Cultural differences affect how health
information and healthcare services are
received, understood, and acted upon.
PRIMARY REASONS OF CULTURAL
COMPETENCE IN HEALTHCARE
1. Eliminate misunderstanding in diagnosis or
in treatment planning that may arise from
differences in language or culture.
2. Improve patient adherence with treatment.
3. Eliminate healthcare disparities.
Cultural Competence
Two Major Categories:
(1) organizational cultural competence
(2) individual cultural competence
CULTURAL COMPETENCE
According to the National Center for Cultural Com,
ice (Georgetown University Center for Child and
Human Development, cultural competence following
characteristics:
 A defined set of values and principles and
demonstration of behaviors, attitudes,
policies, and structures that enable them to
work effectively cross-culturally.
 The capacity to (1) valve diversity, (2)
conduct self-assessment, (3) manage the
dynamics difference, (4) acquire and
institutionalize-cultural knowledge, and (5)
adapt to diversity and the cultural contexts of
the communities they serve.
 Incorporation of the previously mentioned
items in all aspects of policy making,
administration, practice, and service delivery,
and systematic involvement of Consumers,
key stakeholders, and communities.
Culturally Congruent Care
 a holistic and focuses on the complex,
interrelationship of life ways, religion, kinship,
politics, law, education, technology,
language, environmental context, and
worldview-all factors that contribute to
culturally congruent care. (Leininger &
McFarland, 2005)
 defines as the provision of care that is
meaningful and fits with cultural beliefs and
life ways.
Some of the most common forms of nonverbal
communication include gestures, facial expressions,
proxemics (interpersonal distances), haptics
(touching), posturology (posture), paralinguistics
(phonetics) or eye contact. What do certain
gestures and movements mean in other
cultures?
HAND SHAKING
 USA, England, Germany, and New
Zealand - it's used when meeting for parting
and if you know the other person well, you
can skip this gesture
 France and the rest of Europe - people
shake hands even if they know each other
well, sometimes even several times a day
 Russia-shaking hands in a doorway is
considered impolite and allegedly brings bad
luck
 India, Middle East, and Asia - people can
still hold each other's hands, even after they
shook hands
 Japan-handshakes are considered Impolite,
people bow instead and the lower they bow
the more respect they are showing
INTERPRETERS AND TRANSLATORS
Interpreters, including sign language
interpreters and deal blind interpreters, are skilled
and trained professionals who convert "oral or
signed information into another language, including
sign language. Translators are skilled and trained
persons who convert "written information" into
another language.
The role of both interpreters and translators
is to ensure clear communication between the health
care professional and the displaced person who are
speaking or signing different languages. Their goal
is to convert oral, signed, or written information
"meaning for meaning and not purely "word for word.
This implies that interpretation and translation must
be done with some context of the message being
conveyed, as well as the emotions and expressions
conveyed in the delivery.
The National Council on interpreting in Health Care
(2006) has developed the first set of national
standards for medical interpreting professionals in
the ted States. The 32 national standards provide
guidelines on the following name issues:
 ACCURACY: To enable other parties to have
sold know precisely what each speaker
 CONFIDENTIALITY: To Honor the private
and personal nature of the health care
interaction and maintain trust among all
parties.
 IMPARTIALITY: To eliminate the effect of
Interpreter bias or preference,
 RESPECT: To acknowledge the Inherent
dignity of all parties in the interpreted
encounter.
 CULTURAL AWARENESS: To facilitate
communication across cultural differences.
 ROLE BOUNDARIES: To clarify the scope
and limits of the interpreting role to avoid
conflicts of interest.
 PROFESSIONALISM. To uphold the public's
trust in the Interpreting profession.
 PROFESSIONAL DEVELOPMENT: To
attain the highest possible level of
competence and service,
 ADVOCACY: To prevent harm to parties
whom the interpreter serves.