NURSING THEORIES 6
Theoretical Foundations of Nursing | Block 1NU10 | 1st Semester | S.Y 2022-2023
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.”
● “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.”
● A study of cultures to understand both similarities and
differences in patient groups
● Why is it beneficial for nurses to use cultural knowledge
of patients to treat them?
○ It helps nurses to be aware of ways in which a
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 that is often very
present in a nurse's patient load.
○ 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.
○ In using cultural knowledge to treat a patient,
it helps a nurse to be open minded in
treatments that can be considered
non-traditional, such as spiritually based
therapies like meditation and anointing.
● In transcultural nursing, nurses practice according to
the patient’s cultural considerations.
● Culture - a set of beliefs held by a certain group of
people, handed down from generation to generation
○ The learned, shared and transmitted values,
beliefs, norms, and life way practices of a
particular group that guides thinking,
decisions, and actions in patterned ways.
TRANSCULTURAL NURSING THEORY
● Nurses have a responsibility to understand the role of
culture in the health of a patient. Not only can a cultural
background influence a patient’s health, but the patient
may be taking home remedies that can affect their
health as well.
Culturalogical Assessment
● Takes the patient’s cultural background into
consideration in assessing the patient and their health.
● Once the assessment is complete, the nurse should use
the culturalogical assessment to create a nursing care
plan that also takes the patient’s cultural background
into consideration.
Cultural Awareness
● 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
● 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
● State of being disoriented or unable to respond to a
different cultural environment because of its sudden
strangeness, unfamiliarity, and incompatibility to the
stranger’s perceptions and expectations that is
differentiated from others by symbolic markers
(cultures, biology territory, religion).
Cultural Care
● 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
● 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.
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ETHNOHISTORY
● Past facts, events, instances, and experiences of
individuals, 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
● 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 to deal with
handicaps and death situations.
Professional Care System(S)
● 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 (3) NURSING DECISIONS AND ACTIONS TO ACHIEVE
CULTURALLY FRIENDLY CARE FOR THE PATIENT
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.
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 a compromise that can eventually lead to a more
sustainable healthcare plan for the client because
encroachment on beliefs is minimized.
Cultural Care Repatterning or Restructuring
● Dwells on the 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 new practices as long as
they think that the results are culturally meaningful and
satisfying.
Theoretical Foundations of Nursing
● 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.
ROSEMARIE RIZZO PARSE
Human Becoming Theory
THE HUMAN BECOMING THEORY
● Guides the practice of nurses to focus on quality of life
as it is described and lived
● Presents an alternative to both the conventional
biomedical approach of most other theories and models
of nursing
● Rates quality of life from each person’s own perspective
as the goal of the practice of nursing
METAPARADIGMS
Person
● Defines the person (referred to as “man” throughout
the theory) as an open being who is more than and
different from the sum of the parts
Environment
● The environment is inseparable from the person, as well
as complementary to and evolving with the person
Health
● The open process of being and becoming, and involves
the synthesis of values
Nursing
● A human science an art that uses an abstract body of
knowledge to help people
● The theory provides a transformative approach to all
levels of nursing. It differs from the traditional nursing
process, particularly in that it does not seek to “fix”
problems. The model gives nurses the ability to see the
patient’s perspective
● This allows the nurse to be “with” the patient, and guide
him or her toward the health goals
● The nurse-patient relationship co-creates changing
health patterns. Nurses lice the art of human becoming
in presence with the unfolding of meaning,
synchronizing rhythms, and transcendence.
THE HUMAN BECOMING THEORY MAKES THE FOLLOWING
ASSUMPTIONS ABOUT MAN
● The human is coexistent while co-constituting
rhythmical patterns with the universe
● The human is open, freely choosing meaning in a
situation, as well as bearing responsibility for decisions
made
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● The human is unitary, continuously co-constituting
patterns of relating
● The human is transcending multidimensionally with the
possibles
THE HUMAN BECOMING THEORY TAKES THE FOLLOWING
ASSUMPTIONS ABOUT BECOMING
● Becoming is unitary with human-living-health
● Becoming is a rhythmically co-constituting the
human-universe process
● Becoming is the human’s patterns of relating value
priorities
● Becoming is an intersubjective process of transcending
with the possibles
● Becoming is the unitary human’s emerging
HUMAN BECOMING THEORY
Totality Paradigm
● Man is a combination of biological, psychological,
sociological, and spiritual factors
Simultaneity Paradigm
● Man is a unitary being in continuous, mutual interaction
with the environment
MAJOR THEMES IN THE HUMAN BECOMING THEORY
Meaning
● Human becoming is freely choosing personal meaning
in situations in the intersubjective process of living
value priorities
● Man’s reality is given meaning through lived
experiences
● Man and environment co-create
Illimitability
● “The invisible unbounded knowing extended to infinity,
the all-at-once remembering and prospecting with the
moment.”
Paradox
● “An intricate rhythm expressed as a pattern
preference.”
● Paradoxes are not “opposites to be reconciled or
dilemmas to be overcome but, rather, lived rhythms.”
POSTULATES IN THE HUMAN BECOMING THEORY
Freedom
● “Contextually construed liberation.”
● People are free to continuously choose ways of being
with their situations
Mystery
● “The unexplainable, that which cannot be completely
known.”
Theoretical Foundations of Nursing
JOYCE J. FITZPATRICK
Life Perspective Rhythm Model
METAPARADIGMS
Person
● Person includes both self and others
● Seen as an open system, a unified whole characterized
by a basic human rhythm
● The model recognizes individuals as having unique
biological, psychological, emotional, social, cultural, and
spiritual attitudes
Health
● A dynamic state of being that results from the
interaction of person and the environment
● A human dimension under continuous development, a
heightened awareness of the meaningfulness of life
● Optimum health is the actualization of both innate and
obtained human potential gathered from rewarding
relationship with others, goal directed behavior, and
expert personal care
Nursing
● A developing discipline whose central concern is the
meaning attached to life (health)
● Primary purpose of nursing is the promotion and
maintenance of an optimal level of wellness
MAJOR ASSUMPTIONS
● “The process of human development is characterized
by rhythms that occur within the context of continuous
person-environment interaction.”
● Nursing activity focuses on enhancing the development
process toward health
● A central concern of nursing science and the nursing
profession is the meaning attributed to life as the basic
understanding of human existence
● The identification and labeling of concepts allows for
recognition and communication with others, and the
rules for combining those concepts permits thoughts to
be shared through language