Transcultural Nursing Theory: Examples and Application

Transcultural nursing theory, developed by Madeleine Leininger, provides a framework for delivering culturally sensitive care. By respecting patients’ religious beliefs, incorporating traditional healing practices, and addressing language barriers, you can bring cultural competence into healthcare — leading to better treatment outcomes and happier patients.

Want to learn how to provide care that respects your patients’ cultural uniqueness? Madeleine Leininger’s transcultural nursing theory offers practical tips to elevate your nursing practice.

What Is the Transcultural Nursing Theory?

According to Madeleine Leininger, transcultural nursing theory is all about making care fit each patient’s unique background. This can include taking into account traditional healing practices, dietary restrictions, or religious beliefs in their treatment plan, or even inviting shamans or priests to join the care team. The goal is to deliver care that respects individual cultural needs while upholding universal principles of equality in healthcare.

The famous nurse behind the theory is Madeleine Leininger (1925–2012). She started her career in psychiatric nursing, but is best known for creating the transcultural nursing theory that revolutionized global healthcare by bringing cultural awareness into hospital units. This approach has since become a cornerstone of culturally competent nursing practice.

Leininger earned her nursing diploma from St. Anthony’s School of Nursing, then earned her master of science in nursing from the Catholic University of America, and later completed a PhD in Cultural and Social Anthropology at the University of Washington. She also wrote many influential books and articles on nursing and anthropology.

Transcultural Theory in Nursing: Key Takeaways

Let’s delve into the key takeaways of transcultural theory, looking at its main ideas, how it’s applied in practice, and how it boosts patient care and promotes equality in healthcare.

1. Cultural Competence in Healthcare

Did you know that around 281 million people live in countries other than where they were born, and around 285 million tourists travel globally every three months? In this globalized world, you’ll likely encounter a diverse range of patients no matter where you work.

Culturally congruent healthcare is a basic human right, not a privilege. As a healthcare professional, you need to develop skills and strategies for effective cross-cultural interactions, which may include active listening, the ability to modify communication strategies to align with the cultural preferences of the patient, and creativity to deliver healthcare education in a way your patient understands.

2. Cultural Care Actions

So how do nurses ensure culturally congruent care? Leininger identified three main strategies you can use when delivering care that respects cultural differences:

• Cultural preservation: Continuing a patient’s cultural practices during care. For example, encouraging a patient to continue performing their cultural rituals during hospitalization.
• Cultural accommodation: Incorporating a patient’s cultural practices into their treatment plan, such as combining traditional medicine with prescribed therapies.
• Cultural repatterning: Assisting patients in changing harmful cultural practices while still honoring their values. This means offering safer, culturally appropriate options that fit their traditions.

3. Worldview, Cultural, and Social Structure Dimensions

This concept stresses the importance of grasping a patient’s worldview and cultural and social factors that shape their health behaviors.

• Worldview is the big-picture perspective through which people see and interact with the world. This includes understanding religious beliefs, philosophical perspectives, and societal norms.
• Cultural and social structure refers to the ways in which social structures, such as family dynamics, gender roles, and socioeconomic status, shape health behaviors.

Assessing patients’ worldviews and social contexts is vital for effective cultural care. This might mean discussing family involvement in healthcare decisions and other elements that shape their health practices.

4. Ethnohistory and Environmental Context

It’s essential to understand a patient’s ethnohistory and environmental context in providing culturally congruent care.

• Ethnohistory refers to the cultural history of a group, including migration patterns, social structures, and historical experiences.
• Environmental context includes the social, physical, and ecological factors that affect your patients’ health, such as whether they live in urban or rural areas or have access to medical care.

5. Generic and Professional Healthcare Systems

Generic (folk) and professional healthcare systems are constantly influencing each other. Understanding this interplay is key to providing high-quality culturally congruent care.

• Generic healthcare systems includetraditional healers, folk medicine, and community-based health practices.
• Professional health care systems include formally trained medical professionals, such as registered nurses, physician assistants, and nurse practitioners.

One of the goals of culturally congruent care is to develop strategies for effectively bridging the gap between generic and professional health care systems, ensuring that care is both culturally sensitive and medically appropriate.

6. Emic and Etic Perspectives

There is a difference between emic (insider) and etic (outsider) perspectives in understanding cultural health practices.

• The emic perspective involves understanding health and illness from the viewpoint of the cultural group itself.
• The etic perspective involves viewing these practices through the lens of an external observer, such as a healthcare provider.

It’s important to acknowledge this difference and seek to understand by asking questions and actively listening without bias and assumptions.

7. Cultural Imposition

This refers to imposing one’s own cultural beliefs, values, and practices on others, often without recognizing or respecting the cultural differences of the patient. Cultural imposition can lead to conflicts, misunderstandings, and poor patient outcomes.

• Recognizing cultural imposition means being aware of when you might be projecting your own beliefs onto patients.
• Avoiding cultural imposition involves actively understanding and respecting your patient’s cultural background by listening to their preferences and integrating their cultural practices into their care when possible.

Transcultural Nursing Theory Application

Effective application of Leininger’s theory in nursing practice involves understanding and respecting patients’ cultural backgrounds to enhance their overall care experience. Let’s take a look at several transcultural nursing theory examples:

• Nurses in orthopedic settings can incorporate herbal poultices for pain relief, alongside conventional treatments like physical therapy and medication, if the patient values traditional practices.
• Nurses working in labor and delivery units can honor a patient’s cultural traditions by keeping their spouse out of the delivery room if requested. The nurse can adjust the birthing plan to support privacy preferences while still keeping the mother and baby safe.
• Nurses working in geriatric care settings can adjust care to fit cultural attitudes on aging and end of life by adding spiritual support and religious practices.
• Nurses working in psychiatric facilities can use relaxation techniques from patients’ cultures, like meditation or chanting mantras, to teach stress-coping skills.
• Nurses working in home health care settings can develop personalized care plans that incorporate cultural practices, such as setting up automatic lighting systems for patients observing Shabbat.

Transcultural Nursing Theory: Frequently Asked Questions

What challenges might nurses face when implementing the theory of transcultural nursing?

One challenge is bias — remember, not everyone from the same culture shares the same worldview. It’s crucial to assess each patient individually. Integrating cultural practices with standard medical protocols can also be tricky. Plus, language barriers can be a big hurdle, but medical translator services can help bridge the gap.

How can nurses improve their understanding of different cultures?

The Transcultural Nursing Society offers cultural competency training that can significantly boost your skill set. Additionally, you can attend nursing conferences, read nursing books, and ask your more experienced colleagues for help. Most importantly, actively seeking interactions with diverse patient populations can be very beneficial in getting to know the culture of the people you’re serving.

How do you perform a cultural assessment in nursing practice?

To perform a cultural assessment effectively, follow these steps:

• Ask open-ended questions: Start by asking the patient about their cultural beliefs and health practices.
• Explore health beliefs: Determine how they view health, illness, and healing. Include any traditional or folk remedies they use.
• Assess family and social influences: Identify the role of family and community in their healthcare decisions.
• Consider religious and spiritual practices: Find out if they follow specific religious rituals or have spiritual beliefs that impact their care.

After completing your assessment, document this information and tailor the care plan to align with their cultural needs. Cultural assessment questionnaires and cultural competence checklists can be helpful tools in this process.

Need Help Finding a Great Nursing Job?

Ready to bring transcultural nursing theory to the bedside? IntelyCare is your gateway to finding the best-fitting nursing jobs on the market. Sign up today to find your next big opportunity.