Transcultural Nursing Theory

Background 

Transcultural theory of nursing practices was first introduced and developed in the 1950s by    Madeleine Leininger. The theory’s primary intention was to improve the universal patient satisfaction in a care delivery setup. The theory acknowledges that patients belong to different cultures with different social beliefs and practices. It recommends that nurses need to observe the fact that their culture much influences patient’s satisfaction in the quality of care. According to this theory, a nursing practitioner must be sensitive to the patient’s culture and avoid questions or behaviors that are not approved by the patient culture when delivering care service to the patient’s ( Leininger, 1987) . Moreover, the theory demands that all nurses put a significant level of respect to the patient’s culture and avoid any form of criticism based on culture when delivering the care.  

Theorist’s Background 

Madeleine Leininger was born in Sutton, United States. She went to the University of Washington and later to The Catholic University of America, where she advanced her knowledge in nursing care. She became a professor in nursing practices and took particular interest in transcultural care. Madeleine Leininger became the founder and the International leader of Transcultural nursing in 1961 when it was first published. Throughout her career, she worked exceptionally in the field of nursing, specializing in the transcultural aspect of care for nursing practitioners (Leininger, 1987). Her greatest contribution to transcultural nursing was on the discussion of the meaning of care and what it entails in nursing practice. She also wrote several books discussing what it means to care aspects of transcultural care. One of her most renowned books on the topic include; Culture Care Diversity, Transcultural Nursing concepts, Nursing, and Anthropology. Madeleine Leininger became determined in developing the theory; hence, the theory is associated with her name and profession as a nurse. In her description of what care entails in healthcare service delivery, she outlined the various aspects of culture that might affect the perception of a patient regarding the type and mode of delivery of care service. Some of the critical elements of culture that Madeleine Leininger outlined in her theory include; sexual orientation, interpersonal relationship, language and communication, gender, age, socio-economic status, ability/disability status, among others. She stressed that all the aspects were key in the care delivery process, and hence, they are key to note when delivering any care service (Leininger, 1987). Madeleine Leininger also worked as a theorist, anthropologist, public speaker, author, and educator. 

Several other authors and professionals have specialized in research and advancement in the transcultural nursing theory. The American nursing Ph.D. holder, Hiba B. Wehbe-Alamah, is currently working on research to find more about the transcultural nursing theory from the University of Michigan. Priscilla Limbo Sagar is also developing the theory through conducting research and educating on how the transcultural concepts of nursing can apply in nursing administration, practice as well as education (Leininger, 1987). Margaret M. Andrews has also worked considerably in the transcultural nursing theory development. Her contributions to the theory include, through her book, Transcultural Concepts in nursing as well as education among others. 

Diversities among the world’s communities 

The transcultural theory of nursing was developed to address the issue of diversity between various communities in the world in the healthcare delivery context. The world is made of people from different geographical locations who have different beliefs, and their beliefs relate to healthcare delivery in various ways. Despite the diversities in the culture of the world’s communities, the need to satisfy all the clients’ needs remains constant. The theorist, therefore, figured out that there is a need for different approaches to addressing patients from different socio-cultural backgrounds. Before the development of the theory, there had been strategies aimed at improving the quality of care delivered in hospitals. Some of the strategies included reducing pain among the patients when receiving care services, timely delivery of the care services, improving infrastructure for care delivery, and equipping them with adequate knowledge to help he patients. However, there had not been an attempt to address the aspect of cultural diversity among the patients that visit healthcare institutions seeking medical services. This brought a problem such that some patients, especially from minority groups, could avoid seeking medication from hospitals following the clash of culture with modes of delivery of care services. Most patients with such issues ended up not getting satisfactory care despite being put through the best available medication program. 

Theory Description 

Transcultural Nursing Theory utilizes reproductive reasoning in outlining the recommended nursing practices in a healthcare setup. When describing how a patient should be treated to benefit most and be satisfied with the care delivery service, the theory begins by evaluating how individual patient relates to available services. The theory takes into account that patients belong to different cultural categories. Each culture has a set of values that must not be altered. The theory then indicates that respecting the values of a culture is a show of respect to the individual patients. The theory finally establishes that, therefore, when administering care, respect for the values of the culture from which the patient originate contribute significantly towards their satisfaction. 

Concepts 

The United States is a metropolitan country made of people from different parts of the world. The citizens themselves have different ancestry origins. For instance, the black Americans in the nation came from Africa during the slave trade. In contrast, Asian Americans moved into the country by immigration means in search of opportunities f employment and education. The two groups, therefore, have different cultures which, are a reflection of the cultures of people in the lands they left behind while they migrated into the US. The impact of cultural differences between the two minority groups in the country has a substantial contribution to how they interrelate with others, how they communicate, and what they consider moral. Consequently, their difference in beliefs has significant impacts on how they would want to be handled by nurses when receiving medication. Asian Americans, for instance, would always avoid direct eye-contact when being interrogated by healthcare practitioners. However, the case would be different when dealing with a white and black Americans. Also, medical examination that is suitable for a child might not be pleasant to an individual in his or her old age. Therefore, despite a given medical procedure being the most recommended, the level of satisfaction would vary widely when the same medical administration procedure is involved during care service delivery. The transcultural nursing theory puts the difference in beliefs into consideration to address the gap in care delivery criteria that makes some clients dissatisfied or feel offended by the way they have been handled in the hospital. 

Diagram 

( Gonzalo, 2019) 

Evaluation 

Assumption 

The Transcultural Nursing Theory base the arguments of nursing care practice on one key assumption. The theory starts by recognizing that people from a different region or culture believe in specific community-based values. The theory integrates this idea in recommending the kind of care a patient should be given. Having recognized the differences between people of different cultures, the theory assumes that all cultural values have equal weight to the community that believes in them. Therefore, the theory stresses giving all the cultural values the same respect. This is practiced in the aspect that the transcultural nursing theory recommends that a patient should be given the opportunity to decide the way he or he would like to be treated ( Gonzalo, 2019) . This assumption is true and not only cuts across different cultures but also different age groups. The elderly individuals would love to be treated differently from how a young individual would be. Similar medical administration to address a particular health concern would, therefore, be satisfactory and unsatisfactory for individuals belonging to different age groups. This brings in the major assumption in the theory that differences in values have the greatest influence in the level of satisfaction of the delivered healthcare service. 

Metaparadigm 

The theory addresses all four Metaparadigm in the nursing and care environment. The theory addresses the environment component by allowing a chance for a patient to decide on the kind of environment he/she would like to receive healthcare. This involves choosing the type of equipment to be used in their treatment, professionals to treat them, among others. The transcultural nursing theory also addresses the person component by giving priority to personal dignity when addressing their medical issues. According to the theory, any patient has the right to tell what they would and would not approve a process of administering healthcare services to them ( CareeTrend, 2020) . For the health component, the theory tactically recommends that healthcare practitioners deliver care that takes into account patients' emotional, social, and spiritual values and addresses them precisely. The last Metaparadigm that Transcultural theory addresses are the nursing component through insisting that care services must have optimal outcomes. The transcultural theory demands that a nurse should use all necessary skills and display great professionalism through avoiding biased judgments on patient’s requests during healthcare delivery. 

Clarity 

Madeleine Leininger’s Transcultural Nursing Theory is unquestionably clear and outlines all the concepts it addresses in nursing practices. The clarity aspect of the theory comes in with the fact that it describes every concept it addresses. Madeleine Leininger explains what culture means and defines what a cultural value is. She further explains the culture and its values are much of an individual level and not the societal level as it is understood by many. She describes that the values for an elderly individual might be different from that of a young individual despite being from the same bloodline. Also, the theorist explains all that constitute an individual’s culture. According to her, emotions, identity, and socio-cultural aspects are the building blocks of an individual’s culture. Having explicitly defined culture, she furthers to creating an understanding of how to integrate learning in healthcare service delivery. Among the crucial matters that the theorist identified include giving priority to patient’s dignity, displaying professionalism through avoiding biases, and looking down on others ‘cultures when addressing their medical issues, among others. It is, therefore, simplified enough for easy understanding by all the stakeholders involved in the healthcare sector. 

Congruence 

Transcultural Nursing Theory is absolutely in agreement with the primary goal of healthcare service delivery. When delivering a care service to any patient, the goal of any nurse is to deliver it in the patient’s best benefit. The patient is the receiver of the service, and without satisfying their needs, then the care service would not have attained any level of success. Benefiting the patient not only entails offering the drugs that address his or her issue but also communicating with the patient in a manner that is pleasing. Additionally, it requires that the patient’s consent is consulted on the approach for addressing the issue with him or her ( Clerk, 2018) . The primary goal of the Transcultural Nursing Theory is to ensure the appropriate handling of a patient during care delivery. This involves treating them satisfactorily with keynote taken on the different values that patients live with. The theory is aware of the fact that people are not from the same culture and hence, have different spiritual and cultural values that they cannot go against. The theory is, therefore, in agreement with the goals of healthcare delivery as it advocates for giving different approaches when handling patients who do not share a set of beliefs and values. 

Application 

Level 

The transcultural nursing theory is a middle-range theory and addresses matters to do with the relationship between society and nursing administration. The theory application involves both medical professionals and clients seeking medical services. When bringing the theory into effect, a patient needs to tell how they would like to be treated by the professionals. Having informed the professional on how he or she would want to be treated, the theory furthers to cautioning professionals to avoid any biased interpretation of the patient’s cultural values ( Clerk, 2017) . In addition, the theory recommends that all the cultural values obtained during the consultation of the patient’s consent are observed by the healthcare professional at the time he or she is addressing the health concern. The approach of treatment must not violate any aspect of the patient’s values, whether the patient is conscious or unconscious. 

Use 

The theory is used in enhancing satisfactory care service delivery to patients. The primary goal of the healthcare service is to make sure that patients are satisfied with the nature of care. This is through both the approach of care and the effectiveness of the medical administration offered. Despite the advancement in technology and other aspects of healthcare that aims at benefiting the patients most, the cultural difference has not been addressed sufficiently ( Im, & Lee, 2018) . The theory is used in enhancing the cultural approach when addressing healthcare issues among the patients. The theory works to create an environment where patients are wholesomely satisfied when receiving treatment. 

Weaknesses 

Although the theory is keen at promoting healthcare through upholding cultural approach, it fails to recognize development among the nurses themselves. It does not create the desired environment for nurses’ development. The theory ought to have recognized that collaboration of nurses’ help in promoting healthcare delivery efficiency. The theory does not include an important concept of nurses peer development as a practice for improving healthcare services. Additionally, the theory has not given a comprehensive consideration to all aspects of culture in the modern society. In the current societal setup, people are given the chance to decide their sexual orientation and are protected by the low against any prejudice shown towards their choices. For instance, LGBTQ individuals are not well represented in the theory. 

Future 

The theory has significantly improved the care environment through adjusting healthcare to consider cultural differences when addressing healthcare matters among the patients ( Im, & Lee, 2018) . The theory is expected to bring about more satisfaction among patients receiving healthcare services from various healthcare stations in the world. Currently, the theory does not talk much about the care for transgender and the non-usual sexual orientations. However, as the issue about people covered under the LGBTQ umbrella continues to take ground, there is a high possibility that more sections addressing how they should be handled when receiving healthcare services will be included in the theory. Moreover, the theory has improved the general satisfaction levels among patients. As time goes by, the level of satisfaction among patients will continue to rise when facilities care across the world embraces the theory fully. It is therefore, among the most effective theories in the healthcare environment. 

References 

Gonzalo, A. (2019, September 10). Madeleine Leininger: Transcultural Nursing Theory. Retrieved from https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/ 

CareeTrend. (2020). Four Basic Metaparadigm Concepts in Nursing. Retrieved from https://careertrend.com/13373959/four-basic-metaparadigm-concepts-in-nursing 

Im, E. O., & Lee, Y. (2018). Transcultural Nursing: Current Trends in Theoretical Works.  Asian nursing research ,  12 (3), 157-165. 

Clerk, S. (2017, July 24). Cultural Congruent Care: A Reflection on Patient Outcome | Insight Medical Publishing. Retrieved from http://healthcare-communications.imedpub.com/cultural-congruent-care-a-reflection-on-patient-outcome.php?aid=20786 

Leininger, M. M., McFarland, M. R., & McFarlane, M. (1987).  Transcultural nursing  (pp. 1-30). Lincoln Institute of Health Sciences.