Transcultural

Nursing
(Semi-Finals)
Transcultural Health
Domains
Transcultural
Health Domains
qHealth Traditions
qHealing Traditions
qFamilial Health Traditions
qTranscultural Health Care Delivery
Perspectives
qHealth Traditions
• Health Traditions Model
Ø Uses the concept of holistic health and explores what people do from a
traditional perspective to maintain health, protect health or prevent
illness, and restore health, in this traditional context, has nine interrelated
facets, represented by:
1. Traditional methods of maintaining health – physical, mental,
and spiritual
2. Traditional methods of protecting health - physical, mental, and
spiritual
3. Traditional methods of restoring health - physical, mental, and
spiritual
Ø Traditional methods of health maintenance, protection, and restoration
require the knowledge and understanding of health-related resources
from within a given person’s ethnoreligious cultural heritage.
Health Traditions
• Traditional health Maintenance

1. Clothing

boots when it snows and sweaters when it is cold, long sleeves in the sun, and scarves to protect
from drafts and dust.

Many traditional ethnic groups or religions may also prescribe special clothing or head coverings.

2. Food

The food that is eaten and the methods for preparing it contribute to people’s health.

traditional diets are followed, and food taboos and restrictions obeyed.

3. Mental health – maintained by concentrating and using the mind – reading, crafts, games, books,
music, hobbies.

4. Spiritual health – maintained in the home with family closeness – prayer and celebrations
Health Traditions
• Traditional Etiology
Ø The protection of health rests in the ability to understand
the cause of a given illness or set of symptoms.
Ø Some of the traditional health and illness beliefs regarding
the causation of illness differ from the modern model of
etiology.
Ø Illness is most often attributed to the “evil eye”. The evil eye
is primarily a belief that someone can project harm by gazing
or staring at another’s property or person. This belief is
probably the oldest and most widespread of all superstitions,
and it is found to exist in many parts of the world, such as
southern Europe, the Middle East, and North Africa.
Health Traditions
Ø The common beliefs in the evil eye assert that:
1. The power emanates from the eye (or mouth) and strikes
the victim.
2. The injury, be it illness or other misfortune, is sudden.
3. The person who casts the evil eye may not be aware of
having this power.
4. The afflicted person may or may not know the source of
the evil eye.
5. The injury caused by the evil eye may be prevented or
cured with rituals or symbols.
6. This belief helps to explain sickness and misfortune
Health Traditions
Ø The nature of the evil eye is defined differently by different populations
Ø How it is cast:
- Philippines – the evil is cast through the eye or
mouth;
- Mediterranean – the avenging power of God;
- Italy – a malevolent force like a plague and is warded
off by wearing amulets.
Ø Who can cast it:
- Mexico – strangers
- Iran – kinfolk
- Greece – witches
Ø Degree of power:
- Mediterranean – devil
- Near East – Deity
Health Traditions
Ø Germans – evil eye is known as aberglobin or
aberglaubisch and causes preventable problems, such as
evil, harm, and illness. Among the Polish, the evil eye is
known as szatan, literally, “Satan”.
Ø Some “evil spirits” are equated with the devil and can be
warded off by praying to a patron saint or guardian angel.
Ø Szatan is also averted by prayer and repentance and the
wearing of medals and scapulars.
Ø Illness can also be attributed to people who have the
ability to make others ill, e.g. witches, practitioners of
voodoo.
Health
Traditions
• Health Protection
Ø Traditional practices used in the protection of
HEALTH include:
1. The Use of protective objects – worn,
carried, or hung in the home.
Objects that protect health:
Amulets – objects such as
charms, worn on a string or chain around
the neck, wrist, or waist to protect the
wearer from the evil eye or the evil spirits
that could be transmitted from one person
to another, or could have supernatural
origins.
Examples:
Ø Amulets may also be written documents on
parchment scrolls, and these are hung in the home
to protect the family from the “evil eye”, famine,
storms, diseases and countless other dangers
ØBangles are worn by people
originating from the west Indies.
The silver bracelets are open to “let
out evil” yet closed to prevent evil
from entering the body. They are
worn from infancy, and as the
person grows they are replaced
with larger bracelets.
Ø In addition to amulets, there are
talismans. Talisman is believed to
possess extraordinary powers and
may be worn on a rope around the
waist or carried in a pocket or
purse.
Ø Talisman - an object, typically an
inscribed ring or stone, that is
thought to have magic powers and
to bring good luck.
2. The use of substances – ingested in certain ways and amounts or eliminated, and
substances worn or hung in the home.

• Substances that protect health:

Ø People from any ethnic backgrounds eat raw garlic or onions in an effort to prevent
illness. Garlic or onions may be worn on the body or maybe hung in the Italian,
Greek or Native American home

Ø Chahayotel, a seed may be tied around the waist by a Mexican person to prevent
arthritic pain.

Ø Ginseng root, the most famous of Chinese medicines. It has universal medicinal
applications and is used preventively to “build the blood,” especially after childbirth.
Tradition states that the more the root looks a man, the more effective it is. Ginseng
is also native to the United States and is used in this country as a restorative tonic.
Ø Diet regimens also are used to protect health. It is believed that the body is kept in
balance or harmony by the type of food that one eats.
- Traditionalists have strong beliefs about diet and foods and their
relationship to the protection of health.
- Kosher diet – a practice among Jewish people which mandates the
elimination of pig products and shellfish. Only fish with scales and fins are
allowed, and only certain cuts of meat from animals with a cleft hoof and that
chew the cud can be consumed (e.g. cattle and sheep).
- Muslims – avoidance of pig products; the meats are “Halal.”
- Jews – believed that milk and meat must never be mixed and eaten at the
same meal.
- Traditional Chinese homes – a balance must be maintained between foods
that are yin or yang. These are eaten in specified proportions.
- Hispanic homes – foods must be balanced as to “hot” and “cold”. These
foods too, must be eaten in the proper amounts, at certain times, and in certain
combinations.
3. The practices of religion such as the burning of candles, the
rituals of redemption, and prayer.
Ø Spiritual practices that protect health:
Ø Religion strongly affects the way people choose to protect
health, and it plays a strong role in the rituals associated with
health protection.
Ø Religion dictates social, moral, and dietary practices that are
designed to keep a person in balance.
Ø Many people believed that illness and evil are prevented by strict
adherence to religious codes, morals, and religious practices. They
view illness as a punishment for breaking a religious code
Ø Example of protective religious figure is the Virgin of Guadalupe,
the patron saint of Mexico, who is pictured on medals that people
wear or in pictures hung in the home. She is believed to protect the
person and home from evil and harm, and she serves as a figure of
hope.
• Our Lady of Guadalupe (Spanish: Nuestra
Señora de Guadalupe), also known as
the Virgin of Guadalupe (Spanish: Virgen de
Guadalupe), is a Catholic title of Mary, mother
of Jesus associated with a series of
five Marian apparitions in December 1531, and
a venerated image on a cloak enshrined within
the Basilica of Our Lady of
Guadalupe in Mexico City. The basilica is the
most-visited Catholic shrine in the world, and
the world's third most-visited sacred site
• Health Restoration
Ø Health restoration in the physical sense can be
accomplished by the use of countless traditional
remedies such as herbal teas, liniments, special foods
and food combinations, massage, and other activities.
Ø The restoration of health in the mental domain may
be accomplished by the use of various techniques such
as exorcism, calling on traditional healers, using teas or
massage, and seeking family and community support.
Ø The restoration of health in the spiritual sense, can
be accomplished by healing rituals; religious healing
rituals; or the use of symbols and prayer, meditation,
special prayers, and exorcism.
• Folk Medicine

1. Natural Folk Medicine

Ø Represents one of humans’ earliest uses of the natural environment and utilizes, herbs, plants, minerals,
and animal substances to prevent and treat illnesses.

Ø Natural folk medicine has been and still is widely practiced throughout the world. In general, this form
of prevention and treatment is found in old-fashioned remedies and household medicines. These
remedies have been passed down for generations, and many are in common use today.

Ø Much folk medicine is herbal in nature, and the customs and rituals related to the use of this herbs vary
among ethnic groups. Commonly, across cultures, these herbs are found in nature and are used by
humans as a source of therapy, although how these medicines are gathered and specific modes of use
may vary from group to group and place to place.

Ø In general, folk medical traditions prescribed then time of year in which the herb was
to be picked; how it was to be dried; how it was to be prepared; the method, amount, and frequency of
taking, and so forth.
2. Magicoreligious Folk Medicine

Ø Represents the use of charms, holy words, and holy

actions to prevent and cure illnesses.

Ø The magicoreligious form of folk medicine has existed for

as long as humans have sought to maintain, protect, and
or restore their health. It has now, in this modern age of
science and technology, come to be labeled by some as
“superstition,” old-fashioned nonsense,” or foolishness,’
yet, for believers it may go so far on the continuum as to
take the form of religious practices related to health
maintenance, protection, restoration, and healing.
Healing Traditions
• Healing
Ø The professional history of nursing was born with Florence
Nightingale’s knowledge (1860) that “nature heals.”
Ø Blattner (1981) has written a text designed to help nurses assist
patients to upgrade their lives in a holistic sense and to heal the
person – body, mind, and spirit.
Ø Krieger (1979), in The Therapeutic Touch, has developed a method
for teaching nurses how to use their hands to heal.
Ø From the fields of anthropology and sociology come texts that
describe rituals, customs, beliefs, and practices that surround
healing
Ø Buxton (1973) describes traditional beliefs and indigenous healing
rituals in Mandari and relates the source of these rituals with how
man views himself in relation to God and earth. In this culture, the
healer experiences a religious calling to become a healer. Healing
is linked to beliefs in evil and the removal of evil from the sick
person.
• Ancient forms of healing
Ø Illness was considered to be crises and the people of
ancient times developed elaborate system of healing.
Ø The cause of an illness, once again, was attributed to the
forces of evil, which originated, either within or outside the
body. Early forms of healing dealt with the removal of evil.
Once a method treatment was found effective, it was passed
down through the generations in slightly altered forms.
Ø If the house of sickness-causing was within the body,
treatment involved drawing the evil out of the body. This
may have been accomplished through the use of purgatives
that caused either vomiting or diarrhea, or by blood-letting:
“bleeding” the patient or “sucking-out” blood.
Ø Leeching was another method used to remove corrupt
humors from the body.
Ø Ancient forms of healing

Ø If the source of the evil was outside the body, there were a number of ways to deal with it.
One source of “external” evil was witchcraft. In a community, there were often many people
(or a single person) who were “different” from the other people. Quite often, when an
explainable or untreatable illness occurred, it was these people (or person) who were seen
as the causative agents. In such a belief system. Successful treatment depended on the
identification and punishment of the person believed responsible for the disease. By
removing or punishing the guilty person from the community, the disease would be cured.

Ø In some communities, the healers themselves were seen as witches and the possessors of
evil skills.

Ø Various rituals were involved in the treatment of ill people. Often, the sick people was
isolated from the rest of the family and community. Sacrifices and dances often were
performed in an effort to cure the ills.

Ø Another cause of illness was believed to be the envy of people within the community. The
best method, consequently, of preventing such an illness was to avoid provoking the envy
of one’s friends and neighbors.
Familial Health Traditions
• Activity 1:

• Ask yourself the following questions regarding your health/

health beliefs and practices:

1. What remedies and/or methods do you use to maintain, protect,

and restore your health/health?
2. Do you know the health/health and illness beliefs and practices
that were or are part of your heritage?
3. Were you ever thought to be mortally ill/ill?
4. What did your mother or grandmother do to take care of you?
5. Did she consult someone in your own ethnic/religious
community to find out what was wrong?
Familial Health Traditions
• Activity 2:

• Conduct an interview to your grandmothers, great-aunts, and mother.

1. What is your family’s ethnic background? Place of origin? Religion?

2. What did they do to maintain health? What did their mothers do?
3. What did they do to protect health? What did their mothers do?
4. What home remedies did they use to restore health? What did their
mothers use?
5. What are their traditional beliefs regarding pregnancy and childbirth?
6. What are their traditional beliefs regarding dying and death?
Familial Health • Family Health Histories Obtained from Students of
Various Ethnic Backgrounds and Religions
Traditions

Ethnicity/religion Health Maintenance Health Protection Health Restoration

Austrian (US), Jewish Eat wholesome foods, homegrown Camphor around the neck (in the Sore throat: go to the village store; find a
fruits and vegetables, bake own bread winter) in a small cloth bag to salted herring, wrap it in a towel, put it
prevent measles and scarlet fever around the neck, and let it stay there
overnight; gargle with salt water
Boils: fry chopped onions, make a compress
and apply to the infections
Black and Native American, Eat balanced meals three times a day, Keep everything clean and sterile; Bloody nose: place keys on a chain around
Baptist dress right for the weather stay away from people who are sick; the neck to stop.
Regular check-ups; blackstrap
Sore throat: Suck yolks out of eggshell;
molasses
honey and lemon; baking soda, salt, warm
water; onions around the neck; salt water to
gargle.
 • Family Health Histories Obtained from Students of
Various Ethnic Backgrounds and Religions

Black African (Ethiopia), Orthodox Keep the area clean; pray every Eat hot food such as pepper; fresh Eat hot and sour foods, such as lemons, fresh garlic, hot
Christian morning when getting up from bed garlic, lemon mustard, red pepper; make a kind of medicine from leaves and
roots of plants mixed together.

Colds: hot boiled milk with honey.

Evil eye: they put some kind of plant root on fire and make the
man who has the evil eye smile and the man talks about his
illness
Canadian, Catholic Cleanliness Sleep Kidney problems: Herbal teas

Food: people should eat well (fat people used to be Lots of good food Colds: hot lemons
considered healthy
Elixirs containing herbs and brewed, given as a vitamin Infected wounds: raw onions placed on wounds
Prayer: health was always mentioned in prayer tonic
Cough: shot of whiskey
Wear camphor around the neck to ward off any evil spirit;
Use Father John’s medicine November to May Sinuses: Camphor placed in a pouch and pinned to the shirt

Fever: Lots of blankets and heat make you sweat out a fever

Headache: Lie down and rest in complete darkness

Aches and pains: Hot Epsom salt baths

Eye infections: Potatoes are rubbed on them or a gold wedding ring is placed on them and
the sign of the cross is made three times.
 • Family Health Histories Obtained from Students of
Various Ethnic Backgrounds and Religions

Colds: Fluids, aspirin. Rest

Go to doctor when sick
Observe precautions, such as dressing
Stomach upset: eat light and bland foods
Health care for others, not self warmly, not going out with wet hair; getting
enough rest, staying in bed if not feeling Muscle aches: massage with alcohol
Reluctantly sought medical help
well (mother)
Sore throat: gargle with salt water; tea with
Health for self not a priority
Not much to prevent illness-very ill today lemon and honey
Physician twice a year with chronic diseases
Eastern Europe (US); Insomnia: glass of wine; chicken soup used by
Jewish Doctor only when pregnant Vitamins and water pills mother and grandmother
English, Baptist Eat well; daily walks, read, keep warm   Earache: honey and tea, warm cold-liver in ear; stay in bed

Cold: heat glass and put on back

English, Catholic Lots of exercise, proper sleep; lots of walking; no Maintain a good diet; fresh vegetables; vitamins; little meat; Cuts: wet tobacco
drinking or smoking; hardwork; bedroom window open lots of fish; no fried foods; lots of sleep; strict enforcement of
at night; take baths; good housekeeping; never wear lifestyle; keep kitchen at 900F in winter and house will be Colds: chicken soup; herb tea made from roots; alcohol
dirty clothing; immediate clean-up after meals; wash warm concoctions; vicks and hot towels on chest; lots of fluids, rest;
pan before meals; rest vicks, sulfur and molasses

Sore throat: four onions and sugar steeped to heal and soothe the
throat

Rashes: burned linen and cornstarch

 • Family Health Histories Obtained from Students of
Various Ethnic Backgrounds and Religions

French (France), Proper food; rest; proper clothing; cold liver Every spring give sulfur and molasses for 3 days as a laxative to get Colds: rubs chest with vicks; honey
Catholic oil daily rid of worms
French Canadian, Wear rubbers in the rain and dress warmly; Sulfur and molasses in spring to clear the system Colds: brandy with warm milk; honey and lemon juice; hot poultice on
Catholic take part in sports; active body; lots of sleep the chest; tea; whiskey and lemon
Cold liver oil in orange juice
Back pain: mustard packs and
No “junk foods”; play outside; daily use of Geritol; camphor on
clothes; balanced meals Rashes: Oatmeal baths

Sore Throat: wrap raw potatoes in sack and tie around neck; soap and
water enemas

Warts: rub potato on wart, run outside and throw it over left shoulder
Iran (US), Islam Cleanliness; diet Dress properly for the season and weather; keep feet from getting Sore throat: gargle with vinegar and water
wet in the rain
Cough: honey and lemon
Inoculations
Indigestion: baking soda and water

Sore muscles: alcohol and water

Rashes: apply cornstarch

 • Family Health Histories Obtained from Students of
Various Ethnic Backgrounds and Religions

Italian (US), Catholic Hearty and varied nutritional intake; lots Garlic cloves strung on a piece of string around the neck of Chicken soup for everything from colds to having a baby
of fruits, pasta, wine (even for children), infants and children to prevent colds and “evil” stares from
cheese, homegrown vegetables, and other people which they believed could caused headaches Boils: cooked oatmeal wrapped in a cloth (streaming hot)
salads; exercise in form of physical and a pain or stiffness in the back or neck (a piece of red applied to drain pus
labor; molasses on a piece of bread, or ribbon or cloth on an infant served the same purpose) Headache: fill a soup bowl with cold water and put some olive
oil and sugar on bread; hard bread (good oil in a large spoon; hold the spoon over the bowl in front of the
for the teeth) Keep warm in cold weather; Keep feet warm; eat properly;
never wash hair or bathe during period; never wash hair person with the headache; while doing this, recite words in
Pregnancy: 2 weeks early: girl before going outdoors or at night; stay out of drafts; Italian and place index finger in the oil in the spoon: drop three
drops of oil in the water; the severity of headache can be
2 weeks late: boy To prevent “evil” in the newborn, a scissor was kept open determined (large = more severe); after this is done three times,
under the mattress of the crib wrapped around the baby the headache is gone.
Heartburn: baby with lots of hair from the waist to the feet
Upset stomach: herb tea
Eat fruit at end of meal cleans teeth; If infants got their nights and days mixed up, they were tied
early to bed and early to rise upside down and turned all the way around Sprains: beat egg whites, apply to part, wrap part

Fever: cover with blankets to sweat it out

Colic: warm oil on stomach

Acne: apply baby’s urine

Toothache: whiskey applied topically

• Examples of selected Familial Ethnocultural and
Religious Beliefs and Practices Related to birth and
death

Nation of Origin and

Religion Birth beliefs Death beliefs

Cape Verde - Christian Baptism Death is a part of life

England - Christian Baptism Person goes to heaven

Natural event Body dying
Funeral and prayer

Everlasting life with Christ

Germany - Lutheran Do not take baby out until it is God’s will

baptized
Body dies when we die – souls go to heaven and
Mother does not go to the enjoy everlasting life
baptism
Celebrate person’s life and the promise of eternal life
Birth is sacred
 • Examples of selected Familial Ethnocultural and
Religious Beliefs and Practices Related to birth and
death
Greece - Orthodox After 40 days mother and newborn go to church – baby is blessed and The good go to the paradise; the bad go to the hell
prayers are said to keep away the evil spirits
After death light a candle that burns all night
Baptized at 2 gifts given to the baby to protect it from the evil eye –
charms of white and blue beads are worn on the wrist Visit grave daily

If the baby cries excessively, exorcism may be performed Hold a special service on the 40th day

Wrap the baby in blankets and pin to sheets to relax Bones are unburied after 3 years and are put into a holy box and are
placed in the church or are reburied in the family grave

In mourning women wear black for the rest of their lives and men grow
facial hair

Some older people believe in ghosts

Ireland-Catholic Baby shower before birth but never set-up the crib until after birth Wake – “a party with one less person”

Men not present at birth Final separation of the soul from the body – soul lives on and is
transported to God
Tell of pregnancy at 3 months
Dying: pray the Rosary aloud as it is a stepping stone to the Virgin
Mary asking her to watch over this person and guide them to
everlasting peace.

Blessing with oils and receive the Eucharistic for the last time

Dying person wears a Rosary around their neck to keep evil spirits
away and God closer

After death, the body is washed and prepared for the wake at home by
a neighbor and then the wake and mass

Mourning: Keening – a ritual of professional criers coming to the home

and crying for hours over the death of a family member

Gathering family and friends

Spirit goes to heaven or hell

• Examples of selected Familial Ethnocultural and
Religious Beliefs and Practices Related to birth and
death
Closed casket
Italy -
Cathoic Life begins at conception cremation
Japan-Shinto Umbilical cord saved – a lasting bond between Cremation
mother and child

100-day old child taken to the Shrine

Lithuania - Baptism Pray for the dead
Catholic
Visit graves
Portugal Throw a party for the birth of a boy (relates to the Celebrate a painless death – means the person has been good
time when males were needed to work on the farms) and is now with Jesus

Women during pregnancy get less pretty with a girl A party comforts the loved ones
because the baby is taking her mother’s looks
If one dies in a painful way there is no celebration

Widow must forever wear black – this serves as a warning to

other men that she has suffered a loss and is not attractive to
prevent shame from being brought to her
Sicily - Gift from God The day you were born, it was known the day you were to die
Catholic
Baptism Women mourn for years, wearing only black and seldom going
outside

Close all shades and never go out during daylight.

 • What is Transcultural?
II. Transcultural Ø extending through all human
Health Care cultures; "a transcultural ideal of freedom
Delivery embracing all the peoples of the
world" ...(free dictionary)
Perspectives
• What is Transcultural Health Care?
Ø Provision of
individualized and holistic health
care to clients across cultures.
Ø Health Care
professionals recognize and
appreciate cultural differences in
health care values, beliefs &
customs.
Ø The need for
transcultural nursing will continue
to be an important aspect in
healthcare
• What is Transcultural Nursing?
Ø Is a comparative study of cultures to
understand similarities (culture universal)
and difference (culture specific) across
human groups (Leininger, 1991)
Ø a humanistic and scientific area of nursing
study and practice that focuses on how
patterns of behavior in health, illness, and
caring are influenced by the values and
beliefs of specific cultural groups ( medical
dictionary 2015)
• The goal of Transcultural Nursing
Ø to provide culture specific and universal
nursing care practices for the health &
well-being of people or to help them
face unfavorable human conditions,
illness, or death in culturally meaningful
ways.
• The focus of Transcultural Nursing
Ø The focus of transcultural nursing is the
differences between cultural groups that
require care providers to identify culture
specific health and illness practices and
caring behaviors as well as to identify
behaviors that transcend cultural groups
and appear to be universal human care
practices.
• The scope of Transcultural Nursing
Ø The scope of transcultural nursing is
the delivery of personalized care in
health promotion and maintenance, as
well as illness situations.
• Major factors influencing Transcultural Nursing
Ø Trends of globalization, migration, transculturalism,
transcultural nursing, culturally congruent care are new
concepts that nurses must learn to make transcultural
health care more beneficial and meaningful.

Ø Increasing number of immigrants and refugees from diverse

culture.

Ø Advancing technology and worldwide use of cybernetics

and new modes of e-communications, health technologies.

Ø Increased use of alternative/complementary modalities or

generic health care practices

Ø Increased in ethical and moral cultural health care concerns

( e.g.cultures of life & death)

Ø The rise in womens’ and mens’ human rights

• Leininger (1995) cites eight factors that influence her to establish transcultural
nursing.

1. There was a marked increase in people within and between countries

worldwide. Transcultural nursing is needed because of the growing diversity
that characterizes our national and global populations.
2. There has been a rise in multicultural identities, with people expecting their
cultural beliefs, values, and lifeways to be understood and respected by nurses
and other healthcare providers.
3. The increased use of healthcare 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
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 increase demand for community and culturally based
health care services in diverse environmental contexts (Andrews, Margaret M
and Joyceen S Boyle).
• Relevance of Transcultural Nursing
Ø TCN is imperative in nursing education for
nurses to provide safe and meaningful
care to people of diverse culture.
Ø provides nurses a new way to learn about
and provide culturally congruent and
meaningful care to people.
Ø nurses must learn about and respect
different cultures and care needs.
Ø TCN nurses thinking and actions need to
be based about specific cultures including
values, beliefs, caring patterns.
• Historical Development of Transcultural Nursing
• Dr. Madeleine M. Leininger was the founder and
leader of this new, specific cognitive specialty in nursing.
The first professional nurse with graduate preparation to
complete a doctorate in anthropology, Leininger took the
“culture” construct from anthropology and “care” from
nursing and reformulated these two dominant constructs
into “culture care”. Her pioneering work began with her
theory of “cultural care diversity and universality,” refined
by 1975 with the conceptual “sunrise model.” She divides
the evolution of transcultural nursing into three eras:

1. Establishment of the field (1955–1975)

2. Program and research expansion (1975–1983)
3. Establishment of transcultural nursing worldwide (1983
to the present)