Transcultural Nursing and Globalization of Health Care: Importance, Focus, and Historical Aspects

Madeleine Leininger

TRANSCULTURAL NURSING Definition Transcultural Nursing has been defined as a formal area of study and practice focused on comparative human-care differences and similarities of the beliefs, values, and patterned lifeways of cultures to provide culturally, congruent, meaningful, and beneficial health care to people.

Goal The goal of transcultural nursing has been to prepare a new generation of nurses who would be knowledgeable, sensitive, competent, and safe to care for people with different or similar lifeways, values, beliefs, and practices in meaningful, explicit, and beneficial ways.

TRANSCULTURAL NURSES  Nurses as the direct care providers must be prepared to function with transcultural nursing knowledge and competencies to ensure beneficial outcomes to people of different cultures.  Nurses also need to be aware of their own cultural background and how it could influence the client’s care and relationships with other nurses and disciplines.

IMPORTANT IDEAS ON TRANSCULTURAL NURSING  Care needs to be systematically studied to learn about human-care in diverse and similar cultures in the world and environments.  Nurses need to be knowledgeable about their own cultural heritage of biases, beliefs, and prejudices to wok effectively with clients.

 Nurses need to use transculture- specific and comparative knowledge to guide caring practices for culturally congruent care.  A focus on cultural care competencies for diverse cultures and universals is essential.

 Nurses should seek comprehensive, holistic, and comparative culture care phenomena.  Maintaining an open learning-discovery process about care and culture is imperative.  Nurses need creative ways to provide culturally congruent care practices.

GLOBAL FACTORS INFUENCING TRANSCULTURAL NURSING  The steady and marked increase in the migration of people worldwide, especially with immigrants, refugees, the displaced, and others moving to diverse geographic locations within or outside a culture, country, or territory.

 The worldwide fluctuation in cultural populations varying in different countries such as the marked increased numbers of Hispanics moving into the U.S in the last decade.  The rise in cultural identities with health consumers expecting that their cultural beliefs, values, and lifeways will be respected, understood, and appropriately responded to in health care.

 The worldwide increase in the use of modern high technologies cyberspace, and electronic communications and health technologies bringing communication and technologies close to people of diverse culture.  Increased signs of cultural conflicts and clashes, wars and violent acts among and between different cultures and nations influencing the health, survival, or death of people of diverse culture.

 The marked increase number of nurses, physicians, and other health care providers working in many different places in the world with cultural strangers since WWII  An increase in cultural legal defense suits resulting from serious cultural conflicts and problems in health care services showing cultural care and treatment conflicts, ignorance, imposition, and offensive practices by health care providers who are unprepared in transcultural health services.

 The rise in women’s and men’s human rights among cultures regarding their needs for health care services and for staff to understand their cultural care needs and desired treatment modes.  A marked increase in ethical and moral cultural health care concerns with evident conflicts between the “cultures of life and death”.

 A major shift in Western cultures from hospital-managed services to community- based consumer health care, which is intended for more direct care to cultural minorities, the poor, the homeless, and other neglected and vulnerable groups.  An increased use of complementary, “alternative”, folk, or generic health care practices, medicines, treatments, and healing modalities for prevention, healing, health maintenance, cost control, and perceived better health outcomes.

 Increased consumer demand from minorities and the “culturally different” for better access to professional cultural health care and treatments that fit their cultural expectations and values.  A growing gap between the cultures of the poor and homeless and the cultures of the rich, showing a need for social justice and equal human rights in health care.

 An increase in violence worldwide, revealing evidence of violence among diverse cultures that have been oppressed, poor, or neglected.  A general increased awareness by people that we need to find ways to live together in the world with many diverse cultures for reasonable peace, harmony, and healthy living and survival modes.

HISTORICAL ASPECT  Mid 1950s M.L saw the need to address the fact that culture was the critical and major missing dimension of care.  1960s M.L went to the Eastern Highlands of New Guinea to study people in two villages who had limited contact with western people.  1968 The Committee on Nursing and Anthropology within the Medical Anthropology Council was established.

 The Transcultural Nursing Society as the official organization for Transcultural Nursing was launched.  1975 The first master and doctoral programs focused specifically on trancultural nursing in the world was established.  1981 Largest program offerings in Transcultural nursing in the world.

 1989 The Transcultural Nursing Society became the first nursing organization to certify nurses worldwide for cultural care practices.  1990 Dr. G. Kinney established the first integrated undergraduate program focused totally on Trans. Nursing throughout the curriculum.

-END-