Abstract
Psychiatrists and nurse practitioners who possess cultural-competence skills find it easier to deliver evidence-based care to their patients. Madeleine Leininger’s Transcultural Nursing Theory offers powerful insights that can ensure culturally-competent care is available to more patients with psychological needs. This research paper gives a detailed analysis of the Transcultural Nursing Theory. The paper goes further to explain how the theory can be used to inform nursing practice.
Theory Name and Background
Selected Theory
Nurses can use different theories to address the health needs of their clients. Although all mid-range and grand theories of nursing can support the practices of many caregivers, Madeleine Leininger’s theory of Transcultural Nursing appears to stand out. The theory is applicable in different settings to support the needs of many patients with psychological issues (Douglas et al., 2011). From a personal point of view, I strongly believe that the Transcultural Theory of Madeleine Leininger can support my nursing practice. This is the case because the cultural attributes of an individual will determine his or her psychological health outcomes.
Theorist’s Background
Madeleine Leininger is one of the famous theorists whose achievements redefined the meaning of nursing. She was “born in July 1925 and later pursued a Diploma of Nursing from the famous St. Anthony’s Hospital School of Nursing” (McFarland & Wehbe-Alamah, 2014, p. 8). Leininger went ahead to complete her degree from Creighton University (McFarland & Wehbe-Alamah, 2014). She later earned a Master of Science degree. The theorist completed her PhD from the University of Washington in 1966. Her competencies in social and cultural anthropology played a significant role in the development of the Transcultural Nursing Theory. Throughout her career period, Leininger provided quality nursing education to many students and clients. She supported the needs of many people from diverse backgrounds. These practices equipped her with powerful ideas that led to the development of the nursing model.
Crucial References
Leininger polished the Transcultural Nursing Theory in 2002. She had already published several researches that guided her throughout the theory-development process. One of her famous works is the book “Culture Care Diversity and Universality”. This book was published in 1991. She later wrote a second book titled “Transcultural Nursing” in 1995. These works guided the theorist to develop various nursing dimensions and concepts. She later formulated a number of concepts that led to the creation of this nursing theory (Prosen, 2015). Her background in nursing education and collaboration with different scholars played a positive role in the development of the theory.
Issues Addressed by the Theory
This theory is embraced by many caregivers, doctors, and psychologists because of its ability to transform the nature of care. Caregivers are always required to offer quality support to individuals from different backgrounds. Unfortunately, many practitioners find it hard to deliver quality support to clients from different cultural backgrounds. The Transcultural Nursing Theory gives detailed arguments that can guide nurses to offer culturally-competent care to their patients (McFarland & Wehbe-Alamah, 2014). The theory has been widely used by healthcare professionals to develop new skills and implement appropriate nursing strategies (Douglas et al., 2011). The theory has therefore made it easier for psychiatrists and nurses to support the health needs of many patients from diverse backgrounds.
Theory Description
Deductive Reasoning
Madeleine Leininger uses deductive reasoning to develop the Transcultural Nursing Model. The approach starts with a general rule or argument. Once the rule has been outlined, several ideas are identified to show how the idea can be used (Prosen, 2015). This means that, if “the original rule is true, then the conclusions must be acceptable” (Prosen, 2015, p. 150). Madeleine Leininger begins by indicating that human wellness is reshaped by a number of factors. Some of these factors include cultural attributes, social skills, and coping strategies. The author of the theory goes further to outline various cultural attributes that affect the health outcomes of many patients. She concludes by explaining why providers of health care should be aware of the cultural issues affecting the welfare of their patients. The next thing is to engage in positive intercultural communication in an attempt to improve the health outcomes of the targeted patients.
Concepts of the Theory
Several concepts have been used by Madeleine Leininger to describe the theory. In order to support the theory, Leininger defines the concepts both operationally and theoretically. The major concepts used to support this theory include trans-cultural nursing, ethno-nursing, nursing, cultural competence, cultural congruent care, culture care universality, and culture care re-patterning (Prosen, 2015). This discussion shows clearly that the theorist uses and applies the theories consistently. The concepts are combined with other sub-concepts such as cultural imposition, professional care, ethnohistory, and cultural care accommodation (Douglas et al., 2011). The “concept culture care re-patterning helps nurses to reestablish the best approaches towards improving the health outcomes of more patients” (Douglas et al., 2011, p. 324).
Definition of the Major Concepts
One of the outstanding facts about this theory is that each and every concept is defined explicitly. This means that the theorist uses direct descriptions to define the concepts. Additionally, the concepts are analyzed and interpreted carefully in an attempt to support the performance of many healthcare professionals. The first concept is trans-cultural nursing. This concept is defined as a branch of nursing that focuses on the cultural aspects affecting the health outcomes of a client. Ethno-nursing is the second concept and refers “to the study of nursing care practices as perceived by a designated culture through its direct value system and experience” (McFarland & Wehbe-Alamah, 2014, p. 48).
Nursing is another powerful concept used to describe the model. The theorist defines nursing as a scientific discipline aimed at improving the quality of care using culturally-competent approaches (Jeffreys, 2008). The other concept is known as cultural-congruent care. This concept refers to the supportive and facilitative decisions that fit the cultural needs of a patient. The culture care universality concept focuses on “the uniform patterns manifested among cultures and capable of improving people’s health outcomes” (McFarland & Wehbe-Alamah, 2014, p. 54).
Relationships among the Major Concepts
In order to support the meaning of these concepts, Leininger presents a number of propositions that make the theory applicable in different healthcare settings. The first proposition is that different cultural groups practice nursing (or patient care) using different strategies. Despite such differences, some key commonalities in inpatient care exist across all cultures. The second proposition is that caring should be a holistic practice aimed at examining and predicting the health of a patient. Although human care is universal, practitioners should use various patterns, expressions, and meanings to empower their patients. The other proposition is that caring is an essential practice towards supporting the survival, welfare, and growth of all human beings (McFarland & Wehbe-Alamah, 2014). Failure to offer culturally-competent support will affect the health outcomes of many patients. These propositions play a critical role in linking the above concepts. Healthcare practitioners should consider these assumptions in order to deliver quality support to more patients from diverse backgrounds.
Evaluation
Explicit and Implicit Assumptions
There are several assumptions or beliefs underlying this theory. Such assumptions make it easier for more nurses to use the theory effectively. To begin with, the theory assumes that nursing is a trans-cultural discipline that should be used to serve all people from different parts of the world (Jeffreys, 2008). In order to produce positive results, nurses should focus on the needs of all people from different backgrounds. The other assumption is that nursing care should be beneficial and culturally-competent. The theorist also assumes that nurses who fail to offer culturally-congruent care will affect the health outcomes of their clients. This is the case because such patients will show signs of noncompliance and stress. The theory goes further to assume that global cultures have specific commonalities that should be embraced by healthcare providers. This means that the values needed for cultural-competence care should be reshaped by the political, cultural, language, and technological contexts of the targeted cultural groups (Jeffreys, 2008). These assumptions play a positive role in ensuring that more caregivers support the needs of their clients.
Nursing Meta-Paradigms
It is agreeable that Madeleine Leininger’s theory is founded on the four meta-paradigms of nursing. These meta-paradigms are clearly explained in an attempt to support the health needs of more patients. To begin with, health is defined as “the state of well-being that should be culturally practiced, defined, and valued” (McFarland & Wehbe-Alamah, 2014, p. 27). This means that a healthy individual should be able to perform the most desirable activities in a positive manner. The second meta-paradigm outlined in the theory is people or human beings. According to the theory, people are entities capable of caring for one another. Nurses should, therefore, promote the most appropriate interactions by attracting different cultural groups, health institutions, communities, and families (Viadas, 2015). The third meta-paradigm defined by the theory is the environment. Leininger embraces this meta-paradigm from a global perspective. The theory focuses on the social structure dictating the health outcomes of a patient. Nursing, on the other hand, is treated as a humanistic discipline aimed at assisting individuals or cultures to regain their health outcomes from a cultural perspective (Viadas, 2015). These four meta-paradigms make it easier for healthcare providers to formulate the most appropriate nursing philosophies.
Clarity of the Theory
The Transcultural Nursing Theory is a powerful framework capable of supporting the health needs of many people across the globe. This is the case because the concepts and meta-paradigms of nursing are defined in a clear manner. This clarity makes the theory applicable in a wide range of healthcare settings. The author offers clearly-defined concepts, propositions, sub-concepts, and assumptions. The deductive approach makes it easier for the theorist to come up with one of the most appropriate theories in nursing (McFarland & Wehbe-Alamah, 2014). The author presents a wide range of propositions that can be used by psychiatrists to support the mental health needs of their clients. This clarity is what makes the theory admirable and applicable in various healthcare settings. Practitioners who want to support the health needs of their clients should, therefore, be on the frontline to use this theory. Although the concepts might be complex and incomprehensible, the outstanding fact is that nurses can use the model to develop sustainable healthcare delivery models.
Application
Guiding Nursing Actions
One of the outstanding aspects of this theory is that it is applicable in a wide range of health settings. The definition of different concepts in the model makes it easier for different practitioners to support the health needs of their patients. The theory can be used by nurses to examine and understand the unique cultural aspects of their clients. Healthcare professionals provide medical care to patients from diverse backgrounds. Such patients tend to portray specific religious, cultural, and social values (McFarland & Wehbe-Alamah, 2014). These values might dictate the health outcomes of targeted patients. Nurses should, therefore, monitor the unique needs of their respective patients. A caregiver who understands the cultural and social aspects of his or her clients will be able to offer quality care. This theory acts as a powerful guideline that can support the needs of many patients.
Nurses and psychiatrists can identify the best resources and competencies in order to support their clients’ health needs. In the recent past, healthcare professionals have been embracing the importance of cultural-competence in nursing practice. This single fact shows clearly that nurses can use the concept to provide culturally-competent care to their patients. The practice will maximize the outcomes of their patients and support their professional objectives. This theory can make it easier for nurses to deliver quality care to more people from diverse backgrounds. This approach will transform the field of nursing and ensure desirable services are available to more patients across the world (McFarland & Wehbe-Alamah, 2014).
Using the Theory in Nursing
I am currently working as psychiatric nurse practitioner (PNP). This fact explains why I am expected to support the psychological needs of more patients from different backgrounds. That being the case, I will always use this theory to support the health needs of such clients. The theory will play a critical role towards redefining my nursing philosophy (Larson, 2014). For instance, I have understood the importance of involving different players throughout the healthcare delivery process. This practice will make it easier to understand the diverse cultural attributes and needs of my clients.
This theory goes further to support the power of collaboration (Larson, 2014). This practice can support the professional needs of many healthcare workers. I will therefore use this knowledge to create different multidisciplinary teams. Successful multidisciplinary teams should be comprised of different professionals such as nurses, psychiatrists, social workers, caregivers, and doctors (Larson, 2014). The use of such teams will definitely support my approach towards providing cultural-competent care to patients with various psychological needs. This practice will eventually support the needs of more people in the society. Psychiatrists who want to realize their professional goals should therefore embrace the power of the Transcultural Nursing Theory. Consequently, such professionals will ensure every patient receives evidence-based and sustainable mental care. This practice will make it easier for more patients to realize their personal goals.
References
Douglas, M., Pierce, J., Rosenkoetter, M., Pacquiao, D., Callister, L., Hattar-Pollara, M.,…Purnell, L. (2011). Standards of practice for culturally competent nursing care: 2011 update. Journal of Trans-cultural Nursing, 22(4), 317-333.
Jeffreys, M. (2008). Dynamics of diversity: becoming better nurses through diversity awareness. NSNA Imprint, 1(1), 37-41.
Larson, M. (2014). Cultural immersion and compassionate care in a study abroad course: the Greek connection. Journal of Compassionate Health Care, 1(1), 1-8.
McFarland, M., & Wehbe-Alamah, H. (2014). Leininger’s culture care diversity and universality. Burlington, MA: Jones & Bartlett Learning.
Prosen, M. (2015). Introducing trans-cultural nursing education: implementation of Transcultural Nursing in the postgraduate nursing curriculum. Procedia – Social and Behavioral Sciences, 174(12), 149-155.
Viadas, C. (2015). Historic perspectives from anthropology: reflections proposed to Transcultural Nursing. Investigación y Educación en Enfermería, 33(2), 375-379.