Cátia Alexandra Aguilar Martins
Masters in Nursing Student
Catholic University of Portugal (Lisbon)
Madeleine Leininger was the first nurse with a PhD in Cultural and Social Anthropology who addressed how to deal with patients from different cultural backgrounds and cultures. She created the concept of culture shock in 1950, after observing that recurring behavior patterns in children had a and artistic basis.
The theory of Transcultural Nursing, also known as Culture Care Theory, was created in 1950 based on the concept of “culturally congruent care” (1960) after Madeleine identified that there was a lack of cultural knowledge to provide nursing care through “cognitively based assistive, supportive, facilitative or enabling acts or decisions that are, for the most part, tailored to fit the cultural values, beliefs, and ways of life of the individual, group or institution”. In this context, she developed the Sunrise Model with the goal of linking the concepts of culture, care, diversity, and universality.
This model emphasizes that care and health are influenced by the social structure (such as the environmental context, language, and history), and the main goal is culturally congruent care. This care aims to achieve cultural universality and diversity.
The Sunrise Model shows that various factors determine patterns of care that influence people’s health and how nurses should develop their practice by integrating the cultural and social dimensions of each situation. Nursing care, taking this model into account, should have the ultimate goal of preserving/maintaining cultural care, adjusting/negotiating cultural care, and remodeling or restructuring cultural care.
In view of globalization and immigration flows verified in Portugal, I believe it is essential for nurses to adapt their actions and decisions, taking into account the culture of each child and their family, also known as cultural care accommodation. Families whose culture is respected and valued, in my experience, tend to be more accepting of the transition between the child’s health and illness process and are more receptive to nursing instruction, allowing them to provide the child’s caregivers with the knowledge and tools they need to know how to care.
Respecting the cultural values and beliefs of the child/family dyad is fundamental to promoting health, as the child/family will only change their way of life and be healthier if care is remodeled.
Each child and family, taking into account their culture, can practice care differently, even though there are common points between them. The different cultures perceive, know, and practice care differently, but there are some commonalities in care between all the world’s cultures. Culturally related values, beliefs, and practices for care are shaped by, and often embedded in, “the worldview, language, religious (or spiritual), kinship (social), the political (or legal), educational, economic, technological, ethnohistorical and environmental context of the culture”
Although human care is universal in all cultures, it can be demonstrated through diverse expressions, actions, patterns, lifestyles, and meanings. Cultural care accommodation or negotiation argues that the nurse’s role should be to help, support, or facilitate the child/family so that they are able to change their way of life, respecting cultural values and beliefs, in order to become as healthy as possible (Leininger, 1991).
In 1995, Madeleine Leininger defined transcultural nursing as “a substantive area of study and practice focused on comparative cultural care values (caring), beliefs and practices of individuals or groups from similar or different cultures to provide culture-specific and universal nursing care practices in promoting health or well-being or to help people cope with unfavorable human conditions, illness or death in culturally meaningful ways”.
Thus, I decided to apply the Transcultural Nursing Theory and the Sunrise Model to the pediatric context, as I believe that, in today’s world of globalization, child and family care increasingly needs to be structured with different cultures in mind.
Transculturalism in Portugal, as a result of globalization and immigration movements, is a current issue, and us nurses must acquire the knowledge and skills to provide better care for children and families, thus transposing the Transcultural Nursing Theory created by Madeleine Leininger.
In pediatric care, we always have to include both the child and the family/caregiver and implement strategies to address the disease state in the best possible way but to do this. We need to know the habits, diet, language, and culture of the child/family dyad we are caring for. Through this theory, we are able to implement nursing interventions specific to the family’s culture in order to provide care that is congruent with cultural values, beliefs, and practices and thus achieve health status or its improvement as soon as possible.
References
Leininger, M. (1991). Culture care diversity and universality: a theory of nursing. National league for nursing press.
Leininger, M., McFarland, M. (2002). Transcultural nursing: concepts, theories, research & practice (3ª ed.). McGraw-Hill Professional.
Leininger, M., McFarland, M. (2005). Culture care diversity and universality: a worldline nursing theory (2ª ed.). Jones & Bartlett Learning.
Transcultural nursing society. (s.d.). Transcultural nursing society. Transcultural Nursing Society – Many Cultures One World
About Cátia Alexandra Aguilar Martins
I have been attending the Master’s course in critical care nursing since September 2024 at the Health Sciences Institute of the Portuguese Catholic University (Lisbon). This post was created in the curricular unit of Nursing Theories under the guidance of Professor Zaida Charepe (PhD., Associate Professor).