What is transcultural nursing and culturally competent care?

Abstract

Although transcultural nursing and culturally competent care had its origins in the mid-1950s, there are nurses and other health professionals who often seek clarification of these timely and important ideas. In this brief article, I will clarify these two interrelated ideas as the founder and coiner of the terms. Transcultural nursing has been defined as a legitimate and formal area of study, research, and practice, focused on culturally based care beliefs, values, and practices to help cultures or subcultures maintain or regain their health (wellbeing) and face disabilities or death in culturally congruent and beneficial caring ways (Leininger, 1970, 1978, 1995). Transcultural nursing is directed toward holistic, congruent (appropriate), and beneficial health care. It remains one of the most challenging and revolutionizing developments in health care as our world becomes globally multicultural. Transcultural nursing concepts, principles, and research findings are transforming nursing and medical systems and practices. Indeed, transcultural holistic and comparative perspectives are challenging nurses and other health care providers to think broadly and to reduce mechanistic and highly technical and impersonal actions that fail to help cultural clients. Ethical and moral factors become clearly evident as one works with clients of diverse cultures. Most important, transcultural nursing theories with a holistic and comparative perspective have led to culture-specific care. The Theory of Culture Care Diversity and Universality, which I developed in the mid-1950s, has been a major theory to advance the body of transcultural nursing knowledge (Leininger, 1978, 1991). The theory is focused on diverse and universal (common) dimensions of human caring worldwide and is based on my position that care is the essence, the central, dominant, and distinctive domain of nursing and transcultural nursing. The well-known Sunrise Model (Leininger, 1991) guides the researcher and clinician in using the theory to provide culturally congruent care to individuals, families, communities, and institutions. Hence, the construct of culturally congruent care was inherent and the goal of transcultural nursing. Simply, culturally congruent care means to provide care that is meaningful and fits with cultural beliefs and lifeways. From a professional perspective, it refers to the use of emic (local cultural knowledge and lifeways) in meaningful and tailored ways that fit with etic (largely professional outsiders’ knowledge) to help specific cultures, whether ill, disabled, facing death, or facing other human conditions. Because culture is focused on the total or holistic lifeways of human beings, religion (spiritual), kinship, politico-legal, education, technology, language, environmental context, and worldview are all considered. This knowledge is thoughtfully and selectively integrated with medical and nursing physical, psychological, and other knowledge to provide congruent care. To date, transcultural nursing theory and research-based knowledge with general concepts, principles, and practices are transforming nursing and health care in several places. Beneficial (health promoting) and satisfying outcomes are highly rewarding to transcultural nurses but are especially rewarding to consumers of transcultural nursing care. The Journal of Transcultural Nursing has provided evidence of such benefits over the past decade (1989-1999).