Leininger's Sunrise Research Articles

Determine of the health behaviours of Iranian women with international protection status using with Leininger's Sunrise Model: An ethnonursing study

Aim: The study was conducted to define the cultural care of Iranian women with International Protection status with Leininger’s Sunrise Model. Methods: In this research, the qualitative research method known as ethno nursing. It should be Consolidated criteria for Reporting Qualitative research (COREQ) recommendations were followed. The population of the study consisted of Iranian women who are subject to International Protection, registered with the Van Provincial Immigration Administration. Mixed sampling method was used in the selection of samples from the universe. Twenty-five Iranian women who met the research criteria were reached. But the study was completed with seventeen women willing to participate. Data were collected by in-depth interview method between August and December two thousand twenty-two with a semi-structured interview form prepared based on Leininger’s Cultural Care Assessment Guide. No voice recorder was used during the interviews. Findings were recorded by hand. Ethics committee, institutional and individual permissions were obtained before the study. The data were evaluated by descriptive analysis method. Findings were analyzed under twelve headings based on Leininger’s Cultural Care Assessment Guidelines. Findings: Participants stated that their health comes first, they are willing to receive care from nurses, their expectations should be tolerant, knowledgeable and non-discriminatory. They stated that education, technology, health policies and political approaches are effective on health. During the interviews, the participants stated that they generally want to receive care in accordance with their cultural values and religious preferences, as well as professional nursing care, they are stuck with the language barrier in communication and verbal communication is easy for them. They stated that traditional treatments are still practiced in Iran and they continue to practice in Turkey, that there are prohibited foods based on religion in their culture, that the person should first protect their health, then professional care should be taken, that care is voluntary and that cultural differences should be given importance by the caregiver. Results: The participants stated that individuals’ worldviews, education, technology, political and legal factors, family and kinship relations, language, religion, cultural va1-ues, emic and ethical practices are effective on cultural care. (Extended English summary is at the end of this document) Özet Amaç: Araştırma, Uluslararası Koruma Statüsüne sahip İranlı kadınların kültürel bakımın Leininger’in Gündoğumu Modeliyle tanımlanması amacıyla yapıldı. Metod: Araştırma nitel deseni olan etnohemşirelik yöntemiyle yapıldı. Yapılandırılmış Kalitatif Araştırma Raporlama Kriterleri “COREQ” takip edildi. Araştırmanın evrenini Van İl Göç İdaresi’ne kayıtlı Uluslararası Korumaya tabii İranlı kadınlar oluşturdu. Evrenden örneklem seçiminde karma örneklem yöntemi kullanıldı. Araştırma kriterlerini sağlayan 25 İranlı kadına ulaşıldı. Ancak araştırmaya katılmaya istekli 17 kadın ile tamamlandı. Veriler Leininger'ın Kültürel Bakım Değerlendirme Rehberine dayandırılarak hazırlanan yarı yapılandırılmış görüşme formu ile Ağustos-Aralık 2022 tarihleri arasında derinlemesine görüşme yöntemiyle toplandı. Görüşmeler sırasında ses kayıt cihazı kullanılmadı. Bulgular elle not alınarak tutuldu. Araştırma öncesinde etik kurul, kurum ve bireysel izinler alındı. Veriler betimsel analiz yöntemiyle değerlendirildi. Bulgular: Leininger’ın Kültürel Bakım Değerlendirme Rehberine dayandırılarak 12 başlık altında incelendi. Katılımcılar sağlıklarının herşeyden önce geldiğini, hemşireden bakım almada istekli olduklarını beklentilerinin ise hoşgörülü, bilgili ve ayrımcılık yapılmayan bir yaklaşım olduğunu ifade ettiler. Sağlık üzerinde paranın, eğitimin, teknolojinin, sağlık politikaları ve siyasetin etkili olduğunu vurguladılar. Katılımcılar görüşmeler esnasında genellikle profesyonel hemşirelik bakımının yanısıra kültürel değerlerine, dini seçimlerine uygun bakım almak istediklerini, iletişimde dil bariyerine takıldıklarını ve kendileri için sözlü iletişimin kolay olduğunu belirttiler. İran’da uyguladıkları geleneksel tedavileri halen Türkiye’de de uygulamaya devam ettiklerini, kültürlerinde dine dayalı olarak yasaklı gıdaların olduğunu, önce kişinin sağlığını koruması sonrasında profesyonel bakım alınması gerektiği, bakımın gönüllüğe dayalı olduğunu ve bakım verici tarafından kültürel farklılıklara önem verilmesi gerektiğini ifade ettiler. Sonuçlar: Katılımcılar kültürel bakım üzerinde bireylerin dünya görüşlerinin, eğitim, teknoloji, para, politik ve yasal faktörlerin, aile ve akrabalık ilişkilerinin, dil, din, kültürel değerler, emik ve etik uygulamaların etkili olduğunu belirttiler.

Defining the cultural care needs of Syrian university students in Türkiye using Leininger's Sunrise Model

Nurses are expected to recognize the cultures of their patients and provide suitable medical service. Accordingly, the medical services to be provided to foreign students who come from different cultures and whose numbers are on the rise should be adapted to the cultures of these students. This study aimed to use the Leininger’s Sunrise Model for determining the cultural care needs of Syrian University Students in Türkiye. This qualitative study was conducted using the ethno-nursing research method. The sample of the study consisted of 19 Syrian undergraduate students. The Consolidated criteria for reporting qualitative research (COREQ) reporting guidelines were used in both the framing and reporting of this study to guarantee that sufficient details on the methods of data collection, analysis and interpretation were provided. The data examined under the 12 titles was assessed with the descriptive analysis method used in qualitative research. Students noted that care was provided voluntarily in their cultures, that families had the responsibility of providing care, that they needed professional and religious care simultaneously, and that the obstacles of receiving nursing care were language, gender, and privacy. Results in this study indicate that cultural values and beliefs had a significant impact on receiving medical care, and that professional and traditional treatments were used based on relevant cases.

Understanding physical activity from a cultural-contextual lens.

This paper aims to emphasize the need to acknowledge unique cultural and contextual meanings of physical activity to improve health outcomes in different communities. Leininger's Sunrise Model was used as the theoretical base to understand the complex cultural and contextual factors that influence physical activity. Beliefs and practices surrounding physical activity are influenced by a variety of cultural and contextual factors. Providing culturally relevant contexts to the meaning of physical activity allows opportunities for improving policies or programs that would engage individuals and communities in physical activity in culturally meaningful ways. Incorporating cultural and contextual factors is critical to promote physical activity, especially in minority and vulnerable communities.

Cultural Evaluation of a Buddhist Woman Diagnosed with Dementation with Leininger's Sunrise Model

Demans küresel olarak yaşlanan nüfus ve yaşam beklentisinin artması ile giderek sıklığı artan bir hastalıktır. Demansı olan bireylere yönelik tedavi, bakım, müdahale ve destek için; kültürü de içine alan holistik bakım sağlanması gerekmektedir. Bireyin içinde bulunduğu sosyokültürel faktörlerin grup ve bireysel davranışı etkileyen sembolleri, inançları ve gelenekleri içeren geniş bir kültür kavramsallaştırmasını kapsaması gerekmektedir. Bundan dolayı, demansı olan bir bireyin kişiliğini desteklerken de bu unsurları anlamak çok önemlidir. Hasta J.E.’nin inancı olan Budizm, dünyada fazla sayıda üyesi olan inanışlardan birisidir. Kültürlerarası hemşirelik bakım anlayışına göre; hemşirenin uygulayacağı bakım girişimlerini bakım verdiği hastanın inanışına ve kültürüne uygun olarak uyarlaması gerekmektedir. Bu bağlamda incelenen bu olguda da hemşirelerin Budist hastaya bakım verirken, hastanın temel amacının vücudun hastalık nedeniyle bozulan yin/yang dengesini geri getirmek olduğunu anlamaları gerekmektedir. Yapılan incelemede, ulusal ve uluslararası literatürde demansı olan Budist bireylerde Leininger’ın Gündoğumu Modeli’ni kullanan herhangi bir araştırmaya rastlanmamıştır. Bu olgu sunumu, Leininger’ın Gündoğumu Modeli’ni demansı olan Budist bir kadın hastanın kültürel değerlendirilmesinin kullanımına örnek olarak yapılmıştır.

Cultural Care of Pregnancy and Home Birth: An Application of the Sunrise Model.

The role of older women close to the pregnant woman may be relevant when conveying information. The use of theories/models can guide the development of nursing practice. To explore beliefs and practices related to pregnancy and childbirth from the perspective of older women who gave birth at home, applying Leininger's Sunrise Model. Qualitative approach, using semi-structured interviews with 24 older women who gave birth at home (rural area, Spain). Manual content analysis of the data was used, and Sunrise Model guided to explore the role of culture and the factors affecting maternity care. Two main categories emerged: beliefs/practices related to physiological aspects (subcategories: minimal intervention, hygiene, pain control, rest, feeding) and to psychosocial aspects (subcategories: spiritual well-being, company). The experiences of older women who gave birth at home helped us to understand some beliefs that survive in some pregnant women, similar in different cultures, and divided into physiological and psychosocial aspects. Older women have a relevant role as transmitters of information, and can provide some keys to plan health interventions, as companions or counselors. Applying the Sunrise Model, we verified the weight that culture has in maternal health care, and the multiple factors that interfere with the way of caring. The application of models helps us to improve nursing practice: not only should we focus on knowing the physical aspects, but also the social and cultural circumstances surrounding the pregnant woman.

Culturally Tailored Self-Management Interventions for South Asians With Type 2 Diabetes: A Systematic Review.

Diabetes mellitus is one of the most common chronic diseases worldwide and a leading cause of morbidity and mortality. A high prevalence of type 2 diabetes mellitus has been noted among the South Asian population, in general, and migrant South Asians. Self-management is considered a proponent to the management of diabetes. Although empirical evidence supports such interventions, little is known regarding the cultural congruency of such interventions for diverse cultural and ethnic groups, particularly South Asians. Our purpose was to determine the effectiveness of diabetes self-management education (DSME) and diabetes self-management support (DSMS), interventions on migrant South Asian's glycated hemoglobin (A1C) levels and whether DSME and DSMS interventions are culturally tailored to the migrant South Asian population. In this study, a systematic review, with narrative synthesis, was conducted. Data were extracted on the study, participant, and intervention characteristics and the cultural congruity using Leininger's sunrise model. Four studies meeting the inclusion criteria were included. Overall, most (75%) of the DSME and DSMS interventions were not effective in reducing A1C levels. Specific to cultural congruity of the interventions, all studies delivered the intervention based on the participant's preferred language and incorporated culturally sensitive dietary information primarily by persons of the same cultural and ethnic background. However, little information was presented on the provision and integration of culturally congruent care. Findings highlight the importance of rethinking the way in which South Asians are labelled as a homogenous group and accounting for such differences when adapting and designing culturally tailored DSME and or DSMS interventions in clinical practice.

Peritoneal dialysis: family care for chronic kidney disease patients in home-based treatment.

to propose a family care model for patients with chronic kidney disease in peritoneal dialysis based on evidence indicated by family members. this was a qualitative descriptive study that used the Convergent Care Research method. It was conducted at a state hospital in Rio de Janeiro, including techniques for recording individual interviews and consisted of a group of 19 study participants. Data were analyzed according to the stages proposed by the method, generating a category that used a cultural question as the basis for patient care resulting in a proposal for home-based family care. the patient care model proposed includes dialogue and reflection in sharing the knowledge of "professional" and "popular" systems, aiming to improve the patient's quality of life. family members were able to promote care based on cultural preservation, accommodation and repatterning, as proposed by Leininger's Sunrise Model.

Diet and Blood Pressure Control in Chinese Canadians: Cultural Considerations.

Hypertension is highly prevalent in Chinese Canadians and diet has been identified as an important modifiable risk factor for hypertension. The current anti-hypertensive dietary recommendations in hypertension care guidelines lack examination of cultural factors, are not culturally sensitive to ethnic populations, and cannot be translated to Chinese Canadian populations without cultural considerations. Guided by Leininger's Sunrise Model of culture care theory, this paper investigates how cultural factors impact Chinese Canadians' dietary practice. It is proposed that English language proficiency, health literacy, traditional Chinese diet, migration and acculturation, and Traditional Chinese Medicine influence Chinese Canadians' dietary practices. A culturally congruent nursing intervention should be established and tailored according to related cultural factors to facilitate Chinese Canadians' blood pressure control. In addition, further study is needed to test the model adapted from Sunrise Model and understand its mechanism.

Intercultural global health assessment and reflection framework for teaching study abroad courses

Objective: In this paper we describe the development and use of the Intercultural Global Health Assessment and Reflection (IGHAR) Framework. The framework is based on dimensions of Leininger's Sunrise Model and a structured reflection process to guide student journaling. Methods: The framework was tested in a cross-cultural comparison course in China that included didcatic and experiential learning components about Chinese healthcare practcies and the healthcare system. The course included nurisng, social work and public helath students and included a three week immersion component in Beijing. Healthcare issues studies were cancer, mental health and migrant health. Student reflection journals were analyzed using NVivo software. Results: Students demonstrated an increased understanding of similarities and differences in each of the dimensions. In addition, key global perspective taking outcomes were evident. Conclusions: We found that a systematic approach to using the dimensions of the Sunrise Model helped students demonstrate understanding of contextual factors related to healthcare. Interprofessional students learned to use a conceptual intercultural model and reflective learning process for exploring a new culture and healthcare system they can use in the future in both local and global settings. At the school level, the IGHAR framework can be used across disciplines to demonstrate changes in student global perspectives.

La experiencia del padre durante la hospitalización de su hijo recién nacido Pretérmino extremo

Objetivo: identificar el significado que le asigna el padre a la hospitalización de su hijo recién nacido pretérmino extremo. Materiales y métodos: estudio cualitativo, con la metodología de etnoenfermería, realizado en Bogotá, en el que participaron ocho padres. Los datos fueron analizados teniendo en cuenta las cuatro fases para el análisis de la información según Leininger. Resultados y discusión: a la luz de la teoría del Sol Naciente de Leininger surgen dos temas y siete patrones contrastados. Primer tema: “La hospitalización del recién nacido pretérmino extremo: cambios en la estructura social y cultural del padre”, con cinco patrones. Segundo tema: “Unidad de Cuidado Intensivo Neonatal: primer hogar para el recién nacido pretérmino extremo”, con dos patrones. Conclusiones: para los padres la hospitalización del hijo representa un cambio en su vida, donde el eje central son su hijo y su pareja; esto genera modificaciones en la estructura social y cultural, con el propósito de afianzar la relación de pareja, el bienestar de la familia y compartir la situación que están viviendo.

Nursing and medical documentation on patients’ cultural background

To investigate if, and to what extent, nursing and medical documentation in patient records include entries on cultural background. Health care professionals in Sweden may have difficulties in providing satisfactory care, due to lack of knowledge about immigrants' background. According to Swedish law the information needed to guarantee safe care must be specified in the patients' records. It is, therefore, important to investigate what information nurses and physicians document on patients' cultural background. In this descriptive study, archival data concerning older and terminally ill patients were analysed retrospectively. The sample consisted of records from 121 patients > or =65 years at the time of death, who were born abroad and died during the year 1999. Content analysis was used to interrogate data collected from patient records, which related to the patient's cultural background. Entries (sentences or portion of sentences) were identified, coded and categorized using Leininger's Sunrise Model. From the patient records, entries could be related to all the factors in the upper part of the Sunrise Model. Some factors were found in all records, and all factors, except technological factors, could be traced across the patients' records. Information concerning folk/lay care could not be found. The results from this study indicate that nurses' and physicians' documentation in patient records included all factors in the Sunrise Model except technological. The overall impression is that the documentation is partly atomistic and insufficient as cultural assessment. Even if the health care personnel want to reduce the amount of documentation produced, this study highlighted the importance of documentation on cultural factors. To save time the nursing documentation could be based on the Sunrise Model and structured according to the VIPS model.

Ethnopharmacology

Ethnopharmacologic research has revealed that ethnicity significantly affects drug response. Genetic or cultural factors, or both, may influence a given drug's pharmacokinetics (its absorption, metabolism, distribution, and elimination) and pharmacodynamics (its mechanism of action and effects at the target site), as well as patient adherence and education. In addition, the tremendous variation within each of the broader racial and ethnic categories defined by the U.S. Census Bureau (categories often used by researchers) must be considered. Nurses need to become knowledgeable about drugs that are likely to elicit varied responses in people with different ethnic backgrounds, as well as the potential for adverse effects. The existing ethnopharmacologic research focuses primarily on psychotropic and antihypertensive agents, as does this article. Cultural assessment of every patient is vital; thus Leininger's Sunrise Model and Giger and Davidhizar's Transcultural Assessment Models are briefly described as well.

Cultural Perceptions of Finnish Nursing Students Regarding People and Nurses of the United States: A Pilot Study

This pilot study measures cultural awareness through perceptions of 139 Finnish nursing students regarding American people and nurses. Inquiry was guided by cultural dimensions depicted in Leininger's Sunrise Model. Statements of highest agreement were that: U.S. citizens frequently initiate lawsuits, have strong national identity, eagerly try new technological equipment, U.S. nurses have less authority than physicians, the U.S. shares technological advances with Third World countries. Statements of lowest agreement were that health care is available to all U.S. citizens, U.S. people live healthy lifestyles, U.S. nurses have knowledge of other cultures and knowledge of international health care issues, and U.S. citizens are law abiding. Almost half of the responses indicated neither agree nor disagree, with means between 2.7 and 3.3. Responses of Finnish students indicated stereotypical views of U.S. citizens and nurses.

The Process of Seeking and Undergoing Surgical Contraception: An Ethnographic Study in a Brazilian Community

The purpose of this research is to describe the process of seeking and undergoing surgical contraception by women of a low-income community in the city of Sao Paulo, Brazil. The ethnonursing research method was followed and data were collected with seven key and 11 general informants. The three cultural categories described (a) the difficulties women encountered with nonsurgical contraceptive methods, (b) the obstacles and barriers to obtaining surgical contraception for low-income women, and (c) beliefs and values of and about women who have undergone tubal ligation procedures. The cultural theme was that "being operada was the realization of a great dream." Leininger's sunrise model provided a framework for the discussion of the findings and implications for socially and culturally congruent nursing care.

The African American experience in the Islamic faith.

Disparity of health outcomes has been identified as a key concern in the health of Americans. Marginalization of the African American population may be a contributing factor. Identification of health protectors may prove key in decreasing disparities. The effect of spirituality on health is discussed. A historical overview of the African American experience in the Islam faith, from the Nation of Islam to universal Islam, is presented. A systematic assessment of the Islamic faith, with emphasis on the African American Muslim, was conducted as an assessment for a Community Health Nursing class. Leininger's Sunrise Model of Culture Care Diversity and Universality, with the ethnonursing model of data collection, served as the framework for data collection and analysis. The Islamic faith was noted to offer holistic direction for a "way of life" that promotes health and harmony of the mind, body, and soul. Implications for research were discussed.

Perspectives on healing foot ulcers by Yaquis with diabetes.

The purpose of this pilot study was to describe the perspectives of 4 Yaqui Native Americans with diabetes regarding biomedical and traditional methods for healing foot ulcers. Leininger's sunrise model provided the conceptual framework for this study. Analysis of ethnographic data produced four cultural themes: (a) Belief in God is expressed in prayers for healing, (b) the way to keep healthy is to take care of oneself, (c) foot ulcer is a modern illness that takes time to heal, and (d) support is important to survive a difficult journey. Understanding cultural beliefs, perceptions, and healing practices of Yaqui individuals with foot ulcers may provide health care providers with a broader scope for providing culturally competent care.

Clinical nurse specialist practice: addressing populations with HIV/AIDS.

Clinical nurse specialists (CNSs) in public health and human immunodeficiency virus/acquired immune deficiency syndrome are needed to eliminate healthcare disparities, especially with African American women, ages 25-44. This population of women accounts for 64% of acquired immunodeficiency syndrome cases reported among women, and most of these women need nursing care in community settings. Epidemiologic data and nursing research findings demonstrate an urgent need for nurses with advanced practice competencies in human immunodeficiency virus/acquired immune deficiency syndrome. The competencies identified by the National Association of Clinical Nurses Specialists in 3 spheres of influence-direct care, nursing personnel, and organizations/networks-are used to describe clinical nurse specialist competencies as they relate to this population. Leininger's Sunrise Model serves as a framework to help this population preserve, accommodate, and repattern behaviors for the prevention and treatment of human immunodeficiency virus/acquired immune deficiency syndrome.

The culture of the deaf.

The population of the United States includes over 1 million deaf people, the majority of whom have chosen to differentiate themselves in terms of a Deaf culture. These Deaf people share unique values and norms and use sign language for communication. The differences that exist between hearing and Deaf individuals necessitate that the nurse understand this population. This article will describe the Deaf culture using Leininger's Sunrise Model and present specific nursing actions in the modes of culture care preservation and/or maintenance, accommodation and/or negotiation, and repatterning or restructuring that enable the nurse to provide culturally congruent care for Deaf clients.

Transcultural nurses reflect on discoveries in China using Leininger's Sunrise model.

This paper is a descriptive report of transcultural nursing discoveries in China. The authors embarked on this study tour led by an experienced transcultural nurse educator which presented a challenging opportunity to discover Chinese culture, lifeways, and health care systems. The authors were challenged to learn about cultural differences and the importance for nurses to use transcultural nursing principles and the Culture Care Theory with research findings about diverse cultures. Leininger's (1991) Theory of Culture Care and Sunrise Model were the conceptual and theoretical guides used to discover the worldview, lifeways, and cultural values of the Chinese people. The Sunrise Model depicts the components of a culture which include worldview, cultural and environmental context, and seven social structure factors. Analysis of these dimensions of the Sunrise Model enabled the authors to discover the important values, beliefs, and lifeways of the Chinese people. Religious and philosophical, kinship and social, political and legal, and economic factors were most important for this culture. In addition culture care expressions, patterns, and practices for health and well being were highly valued by this culture. The Sunrise Model includes diverse health systems which offer generic, folk, and/or professional care. The Chinese culture includes a strong reliance on folk health care systems which persists today. This paper discusses the simultaneous use of folk and professional health care by the Chinese people and implications for transcultural nurses.

Use of Culture Care Theory with Baganda women as AIDS caregivers.

In Uganda, AIDS patients are increasingly cared for at home by women in their traditional role of family caregiver. This transcultural nursing study utilized Leininger's (1991) Culture Care Theory to discover the meanings, patterns, and expressions of AIDS caregiving for Baganda women. Ethnonursing, supported by life history and Leininger's (1988, 1990, 1991, 1993) Sunrise Model, was used to discover care among 12 key and 25 general Baganda informants providing AIDS caregiving to family members at home. In-depth interviews were conducted with informants selected from home-based nursing care programs in the Rakai/Masaka and Kampala areas. Data were analyzed using Leininger's (1990) Phases of Ethnonursing Analysis for Qualitative Data. Six major themes were identified. The findings highlighted the struggle of Baganda women to provide care and love for family members with AIDS, identified intergenerational care as essential for survival and prevention of HIV infection, and offered insight into improving the quality of life for those who are HIV positive. Care knowledge from these findings can be used to provide culturally congruent nursing care to Baganda families who are affected by AIDS through the three modes of action and decision of the theory.