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• Cultural Belief System


  Develop from the shared experiences of a social group and are expressed symbolically
• Metaphor


  Most common expression of symbolism
• Example of metaphor


  • "what a tangled web we weave" – human deception and spider web
• Paradigm


  A way of viewing the world and phenomena in it, including the assumptions, premises, and linkages that hold together a prevailing interpretation of reality
• Example of paradigm


  • Nursing care, health promotion, and illness and diseases
• Theories of health and disease or illness causation

  • Magico-religious
  • Scientific (biomedical)
  • Holistic
• Magico-religious health paradigm


  Dominated by supernatural forces, depends on human and actions of God, or gods, or supernatural forces for good or evil
• Examples of cultures with magico-religious health paradigm

  • Latino, African American and Middle Eastern cultures
  • Christian scientists – physical healing – prayer alone
• Categories of events responsible for illness

  • Sorcery
  • Breach of taboo
  • Intrusion of a disease object
  • Intrusion of a disease-causing spirit
  • Loss of soul
• Example of illness causation

  • Alaska Natives (Soul loss and breach of taboo)
• Scientific or biomedical health paradigm

  Life is controlled by a series of physical and biochemical processes that can be studied and manipulated by humans
• Biomedical model


  • All aspects of human health care can be understood through natural sciences, biology, chemistry, physics, mathematics
  • Diseases is viewed metaphorically as breakdown of the human machine because of wear and tear (stress), external trauma (injury, accident), external invasion (pathogens), internal damages (fluid and chemical imbalances, genetic)
• Holistic health paradigm


  The forces of nature itself must be kept in natural balance or harmony
• Yin and Yang


  The forces of nature are balanced to produce harmony, with yin representing the female, negative, dark, cold aspects and yang representing the male, positive, light, warm aspects
• Hot/cold theory of disease

  Imbalance of the four humors - yellow bile, black bile, phlegm, and blood - causes illness
• Ecrasia


  When the humors are balanced
• Dyscrasia


  Imbalance of the humors
• Health behavior


  Any activity undertaken by a person who believes himself/herself to be healthy for the purpose of preventing disease
• Illness behavior


  Activity undertaken by a person who feels ill to define the state of his or her health and discover a suitable remedy
• Sick role model


  Any activity undertaken by a person who considers himself ill to get well or to deal with the illness
• Factors influencing health and illness behaviors

  • One's beliefs about health and illness
  • Personal factors such as age, education, knowledge, or experience with given disease condition
  • Cues to action, such as advertisements in the media, the illness of a relative, or the advice of friends
• Determinants of illness behavior

  • Quality of symptom
  • Seriousness of symptom
  • Disruption of daily activities
  • Rate and persistence of symptoms
  • Tolerance of symptoms
  • Sociocognitive status
  • Denial of symptoms
  • Motivation
  • Assigning of meaning
  • Treatment accessibility
• Healing system


  Accumulated sciences, arts, and techniques of restoring and preserving health that are used by any cultural group
• Types of healing systems

  • Professional care system
  • Folk healing system
  • Complementary, integrative, and alternative health system
• Professional care system


  Referred to as scientific, or biomedical systems, formally taught, learned, and transmitted professional care, health, illness, wellness, and related knowledge and practice skills, characterized by specialized education and knowledge, responsibility for care, and expectation of remuneration for services rendered
• Examples of professional care system

  • Nurses, Physicians, Physical therapists
• Folk healing system


  Set of beliefs that has a shared social dimension and reflects what people actually do when they are ill versus what society says they ought to do according to a set of social standards, uses healing practices that are often divided into secular and sacred components
• Examples of folk healers

  • Traditional, lay, indigenous or generic healers
• Complementary, integrative, and alternative health system

  An umbrella term for hundreds of therapies based on health care system of people from around the world, allopathic or biomedicine considered as complementary, integrative health care is a comprehensive, interdisciplinary approach to treatment, prevention, and health promotion that brings together complementary and conventional therapies
• Types of complementary health approaches

  • Alternative Medical System
  • Natural Products
  • Mind and Body
  • Manipulative and body-based methods
  • Energy therapies
  • Biofield therapies
  • Bioelectromagnetic-based therapies
• Transcultural Nursing


  The blending of nursing and anthropology into an area of specialization within the discipline of nursing
• Madeline Leininger


  Established TCN as the theory and evidence-based formal area of study and practice within the nursing
• Transcultural Nursing


  Focuses on people's culturally based beliefs, attitudes, values, behaviors, and practices related to health, illness, healing, and human caring
• When dealing with patients belonging to other cultures, the nurse needs to take many aspects into consideration
• Symbolic interactionism knowledge has to be implemented
• Transcultural Nursing (as defined by Leininger)


  A substantive area of study and practice focused on comparative cultural care (caring) values, beliefs, and practice of individuals or groups of similar or different cultures with the goal of providing culture-specific and universal nursing practices in promoting health or well-being or to help people to face unfavorable human conditions, illness, or death in culturally meaningful ways
• Leininger's theory represents a holistic and comprehensive approach to nursing
• Culturally congruent care


  The primary goal of transcultural nursing practice
• Care


  To assist others with real or anticipated needs in an effort to improve a human condition of concern or to face death
• Caring


  An action or activity directed towards providing care