Madeleine Leininger Interview Part 1
Summary
TLDRDr. Madeleine Leininger's visit to Home Care of Rochester in 2008 highlighted her pioneering work in transcultural nursing. She emphasized the importance of understanding diverse cultures to provide culturally congruent care, a concept she found lacking in existing theories. Leininger's ethnonursing research method, a qualitative approach, aimed to unlock cultural insights and ensure patient protection. Today, transcultural care is federally mandated, and nine states require physicians to demonstrate knowledge in this field, reflecting a significant transformation in healthcare practices.
Takeaways
- 📚 Dr. Madeleine Leininger pioneered the discipline of transcultural nursing, which began in the late 1950s and is the only single discipline created by nursing.
- 🌐 Transcultural nursing is important for addressing the critical deficit in understanding and caring for people of diverse cultures, emphasizing the need to know about their culture and what care means to them.
- 🔍 Dr. Leininger found existing theories inadequate for addressing cultural aspects of care, leading to the development of new theories and approaches that consider culture and care holistically.
- 🌟 The goal of transcultural nursing is to provide culturally congruent care, which is care that fits or is sensitive to the culture of the individual receiving care.
- 📈 There has been a significant transformation in the approach to patient care, with a shift towards a more holistic understanding that includes cultural considerations.
- 🏥 Culturally congruent care is now a federal mandate, and in some states, physicians cannot become licensed without demonstrating knowledge and practice of transcultural human care.
- 🔑 Trust is identified as a universal and dominant care construct in transcultural nursing, essential for establishing a relationship where patients feel comfortable sharing their experiences and concerns.
- 🤝 Trust is established through gestures, mannerisms, and open communication, allowing patients to reveal their 'inner secrets' and feel understood by their caregivers.
- 🌍 Dr. Leininger's ethnonursing research method was developed to address the lack of a qualitative methodology that could unlock cultural insights and ensure the protection of participants' voices.
- 💡 The significance of transcultural nursing is highlighted by its ability to provide meaningful, sensitive, and useful care that patients are likely to adopt or respond to positively.
- 🛑 Cultural misunderstandings in healthcare settings can lead to negative outcomes, such as fear and avoidance of certain medical procedures, which transcultural nursing aims to prevent.
Q & A
Who is Dr. Madeleine Leininger and what did she contribute to the field of nursing?
-Dr. Madeleine Leininger is a pioneer in the field of transcultural nursing. She established the discipline of transcultural care theory and research, which is the only single discipline created by nursing, focusing on the cultural aspects of patient care.
What is the significance of transcultural nursing in healthcare?
-Transcultural nursing is significant because it addresses the critical need to understand and respect the diverse cultures of patients worldwide. It helps in providing care that is sensitive and meaningful to different cultural backgrounds, leading to better patient outcomes.
Why was it important for Dr. Leininger to develop a new understanding and approach to patient care?
-Dr. Leininger found that existing theories were not sensitive or open to discovering cultural aspects of care. She developed a new approach to provide a holistic understanding of patient care that integrates cultural considerations.
What is the goal of transcultural nursing theory?
-The goal of transcultural nursing theory is to provide culturally congruent care, which means care that fits or is sensitive to the patient's cultural background.
What is the significance of the year 1959 in the context of transcultural nursing?
-In 1959, Dr. Leininger set the goal of transcultural nursing to provide culturally congruent care, marking the beginning of a formal approach to integrating cultural understanding into nursing practice.
How has the importance of transcultural nursing evolved over time?
-Over time, the importance of transcultural nursing has grown significantly. It is now a federal mandate in the United States, and there are nine states where physicians cannot become licensed without demonstrating knowledge and practice of transcultural care.
What is the Ethno Nursing Research Method developed by Dr. Leininger?
-The Ethno Nursing Research Method is a qualitative research approach developed by Dr. Leininger to unlock and understand the cultural perspectives of patients, ensuring their voices are heard and respected in the healthcare setting.
Why was there a need for a new methodology in transcultural nursing research?
-There was a need for a new methodology because existing quantitative methods focused on numbers and did not adequately capture the quality of life or cultural nuances that are essential in understanding patient care.
What is the role of trust in transcultural nursing?
-Trust is a universal and dominant care construct in transcultural nursing. It is essential for establishing a rapport with patients, allowing them to share their experiences and cultural perspectives, which is crucial for providing culturally congruent care.
Can you provide an example of how trust is built in transcultural nursing?
-An example of building trust in transcultural nursing is when patients begin to share personal and sensitive information, indicating that they feel secure and respected in their cultural identity within the healthcare setting.
How does cultural understanding impact the use of medical technology in patient care?
-Cultural understanding is crucial in the use of medical technology as it can help healthcare providers navigate cultural fears or taboos associated with certain procedures. For example, the use of a sonogram in Japan was initially met with fear due to cultural beliefs, which required a transcultural approach to address and alleviate.
Outlines
🌟 Transcultural Nursing Discipline Establishment
Dr. Madeleine Leininger's visit to Home Care of Rochester in 2008 is highlighted, where she shared her theories and research on transcultural nursing. The discipline, which began in the late 1950s, is the only one created by nursing and focuses on caring for people of diverse cultures with an understanding of their cultural needs. The importance of this discipline is underscored by the critical need to address the deficit in cultural care, which was initially overwhelming due to the lack of existing theories that were sensitive to cultural nuances. Leininger's work led to the development of a new understanding and approach to patient care, aiming to provide culturally congruent care. This approach has had dramatic outcomes, opening doors to cultural understanding and the provision of care that is sensitive to cultural differences. The discipline's goal is to ensure that care is meaningful, sensitive, and useful to the culture it serves, with Leininger's ethnonursing research method being a significant development in the field, emphasizing qualitative aspects of care over quantitative measures.
🌱 Cultural Congruence in Healthcare: A Federal Mandate
This paragraph discusses the evolution and significance of culturally congruent care, which has become a federal mandate in the United States. It highlights the transformation in healthcare over the past 20 years, emphasizing the importance of understanding and practicing transcultural human care. The paragraph notes that in nine states, physicians cannot be licensed without demonstrating knowledge and practice of transcultural care. The concept of care is defined as an enabling process that facilitates, assists, and guides individuals, linking the care provided with their cultural context. Trust is identified as a universal care construct, essential for effective healthcare interactions. The paragraph provides examples of cultural misunderstandings in healthcare settings, such as the fear of technology in Japanese culture and the discomfort of Middle Eastern women with male medical staff during intimate procedures. It illustrates the importance of transcultural nursing in overcoming these barriers and ensuring that care is culturally sensitive and effective.
🛡️ Overcoming Cultural Barriers in Medical Settings
The third paragraph of the script delves into specific examples of cultural barriers encountered in medical settings and how they can be overcome with the help of transcultural nursing. It recounts an incident in Japan where the use of sonography was feared due to cultural beliefs, and another in Detroit, Michigan, involving Middle Eastern women who were uncomfortable with the bright lights and male medical staff during a gynecological examination. The narrative demonstrates the importance of cultural sensitivity and the role of a transcultural nurse in mediating these situations, ensuring that patients feel safe and understood. The paragraph emphasizes the need for healthcare providers to be aware of and respect cultural differences to provide effective and compassionate care.
Mindmap
Keywords
💡Transcultural Nursing Theories
💡Cultural Deficit
💡Ethno Nursing Research Method
💡Culturally Congruent Care
💡Discipline of Transcultural Nursing
💡Holistic Concept
💡Federal Mandate
💡Trust
💡Qualitative Methodology
💡Cultural Sensitivity
💡Care Constructs
Highlights
Dr. Madeleine Leininger's visit to Home Care of Rochester in 2008 to share her transcultural nursing theories.
Transcultural nursing as a discipline created by nursing, formalized in the late 1950s.
The critical need for understanding diverse cultures in patient care.
The absence of existing theories that were sensitive to cultural aspects of care.
The development of a new holistic approach to patient care integrating culture and care.
The introduction of the goal to provide culturally congruent care.
The significance of cultural congruence in care and its impact on patient outcomes.
The development of the ethnonursing research method by Dr. Leininger.
The qualitative approach to methodologies in contrast to the prevailing quantitative focus.
The importance of trust as a universal care construct in transcultural nursing.
Cultural nuances affecting trust, such as political safety and misinterpretation concerns.
The role of trust in sharing personal and sensitive health information.
Cultural differences in the perception of medical technology, such as sonograms in Japan.
The impact of cultural taboos on patient care, illustrated by the example of中东 women in Detroit.
The importance of culturally sensitive healthcare providers in patient care.
The transformation in healthcare practices towards providing culturally congruent care, now a federal mandate.
The requirement for physicians to demonstrate transcultural human care knowledge for licensing in nine U.S. states.
The definition of caring as an enabling process that facilitates and assists individuals in relation to their culture.
Transcripts
in 2008 dr. Madeleine Leininger visited
home care of Rochester to share her
transcultural nursing theories
discipline of transcultural care theory
and research
and as you and others know I've been
working in this field to establish the
discipline now it is a discipline it is
the only single discipline created by
Nursing and it is called the discipline
of transcultural that means that it is a
formal area of study and practice and
that started in the late 1950s why is it
important because first of all it was a
critical deficit why in the world did we
think we could care for people of
diverse cultures of the world and not
know something about what is their
culture and what does care mean to the
culture and so those were very important
research and theoretical questions that
had to be addressed to me it first was
overwhelming because I couldn't there
were no theories that truly addressed
and work on ruled or even sensitive to
cultures and after studying it nearly 5
to 10 years different theories and even
going into the disciplines to say what
their theories were I came to the
conclusion that the theories that
existed would not really open the doors
to discover culture or to discover care
or to put care and culture together as a
holistic concept so what is really
happened is the importance it is a
complete kind of new understanding it is
a new approach to patient care it is a
not only most holistic approach of the
totality of the whole human being but it
also is providing some dramatic and I
mean dramatic
outcomes because the outcomes are really
opening the door to these cultures to
say aha you are interested in our
culture you are interested in what care
means and you're willing to provide
services that are going to be which is
the goal of the theory to provide
culturally congruent care or care that
fits or is sensitive to the culture well
I think there's a lot of many many
different examples but in the process of
studying using the theory and using my
ethno nursing research method because
that was the second problem there was no
theory to get into and there was no
methodology that would enable the people
to what I call unlock or tell what they
wanted to and to be sure that they were
protected and that what they said was
important to listen to and so the Epling
method was developed and that was very
very important but it was a difficult
thing because our methodologies were all
quantitative to the hilt numbers were
the only damn thing that counted and my
methodology was a qualitative that we
looked at what is the quality of life
what is it that these people are
responding to or what is it they want to
tell about something of the quality of
care
the significance of transcultural
nursing today
the game and the whole thing is to
provide which is the goal of the theory
to provide culturally congruent care or
care that fits the culture because the
importance is that if you theoretically
provide that it provides that it's
meaningful sensitive and is useful
they'll adopt it or go restate respond
to it or if you have to negotiate with
them they'll do it though so that's the
big goal now today in case you don't
know that started in 1959 when I said
the goal of transcultural nursing was to
provide culturally congruent care just
two years ago it is now a federal
mandate that culturally congruent care
must occur and now today in case you're
not aware and for nurses to know there
are now nine states where no physician
can become licensed unless they have
knowledge and can practice and
demonstrate transcultural human care is
that remarkable now that didn't exist
even 20 years ago likewise it didn't
exist for nursing for nearly 50 years so
there's been a great transformation in
the way you approach the way you work
with and the way you assist or help
people and caring as I have defined it
is an enabling in enabling process by
which you facilitate by which you assist
by which you guide by which you help
someone to link what you're trying to
help them with with their culture
CAIR constructs in transcultural nursing
and one load alma care constructs that
has been along with us is that that care
is doing we're nursing was a doing
culture do-do-do-do-do-do and that you
don't really care for people unless you
do something for them be it whatever it
might be her but there was more to that
that what we phone even with the
anglo-americans
that doing had to have something linked
with it and that doing was related to
the first dominant care construct they
became a universal and that was the
concept of trust if I didn't trust
somebody there's no way that I'm going
to begin to share with you what's going
on so that highest and the most
universal construct was trust so amid
American anglo-american would not really
share of us they saw signs that you
trusted them and they trusted you as a
reciprocal thing now that's a pretty
tall order and how do we know that well
we know it sometimes by their gestures
by their mannerisms sometimes they're
even candid and Frank enough to say I
don't know if I should really share with
you this and they'll tell what the
problem is why they're afraid to so the
trust may be linked to many things it
may be linked to the whole concept of
politically what is safe to say what
might I not say and what can I say
so there's a feeling ground when you
begin to work with people as how do you
know trust how do you know when trust is
established and one of the most
significant things is when the client or
the person or the recipient on two
begins to tell some of what I call the
in her secrets I shouldn't really tell
you this but I want you to know that in
the past I didn't trust white doctors
white nurses what blah blah blah
because they were afraid of the concept
of gossip or being misinterpreted of
what they were saying and this was
especially keen with sometimes the
Hispanics with a mexican-american were a
lot of distrust and misrepresentation
and misinformation got construed
disturbed so that it wasn't truthful so
Trust is really began to build on are
you getting to my truth and do you
understand the truth as I'm telling you
and that's a very important thing you
have to look for all kinds of indicators
of how it holds together well this is an
example of trust and when I went to
Japan the women when I was interviewing
them because I was curious as you know
with my sunrise in a blur one of the
dimensions we need to look at is how
they trust technology and what I found
in talking with the women when they went
into the delivery is that so often they
wheeled in the big machine and they were
going to do a sonogram they went to find
out exactly
boy or girl you know that the American
culture on knowing oil girl but to the
Japanese people this was very
frightening and I said what is it here
oh this machine could kill our baby we
don't want this technology we don't want
to use that now immediately if there was
a transcultural nurse she would
intercede in that it was the same way
when I was this was in Detroit Michigan
and it was on the ob/gyn and we had a
lot they Middle East
women who were there and the incredible
thing was they would put the bright
lights on the vagina the bright lights
on everything that was a sexual taboo
and what it did it just froze that
Iranian woman she wouldn't she wouldn't
respond at all second thing that frozen
was not only the technology of the
lights that all of those but there was a
male physician and a male nurse down
there by the vagina they wouldn't speak
they wouldn't say anything so one of my
first move was to say let us think about
what would happen if you dr. so-and-so
might go next door and have a cup of
coffee secondly we have a wonderful
nurse here and she was a trans culture
she will stay right here with you and
with your mother or sister because they
were the support and we did that and the
woman dilated and delivered the baby
within a short time now that was almost
magical well
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