Transcultural Nursing Theory vs Humanistic Nursing Theory

This article covers Transcultural Nursing Theory vs Humanistic Nursing Theory;These nursing theories have been formulated with the main component being the care of the patient. All the theories respect the quality of life and offer the best course for patient and nurse interactions.


The profession of nursing is an action or duty to provide for others, based on the science of caring. Throughout the years, many nursing leaders have developed ideas and concepts about the nursing profession. There have been attempts to define the profession and identify exactly what it is that motivates nurses to give compassionate care to their patients. As a result, nursing theories have been developed to assist in understanding the art of caring. Nursing theories are concepts and ideas that are grouped together for the purpose of describing, explaining, predicting, or prescribing nursing care (George, 2002, p. 5).


The purpose of this paper is to compare and contrast the culture care diversity and intercultural nursing theory of Madeleine Leininger with the humanistic nursing theory of Josephine Paterson and Loretta Zderad. There will be identification of the key concepts of each theory, presentation of similarities and differences of the theories, and connection of these theories with other related theories.


Nursing is the act of caring for others, which requires the use of knowledge and performing actions to provide health services for other people. According to Dr. Gail Mitchell (George, 2002), “Nursing science represents clusters of precisely selected beliefs and values that are crafted into distinct theoretical structures” (p. 2). Nursing theories have been present for many years, dating back to the ideas of Florence Nightingale, to the current ideas of nursing leaders of modern day. Madeleine Leininger’s theory of culture care diversity and universality was developed in 1976. The formulation of this theory was a result of Leininger’s experiences working in a child guidance home during the 1950’s. She realized that recurrent behavioral patterns in the children appeared to have a cultural basis. This motivated Leininger to discover unknown knowledge about cultures and their core values, beliefs, and needs, in order to provide culturally congruent and competent care for all patients (Parker, 2006). This theory became known as the transcultural nursing theory. It addresses the cultural dynamics that have an effect on the nurse-patient relationship.

Josephine Paterson and Loretta Zderad are credited with the formation of the humanistic nursing theory, which was first published in 1976. Paterson and Zderad originally developed the ideas associated with the humanistic nursing theory as a way to define the nursing profession. It was a way to illustrate the values and meanings central to nursing experiences. The nurse-patient relationship is formed when there is a call from a person, a family, a community, or from humanity for help with some health-related issue (Parker, 2006). The response between the two parties, nurse and patient, is the act of nursing.

Madeline Leininger’s Intercultural theory

The culture care theory is very established in the contemporary setting and used by various nursing institutions globally. It is in fact regarded as the most noteworthy nursing breakthrough in the health sector in the last century. The culture is renowned for its extensive, holistic but culturally-specific concentration in discovering resourceful healthcare to different world cultures. The theory provides a hypothetical study information for the ever expanding faculty of transcultural nursing. It avails new educational material on ways of caring for immigrants of various ignored cultures.

The theory remains one of the oldest in nursing having been initiated 1950s and has unique features separating it from the other theories. It is the sole nursing theory overtly centered on cross-cultural relationships of health related complications. It is also the lone theory that attempts to dissect culture care. It is very holistic when compared to the other nursing theories and extends to cover multi-dimensional aspects of culture based healthcare. Its research methodologies extend across global cultures, analyzing the differences or diversities and commonalities of health complications and associated care across cultures. It uses a research method-ethnonursing, a feature that uniquely separates it from humanistic nursing theory. It employs theoretical and practical concepts (Parker, 2006).

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Transcultural Nursing Theory vs Humanistic Nursing Theory

The hypothetical tenets of this theory are pulled from Leininger’s broad and diverse experiences in nursing, anthropological approaches, experiences of life, human values and ingenious thoughts. The main point of this theory is determine and elucidate different and global ethnically based care aspects that influence health, illness and individual or mass deaths. The research findings of the theory are meant to offer solutions that are safe, resourceful and most importantly congruent with specific cultural identities. The means for safe, resourceful and congruent decisions and actions are the explained in the theory’s proposals, a slight deviation from this means would imply illness or death of the patients.

The theory has assumptive theories. First, care of patient is the essence of the practice of nursing and a discrete, overriding, essential and uniting focus. Second, care based on cultural profiling is crucial for health, development, continued existence and in facing disability or death. Third, care based on culture is the broadest, holistic and definitive means of knowing, elucidating, interpreting, and forecasting assistive congruent healthcare practices. Fourth, care based on culture is crucial in attempts to cure and heal, because there can be no healing without specific care. Lastly, concepts, patterns, implications, expressions and procedures differ across cultures, with manifestation of differences and similarities.

Basically, the theory proposes the application of a culture’s traditionally used healing methods, then use of worldwide practices. For instance, in the case of a bee sting in a practical example, a mother of a Hispanic male used garlic to try and slow down the swelling from the sting. The use of the garlic to help against the bee sting is that culture’s unique curing and healing methods (generic).

Humanistic Nursing Theory

The humanistic nursing theory postulates that professional nurses have a duty to knowingly and deliberately approach the practice of nursing as an ongoing experience. After an experience, nurses have a duty to reflect and draw their calls and response from lessons learnt. Collection and corresponding syntheses of observed nursing phenomena over a period of time will produce explicit description of scientific tenets to be observed in nursing. Humanistic theory views nursing as an experience assembled over time among humans. Every nursing circumstance evokes responses, and influences the expression and materialization of humans’ ability to survive particular existent conditions (Parker, 2006). A nurse has a responsibility to manage these situations and associated conditions of being or herself.

Humanistic nursing takes into account more than caring, technically capable nurse-patient relationship. Rather, it requires that nursing is a liable insight, transactional association whose resourcefulness demands abstraction rooted on a professional nurse’s experiential consciousness of self and others. Existential experience supposes human being awareness of self and others, and recognition of all individuals’ singularity existence and their own uniqueness in situations. Only an individual can know his or her situation and therefore understand what is needed in his or her situation. The uniqueness of humans presents both fear and hope. However, while each man is unique in his or her own way, he or she is like other fellow human beings. Man’s uniqueness makes him similar to all others, since all are unique.

Existential consciousness necessitates one self’s authenticity. This authenticity is more than intellectual, academic or scholarly awareness. Issues involved are “auditory, olfactory, oral, visual, tactile, kinesthetic, and visceral responses” (Peterson & Zderad, 2008). Each of these can transmit distinctive connotation a human being’s consciousness. When one is in touch with these issues, he or she can form responses about quality of life and extent of his or her presence with the rest. When human beings stop hiding more of themselves, the more they open up to others. Self-awareness, being in touch with self, acceptance of the self and materialization of potential enables one to enter into a sharing relationship with others. From existential relationship, a nurse confronts a man as a singular and uniquely peculiar, with his or her own lived existence. The interaction of a nurse and her patient will determine her actions, since she relies on insight from the patient for diagnosis. This theory greatly uses phenomenological account of individual nursing cases from the nurse’s viewpoint, the response from the patient and interaction. The main beneficial attribute of the theory is its infusion of art and science in nursing. Caring is emphasized as a key ingredient of nursing.

This approach to nursing places an emphasis on the nurse-patient relationship, in which both people influence the outcome of the nursing interventions. The function of the nursing approach shows that the relationship between the nurse and patient has as much to do with the patient’s healing as medical interventions. Humanistic nursing focuses closely on how the relationship between the patient and nurse develops in addition the patient’s physical and mental health.

The humanistic model of nursing looks at the patient as an individual, and each situation as unique. In this nursing approach, there is no formulaic method or process in order to care for patients. Each patient is assessed and treated on a case-by-case basis.

The Humanistic Model of Nursing is an approach to nursing that encompasses a number of individual theories, including Patricia Benner’s From Novice to Expert Model of Nursing and Jean Watson’s Theory of Caring.

Benner’s From Novice to Expert Model of Nursing proposes that a nurse can gain knowledge and skills without ever learning the theory behind it. Benner explains that the development of knowledge in applied disciplines such as medicine and nursing is composed of the extension of practical knowledge through research and the characterization and understanding of the “know how” of clinical experience. The theory explains the five levels of nursing, which are: novice, advanced beginner, competent, proficient, and expert. How nurses approach patients is dependent on the level of expertise of the nurse.

In Watson’s Theory of Caring, nursing is “concerned with promoting health, preventing illness, caring for the sick and restoring health.” Watson believes that holistic health care is central to the practice of nursing, and defines nursing as “a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic, and ethical human transactions.” Watson’s model contains seven assumptions about care and caring, as well as ten primary carative factors. It places the patient in the
context of the family, community, and culture, and the focus of the practice is on the patient rather than the technology.

The Role of Self-Reflection in Humanistic Nursing Theory

The researchers continue to define aspects of HNT throughout the study.  Another aspect of HNT is that, “humanistic nursing is experienced in the real world, and it is characterized by existential, nurturing, intersubjective and transactional relationships between nurses and patients and nurses and community”.  Within HNT, nurses are charged with nurturing “human potential”.  Nurses will inevitably share a bond with patients (some stronger than others) which will influence patient care.  Being cared for and providing care makes the nurse/patient relationship an intimate one.  If utilizing effective practice of HNT, nurses will have a need for self-reflection in order to better understand the patient and the patient/nurse relationship.  By re-assessing motivations and goals, nurses can provide more empathetic care and even overcome significant differences that may exist between the patient and themselves.


Humanistic Nursing Theory – Real World Application

There have been numerous studies regarding the application of Humanistic Nursing Theory over the last several decades.  HNT differs from other schools of thought in that it is not as regimented thus, more difficult to document in terms of success and failure.  Some important findings over the years are highlighted below:

•    Advanced breast cancer patients under HNT nurses reported that due to their care experience they experience an increased personal growth, self-worth and changed sense of purpose in life (Coward, 1990).

•    An additional study on women with advanced breast cancer under the care of nurses practicing HNT found a high and positive relationship between self-transcendence and emotional well-being, this served to decrease illness-related distress (Coward, 1991).

•    A study examining patients in the end-stages of life-limiting diseases being treated by nurses utilizing the HNT model reported that patients felt comfortable, valued and less isolated as a result of the care provided by the nurses (Hopkinson & Hallett, 2001).

Defining Characteristics of Humanistic Nursing Theory

After implementing HNT in a wide variety of settings, certain elements of HNT care became evident to researchers and were given more specific definition.  Each will be outlined in the following.

Moreness-choice – When surveyed, many hospice and palliative care nurses utilizing the HNT model expressed their motivations and reasons for practicing in the particular field.  Many nurses expressed the same motivations for working in hospice (alleviate suffering, provide holistic care, etc.).  “Moreness-choice” refers to each individual nurses preferences on how to respond to situations in the field.  Generally, HNT finds that these nurses choose to work in the hospice field as well as a desire for a feeling of “moreness” (helping others) as key components to the success of the HNT model.

Call and response – “Call and Response” is referred to as the relationship between the patient and nurse in the context of the patient asking for care.  It is a very specific situation because (1) the patient is experiencing a form of discomfort or pain, (2) the patient is actively asking for treatment to alleviate said symptoms and (3) the nurse reacts in a context-specific manner by providing quality care to the best of their efforts.

Inter-subjective Transaction – According to the researchers, when care begins, patients and nurses, “hold their own ‘angular’ or unique views through which to experience the world.  The nurse and the patient each experience the transaction (need for care -> providing care) differently.  However, it is outlined in HNT that the two independent individuals (nurse and patient) reach a trusting and supportive relationship so that the nurse may promote “comfort, self-determination and an enhanced sense of dignity” (Wu, Volker, 2011).  This relationship may be strengthened by demonstrating compassion, reliability and establishing a good rapport.

Uniqueness-otherness – The HNT model encourages and focuses on the nurse at the individual level.  Nurses are encouraged to reflect on their own feelings and biases which cause them to face some of their own fears, insecurities and vulnerabilities (Wu, Volker, 2011).   HNT argues that this helps the nurse understand themselves better as care providers, allowing them to be more effectual in patient care situations.


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Transcultural Nursing Theory vs Humanistic Nursing Theory

Difference and Other theories

The transcultural theory as hypothesized by Leininger is a middle-range theory because it is resourceful in ambiguous circumstances. The humanistic theory is a grand theory because it does not have a holistic approach and is merely theoretical. Grand theories have less holistic approaches as compared to the middle-range theories, and are inferior in their practical usefulness. Factual work gained from phenomenological and existential observations provide a powerful framework for the transcultural nursing theory.

An example of a related nursing theory is Kathryn Barnard’s Parent-Child interaction Theory that was launched in 1979. It draws from the reality that the development of a healthy child after conception is heavily dependent on the infant’s parent of guardian. Such a parent has a duty to raise the child in a caring and loving way (Wacharasin, Barnard & Spieker, 2003). Kathryn has created, published, and implemented child assessment protocols that are based on evidence. In the theory, issues like maternal aspects, growth and development knowledge, depression and stress heavily affect the quality of interaction of infant and its mother.

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These nursing theories have been formulated with the main component being the care of the patient. All the theories respect the quality of life and offer the best course for patient and nurse interactions.

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