Transcultural nursing theories acquired extensive attention at the end of the 20th century. At present, transcultural aspects are often regarded as central due to the changing demographics. Globalization and population aging contributed to the shortage of nursing professionals who could provide high-quality care to diverse populations. Andrew and Boyle praised the focus on cultural issues and elaborated on the development of a comprehensive model that could help nurses handle their tasks and duties. The concepts have been employed for several years and have proved to be relevant due to their clarity and applicability.
Andrews and Boyle both have extensive experience in nursing practice. They are Fellows of the American Academy, and they also hold Doctoral degrees in nursing. The two nursing professionals developed their transcultural nursing model and described their framework in 1997 (Shen, 2015). Andrews and Boyle published a number of books to further expand the scope of their model and provide various applications of their paradigm. They stress that the major purpose of their effort is to fill in the existing gaps in transcultural nursing theory and develop clear guidelines that could be helpful for practitioners.
Cultural competence is referred to as a “process in which the nurse continuously strives to work effectively within the cultural context of an individual, family, or community from a diverse cultural background” (Shen, 2015, p. 310). According to the theorists, cultural competence is a dynamic process as new skills and knowledge evolve. The authors also claim that their model can be used on the individual/family, group/community, and organizational levels (Sagar, 2014). Andrews and Boyle developed three comprehensive guides to assist healthcare professionals in improving their cultural competence as applied on the three levels mentioned above. The concepts are developed for a wide audience including nursing professionals, nursing leaders, administrators, officials, and policymakers.
The guides produced on the basis of the model include the major concepts of the theoretical framework under consideration. All the three domains are associated with such aspects as religious, social, linguistic, economic, and educational. The group and organizational levels also include political aspects. Social links and communication can be regarded as central to the model. The theorists emphasize that communication is the key to the development of cultural competence as well as the improvement of the provided care and the entire American healthcare system.
It is possible to note that the theory is logically adequate. The authors employ clear concepts that are linked to a number of core aspects. These primary aspects include communication, social links, beliefs and practices, norms and regulations, and decision-making. These core domains are divided into simple concepts that can be applied on different levels. For instance, decision-making is manifested as individuals’ health-related practices, cultural norms, and political aspects. The theorists move from simpler concepts and levels to more complicated, which helps nurses to understand and apply them in their practice.
The theorists help nursing practitioners to identify concepts they can utilize on different levels. For example, the theory can be instrumental in developing the necessary knowledge and skills in nursing students and new practitioners (Chen & Huang, 2018). LaFleur, Truscott, Graybill, Crenshaw, and Crimmins (2017) also argue that the model can be helpful in the continuous training of nursing professionals. Clearly, the theory can be applied in research and nursing practice as it can identify specific areas to concentrate on when providing care to diverse populations (Rong, Peng, Yu, & Li, 2016). Rong et al. (2016) identify certain needs of Chinese elderly patients with heart failure regarding their nutrition. Apart from education and training, the model and the guidelines can be used when working with patients and their families, with healthcare professionals and administrators, communities and facilities. By improving their cultural competence, nurses will be able to provide high-quality care to people of different cultural backgrounds. Moreover, nursing practitioners can become more active advocates for the needs and rights of culturally diverse groups. The use of the concepts and guidelines mentioned above can help in improving such systems as communities, facilities, as well as the entire US health care.
Generalizability and Testability
Andrews and Boyle developed generalizable theory and concepts that are consistent with other transcultural frameworks (Shen, 2015). The theorists use concepts that have been widely applied in other frameworks, so they are well-known. However, the authors give slightly new meanings and provide methods to apply these updated concepts to their practice (on different levels). The fact that the concepts remain almost unchanged throughout the three levels helps nursing professionals to understand different systems they have to function in and sometimes beyond.
The theory is also testable as the guidelines (as well as concepts) can be easily applied in nursing practice and any clinical setting. Rong et al. (2016) have used the concepts to identify the needs of a specific group of patients. By evaluating these needs in different populations, it can be possible to identify the relevance of the concepts suggested by Andrews and Boyle. In day-to-day practice, nursing professionals can also evaluate the effectiveness and applicability of the guidelines.
Andrew and Boyle’s Transcultural Concepts can be helpful in nursing practice as healthcare professionals can use them in their daily practice, clinical settings, research, education and training, as well as advocacy. The guidelines provided by the theorists make their theory understandable as the authors show how the concepts they refined can be utilized in nursing practice. The theory is testable, and it is consistent with other frameworks related to transcultural nursing, which makes it reliable and valid.
Chen, C. I., & Huang, M. C. (2018). Exploring the growth trajectory of cultural competence in Taiwanese paediatric nurses. Journal of Clinical Nursing. doi: 10.1111/jocn.14526
LaFleur, R. C., Truscott, S., Graybill, E., Crenshaw, M., & Crimmins, D. (2017). Improving culturally congruent health care for children with disabilities: Stakeholder perspectives of cultural competence training in an interdisciplinary leadership training program. Journal of Transcultural Nursing, 29(1), 101-111. doi: 10.1177/1043659617699065
Rong, X., Peng, Y., Yu, H. P., & Li, D. (2016). Cultural factors influencing dietary and fluid restriction behaviour: Perceptions of older Chinese patients with heart failure. Journal of Clinical Nursing, 26(5-6), 717-726. doi: 10.1111/jocn.13515
Sagar, P. L. (2014). Nursing education and transcultural nursing. In P. L. Sagar (Ed.), Transcultural nursing education strategies (pp. 1-22). New York, NY: Springer Publishing Company.
Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing. Journal of Transcultural Nursing, 26(3), 308-321. doi: 10.1177/1043659614524790