Sir Castelo Edited

MANILA DOCTORS COLLEGE
EXTENT OF TRANSCULTURAL NURSING PRACTICES IN MANILA

DOCTORS HOSPITAL
A Research Paper
Presented to
The Faculty of the College of Nursing
Pasay City
In Partial Fulfilment
Of the Requirements for the Degree
BACHELOR OF SCIENCE IN NURSING
Christy Ann S. Camballa

Joshua D. Flores
Ronalyn S. Guevara
Francis D. Ibase
Niña Rose C. Maderazo
Kristine Mae D. Mejia
Yessa P. Ortega
24-1
October 2009
RESEARCH CENTER
MANILA DOCTORS COLLEGE ii
APPROVAL SHEET
In partial fulfillment of the requirements for the degree of BACHELOR OF

SCIENCE IN NURSING, this research paper entitled “EXTENT OF
TRANSCULTURAL NURSING PRACTICES IN MANILA DOCTORS
HOSPITAL ” has been prepared and submitted by CHRISTY ANNE S.
CAMBALLA, JOSHUA ANDREW D. FLORES, RONALYN S. GUEVARRA,
FRANCIS D. IBASE, NINA ROSE C. MADERAZO, KRISTINE MAE D.
MEJIA, YESSA P. ORTEGA, who are hereby recommended for Oral
Examination.
_________________________________
ARMEL B. GONZALEZ, RN MHA
Adviser
Approved by the Committee on Oral Examination with the grade of

______.
_______________________________ _______________________
MICHAEL LEOCADIO, RN MAN NORA NARON, RN MAN
Member Member
Accepted and approved in partial fulfillment of the requirements for the

degree of BACHELOR OF SCIENCE IN NURSING.
_______________________________
EMILIE M. LOPEZ, RN MAN
Officer-in-Charge, College of Nursing
Date: October 2009
RESEARCH CENTER
MANILA DOCTORS COLLEGE iii
ACKNOWLEDGEMENT
We would like to express our deepest gratitude to the following to help and
support us to make this research possible:
To Mrs. Armel Gonzalez our thesis adviser for her unselfish time, effort,
encouragement that give us the strength to pursue this study and for sharing her
knpwledge, for guiding us and being patient with us despite her busy schedule.
To Ms. Emervic Gargoles, our statistician for her assistance in making this
research possible
To Ms. Rosie De Leon (Chief Nurse), Manila Doctors Hospital, for granting
us the permission to counduct our study in the respective areas.
To Mrs. Julita Fiesta, Mr. Demetrio Gamayon, Mr. Gregorio Mendoza III,
for imparting their knowledge and expertise in the validation of our questionnaires.
We would like to extent our warm thanks to our families and friends for
giving us a hand in all our difficulities and for giving their all-out support.
Above all, we would like to thank our Lord Almighty for his unconditional
love and guidance and making everything possible.
RESEARCH CENTER
iv
Dedication
We have conducted this study for eight (8) months. We went to different
hardships, we exerted effort, and time to make this study feasible.
This study is heartfully dedicated to all the people whose unwavering
support, belief and guidance ensured that we would be able to graduate for this
esteemed College. We would also like to dedicate this to our parents, guardians
who never failed us to give financial support in conducting this study. This is also
dedicated to the Lord Our God for his everyday blessing to us, and lastly, to our
friends for their time and motivation.
RESEARCH CENTER
MANILA DOCTORS COLLEGE v
RESEARCH ABSTRACT
Research Title : EXTENT OF TRANSCULTURAL NURSING

PRACTICES IN MANILA DOCTORS HOSPITAL
Researchers : CAMBALLA, CHRISTY ANN S.

FLORES, JOSHUA ANDREW D.
GUEVARA, RONALYN S.
IBASE, FRANCIS D.
MADERAZO, NIÑA ROSE C.
MEJIA, KRISTINE MAE D.
ORTEGA, YESSA P.
Adviser : MRS. ARMEL GONZALEZ, RN MHN MAN
School : MANILA DOCTORS COLLEGE
Degree Conferred : BACHELOR OF SCIENCE IN NURSING
Date Completed : October 2009
No. of pages : 138 pages
This quantitative analytical research assessed the Extent of Transcultural
Nursing Practice in Manila Doctors Hospital. The study was conducted last May
2009.
A purposive sampling technique was used in distributing the questionnaire
to a total of thirty (30) nurses from selected floors at Manila Doctors Hospital
participated as respondents to this survey. The quantitative data obtained were
tabulated and presented using frequency tables with the use of Statistical Packaged
for Social Science (SPSS) software.
RESEARCH CENTER
MANILA DOCTORS COLLEGE vi
The demographic data gathered for respondents were the following: age,
gender, and number of patients handled. To assess the extent of transcultural
nursing practice of the staff nurses in Manila Doctors Hospital, researchers used
chosen Sunrise Model (environmental, communication and space) from Madeleine
Leininger.
Majority of the nurses belongs to age 21-29 years old and have handled 1-2
foreign patients.
As result, the study shows that there is no significant difference in the
extent of transcultural nursing practice based on the given factors according to the
profile.
In the light of the findings and conclusions, the following recommendations
are hereby offered. Firstly, for the staff nurses of Manila Doctors Hospital (MDH),
to continue to develop the caring attitudes and provide the best quality nursing care
as possible t their patient in spite of culture indifferences. Secondly, to the College
of Nursing to suggest and encourage Commission on Higher Education to include
Transcultural Nursing Practices patterned according to Leininger’s Sunrise Model
in the curriculum of Bachelor of Science in Nursing to help nurses prepare
themselves as they have a greater chance and possibility of working abroad.
Thirdly, to the students wherein they can read cultures of other country to update
themselves regarding different cultures needed to consider before giving care.
RESEARCH CENTER
MANILA DOCTORS COLLEGE vii
Fourthly, to Nursing Service that they should monitor the knowledge of staff nurses
not only in terms of different nursing procedures they can perform or intervention
but also include in their training on providing care for foreign patients. Lastly, to
the future researchers, we recommend that they explore other data gathering
techniques for them to find the different result between the profiles of the
respondents. And test other factors like religion, economic status and others;
included in the umbrella of Sunrise Model of Leininger. Furthermore, they could
increase the number of respondents, if possible, all the nurses in the said institution.
RESEARCH CENTER
MANILA DOCTORS COLLEGE viii
TABLE OF CONTENTS
Approval Sheet ii
Acknowledgment iii
Dedication v
Research Abstract vi
Table of Contents viii
List of Tables x
List of Figures xi
List of Appendices xiii
CHAPTER PAGE
1 THE PROBLEM AND ITS BACKGROUND
Introduction 1
Background of the Study 3
Conceptual Framework 6
Conceptual Paradigm 9
Statement of the Problem 10
Statement of Hypothesis 11
Significance of the Study 11
Scope and Delimitation of the Study 14
Definition of Terms 15
2 REVIEW OF RELATED LITERATURE AND STUDIES
RESEARCH CENTER
Local Literature 17
Foreign Literature 19
Local Studies 37
ix
Foreign Studies 38
Relevance to the Present Study 40
3 METHOD AND PROCEDURE
Research Method/Design 43
Research Locale 43
Sample and Sampling Technique 43
Research Instrument 43
Validation of the Instrument 45
Test for Reliability of the Instrument 46
Data Gathering Procedure 46
Statistical Treatment of Data 47
4 PRESENTATION, ANALYSIS AND
INTERPRETATION OF DATA 51
RESEARCH CENTER
5 SUMMARY OF FINDINGS, CONCLUSIONS
AND RECOMMENDATIONS
Summary of Findings 73
Conclusions 76
Recommendations 77
REFERENCES 79
APPENDICES 82
LIST OF TABLES
RESEARCH CENTER
TABLE PAGE
A Four Point Likert Scale 49
1 Frequency and Percentage Distribution of 51
Staff Nurse According to Age
Staff Nurses According to Gender

Staff Nurses According to Number Patients
Handle
4 Extent of transcultural Nursing Practices in 56

Manila Doctors Hospital Based on
Communication

Manila Doctors Hospital Based on Space

Manila Doctors Hospital Based on
Environment
7 Summary of Categories 63
8 Difference in the Extent of Transcultural 64
Nursing Practices Grouped According to Age
9 Difference in the Extent of Transculural 66

Nursing Practices Grouped According to
Gender
10 Difference in the Extent of Transculural 69

Nursing Practices Grouped According to
Number of Foreign Patient Handled
RESEARCH CENTER
MANILA DOCTORS COLLEGE xi
LIST OF FIGURE
FIGURE PAGE
1 Conceptual Paradigm 9
RESEARCH CENTER
xii
LIST OF APPENDICES
Appendix PAGE
A Recommendations and Suggestions of the Panel 83

B Methods 85
C Statistical Analysis 93
D Communication Letters 103
E Certifications 110
F Gantt chart and Line Item Budget 117
G Photographic Documentations 119
H Curriculum Vitae 121
RESEARCH CENTER
CHAPTER I
THE PROBLEM AND ITS BACKGROUND
Introduction
"..I will serve mankind with love and compassion, recognizing their dignity
and rights irrespective of color, caste, creed, religion and nationality.” - Florence
Nightingale.
Pain is experienced by people of all cultures, communities and economic
strata. It is the fifth vital signs that nurses included in assessing their patients every
day. Nurse handles different people every day holding different beliefs, practices,
values, religion, and cultures of clients, thus nurses have to face, accept, and must
do their job in giving, providing, and fulfilling the needs of every client they have.
It is like nurses wearing a mask in every time they are going to attend to the needs
of their patients every day. No matter how kind or cruel the patient is, nurses
should smile, show goodness, and understand the condition of their client.
Different cultures of client is not a simple task for nurses, there are things to
consider in providing an optimum care in each client.
In year 2005, according to a senior Taiwanese Department of Health (DOH)
official in Taipei said that there would be a self-payment ratio hike for out-patient
and emergency patients. Increase in payment in medical services will be effective
RESEARCH CENTER
2
on 16th of July in the same year. Taiwanese as well as other nationalities come to
the Philippines for medical professional help because aside from lower rates; they
can avail wellness not mentioning the global competitiveness of medical
practitioners and equipment available. Nurse prepares their selves in handling
patients with different culture patterned to their client’s culture, beliefs, values,
practices, and even with their superstitious beliefs.
Visiting one place from another dictates a big adjustment on the part of
foreigners which, sometimes they cannot cope with changes around them affecting
their health. There are a lot of factors that can affect the health of foreigners such
as, weather, environment, food, water, hygiene, and presence of communicable
disease like pulmonary tuberculosis.
As nurses and future professional nurse, taking care not only the health of
Filipinos but as well as foreigners is a major responsibility. Nurse’s profound
knowledge and skills in giving care and practicing nursing skills will be used as a
guide in assisting health needs of foreign clients. It will also support nurse’s duties
in maintaining care and in preventing both local and foreign clients from acquiring
any kind of diseases present in the environment.
Each nationality deserves to have an adequate service and care that is
patterned according to their cultural beliefs and practices that each professional
nurses and future nurses should have knowledge of. Studying their culture and
RESEARCH CENTER
3
practices, understanding their culture, and applying what the nurse’s learn will help
nurses to be equipped and to be an effective nurse here and in abroad. To be
globally competitive is the aim of each nurse who is planning to practice their
profession outside the Philippines.
As a response to these conditions, it is essential to study the extent of
transcultural nursing practices of nurses in Manila Doctors Hospital.
Background of the Study
In the last four decades, understanding and acceptance of the need to
prepare nurses and other practitioners to provide culturally competent care has
grown around the world.
In year 2005, a senior Taiwanese Department of Health (DOH) official in
Taipei said that a self-payment ratio hike for out-patient and emergency patients
will be announced. DOH Secretary-General Lai Chin-Hosing also said that hike is
expected to be put into effect July 16, 2005. According to the fee hike plan
envisaged by the Bureau of National Health Insurance (BNHI), the self-payment
amount for outpatients as well as amount for emergency patients for district,
regional and national hospitals will be raised. Based on the information, their fees
are visibly higher than medical fees in our co untry. In relation to that,
Taiwanese as well as other nationality come to our country for medical professional
help because aside for lower rates; they can achieve wellness not mentioning the
RESEARCH CENTER
4
4
global competitiveness of our medical practitioners and the equipment available.
Nurses should be prepared of handling patients according to their culture without
violating anything from their beliefs, values, practices, or even to their superstitious
beliefs. Nurses should respect their attitudes towards dealing with nurses, and
nurses should understand that cultures should consider in giving care to foreign
patients and know their limitations in giving care.
In 2008, based on medical Tourism Monitoring Sheet of Manila Doctors
Hospital (MDH), there were foreign patients coming from different countries who
seek for medical assistance. With this record, it is evidently seen that nurses of
Manila Doctors Hospital handled foreign clients who needs medical assistance.
A student nurse experienced handling a Japanese patient in Manila Doctors
Hospital and had a problem in communication. He needs an interpreter in order for
him to understand the student nurse and vice versa. But unfortunately, there was
no interpreter to relay and interpret the message to client. Action is the only means
of communication similar to pantomime in order for client to understand different
instructions, and answer questions given to client; and for client to ask questions as
well. Even though actions were performed still there is a delay of understanding
instructions and questions. On the brighter side, putting the words into actions is
helpful compared to no total no means of communication.
RESEARCH CENTER
5
Manila Doctors Hospital is the base hospital of students from Manila
Doctors College. In relation to hospital’s location, there is a hotel and game
amusement near the area where a lot of foreigners visit and stay. In mentioning
that situation, there is a high probability that Manila Doctors Hospital might have
foreign patients who might ask and consult for medical services once they need
medical assistance. Students from Manila Doctors College has a high probability
of handling a foreign patients as well since the aforementioned hospital serve as
their training hospital in developing their skills and molding students to a
professional nurse some day.
Handling different nationalities in the hospital is not an easy task. There are
a lot of things to consider especially when culture comes in the process of giving
care. Soon, student nurses will become professional nurse and will be facing
different people not only coming from different provinces but from other country
as well who have a different culture from Filipino nurses. Culture especially
transcultural nursing is very important to nurses as nurses’ service will be evaluated
and will be assessed by any patients as they leave the hospital. if nurses did not
satisfied the standards of every culture in receiving care it will only reflect that
nurses of Manila Doctors Hospital is short in terms of providing optimum care
which is the primary goal of nursing profession as well as any hospital institution.
In relation to this, this study was conceived in order to further assess the nursing
practices of nurses of the said hospital in handling foreign clients. It is important to
RESEARCH CENTER
6
know how wide is the practice of nurses in handling foreign clients in order to
serve as a guide and a model for future nurses in Manila Doctors College. In
addition, to gain knowledge of what is missing in terms of nursing practices in
handling foreign client who has different culture to nurses in said hospital. This
will be helpful for both registered nurses and future nurses. With this, the author
would like to know the extent of transcultural nursing practices in Manila Doctors
Hospital.
Conceptual Framework
Big responsibilities are on the shoulder of nurses since nurses serve as the
front liner in facing different client every day. Interventions that every nurse
employs are very important to help client improve and achieve optimum health as
well. Thus, nursing practice should be considered in dealing with different client
especially with foreign patients or clients.
The study was based on Madeleine Leininger’s theory patterned in her
Sunrise Model of Transcultural Nursing, the author would like to investigate the
factors suggested by Leininger namely, communication, space, and environmental
control that can affect the extent of delivery of care for foreign patients.
Transcultural nursing is a humanistic and scientific area of formal study and
practice in nursing which focused upon differences and similarities among cultures
with respect to human care, health, and illness based upon the people’s cultural
RESEARCH CENTER
7
values, beliefs, and practices, and to use this knowledge to provide cultural specific
or culturally congruent nursing to people. Leininger noted the main goal of
transcultural nursing in her study is to discover and explain diverse and universal
culturally based care factors influencing the health, well-being, illness or death of
individuals or groups. Leininger theorized that every culture had access to some
form of folk indigenous health care system and that some, but not all, had access to
a professional health care system.
According to Leininger, sunrise model provide a valuable guide to obtain
data to gain cultural knowledge and understanding. Moreover, it can help
transcultural visitor like the author to discover data about specific individuals,
groups, families, communities or institutions, and can be used in diverse settings
(Leininger, 1997).
The author focuses on communication, space and environmental control.
The extent of transcultural nursing practices in Manila Doctors Hospital is based on
Sunrise Model. Sunrise Model will help the author to assess the extent of
transcultural practices that every nurse performs in handling foreign patients. The
factors chosen by the author are part of environmental context, language and
ethnohistory. Under communication, language spoken, voice quality,
pronunciation, and nonverbal communication; while under space were the
following: degree of confront observed (conservation), proximity to others, body
RESEARCH CENTER
8
movement and perception of space; and lastly in environmental, cultural health
practices efficacious neutral dysfunctional uncertain, values, and definition of
health illness were part of the author’s study.
Communication is very important not only in transcultural nursing because
communication is a way for people to express their selves and in order to maintain
peace due to comprehending ideas, thoughts, instructions, and procedures to each
and everyone especially between nurses and foreign patients. Leininger stated that
to ensure a mutually respectful relationship between foreign patients and nurses,
nurse should introduce her or himself and indicate to the foreign patients on how he
or she wants to be address by his or her nurse, it can either be by name, last name,
and or title. Nurse should elicit from the foreign client because this enables the
nurse to address the foreign clients in a manner that is culturally appropriate.
According to Leininger cited by Andrew and Boyle space is significant in
cross-cultural communication. Space and distance from the client will help nurses
to avoid conflict with foreign patients they handle. It is included in Leininger’s
Sunrise Model because there are culture that give values to space and distance like
for instance those from Latin America, Japan, and Middle East which they need the
least amount of space and feel comfortable standing close to others.
Lastly, environmental control which has a significant influence upon
client’s healthcare practices (Leininger cited by McFarland, 2008). Different
RESEARCH CENTER
9
cultures might have different beliefs in relation to environment. Foreign patient’s
belief and attitude towards his treatment and prognosis might be influenced by his
or she believes which can control over events or whether he or she is more fatalistic
and believes that chance and luck determine what will happen to him or her.
Patients may cooperate with health regimens and can see the benefit of developing
behavior that could improve his or her health. Some American Indians and Asian
Americans believe in this category. With these factors to consider, it will help the
author to assess the extent of transcultural nursing practices in Manila Doctors
Hospital.
Conceptual Paradigm
Profile: Extent of Transcultural
Nursing Practices:
 Gender
 Age  Communication
 Number of Foreign  Space
Patients Handled  Environmental
Control
Figure 1 Conceptual Paradigm
Figure 1 shows the interplay of the variables chosen. The independent
variable which is profile includes the age, gender, and the number of foreign
patients handled of staff nurses in Manila Doctors Hospital while the extent of
transcultural nursing practices is the dependent variable which refers to
RESEARCH CENTER
10
communication, environmental control, and space that could affect nursing
practices in performing different interventions in giving care.
Statement of the Problem
This study aims to answer the following question:
1. What is the profile of the respondents in terms of:
1.1 Age,
1.2 Gender,
1.3 Number of foreign patients handled?
2. What is the extent of transcultural nursing practices of respondents in
terms of:
2.1. Communication,
2.2. Space,
2.3. Environmental Control?
3. Is there a significant difference in the extent of transcultural nursing
practices of Manila Doctors Hospital when grouped according to the profile?
RESEARCH CENTER
11
Statement of Hypothesis
The hypothesis was tested at 0.05 level of significance.
There is a no significant difference in the extent of transcultural nursing
practices in Manila Doctors Hospital when grouped according to the profile.
Significance of the Study
The study was designed to overview the extent of transcultural nursing
practices of staff nurses in providing care to foreign patients. The study will
benefit to the following:
For the Staff Nurses of MDH, The study will help the staff nurses in Manila
Doctors Hospital to realize how important is considering their patients culture.
They can foster also cooperation to achieve an effective nursing care. Expertise in
their medical profession is not enough because having and maintaining a
harmonious relationship with different patients is very important so that patients
will trust the nurse who is attending and providing to their needs. It will train them
on how to become more effective staff nurse in dealing with foreign patients.
Knowing the extent of transcultural nursing will help staff nurses to identify what is
missing and needs improvement of providing care to foreign patients. And for
nurses to be globally competitive who has plan of and planning to go back abroad
to practice their profession. So that nurses will be independent in rendering care
RESEARCH CENTER
12
and services to different patients of providing quality care. It can help nurses to
have an effective care if they will consider different practices and cultures of each
patient they encounter and handle regardless of their culture and country they come
from.
For the College of Nursing, since many staff nurses in Manila Doctors
Hospital are products of the College, this study will help and guide the College of
Nursing (CON) in Manila Doctors College to know how profound the knowledge
of students regarding transcultural nursing. They will be aware that transcultural
nursing practices should be given emphasis in their curriculum since there is an
evidence of foreign patients comes to the Philippines to seek for medical help.
There is a greater probability that students would handle foreign patients. Having
the background of the extent of transcultural nursing practices of staff nurses will
help the faculty to determine the focus of learning that faculty should focus on as
well as to determine the other factors of transcultural nursing that students needs to
know in order to develop their skills of providing care to different patients
regardless of different cultures and country they come from. CON can lead their
students to practice and become an effective student nurse and eventually
professional nurse in providing an effective care to foreigners.
For the Nursing Students, as this early stage, it is important for student
nurses to value the importance of considering their patients culture before
RESEARCH CENTER
13
administering care in order to encourage cooperation, and to have an effective care.
It might be the source for students to have the knowledge regarding the appropriate
knows approach or style to use in dealing with foreign patients. Handling foreign
patients in different hospitals will train students from Manila Doctors College who
have plans of practicing their profession as nurses, once they pass the nursing board
examination, outside the country and be globally competitive. And lastly, to
address the students of mentioned institution the importance of transcultural
nursing practice to their future profession and to inform the students regarding the
importance of learning different transcultural nursing practices that are necessary in
giving care and dealing with different patients.
Nursing Service, with this study, it will help the nursing service to
determine if they have the need to further develop their staff nurses in handling
foreign patients by giving seminars, trainings or even refreshment courses that can
develop the skills of staff nurses in facing, handling, and improve nursing practices
to facilitate cooperation and fast recovery of foreign client.
Future Researchers, with this study, future researcher will help determine
the coverage of their future study if they want to continue studying transcultural
nursing practices here in the Philippines. This study only covers the extent of
transcultural nursing practices. Future researchers can study the different indicators
that can affect staff nurses of providing care to foreign patients. They can also
RESEARCH CENTER
14
study the different factors that can affect transcultural nursing practices like if
politics, economics, and technological factors can affect staff nurses in giving and
providing care to foreign patients.
Scope and Delimitations of the Study
The scope of the study was delimited to the extent of transcultural nursing
practices of staff nurses in Manila Doctors Hospital (MDH). The research does not
focus on the relationship among staff nurses and their employer rather on the extent
of staff nurses of practicing transcultural nursing to their patients.
This study focused only to staff nurses of Manila Doctors Hospital (MDH)
who are working in different floors of the said hospital such as from 3rd up to 5th
floor of the old building, and from 3rd up to 11th floor of the new building.
Respondents are registered nurses who has experienced of handling foreign
patients, and with at least 20 years of age. .
The respondents of this research are representatives of the whole Manila
Doctors Hospital (MDH). There are 11 floors in the new building and 5 floors in
the old building but the researcher focused on 30 staff nurses of private wards of
the said hospital due to limited time of the study. It would be difficult and
impractical to give questionnaires with all nurses of all floors of both building.
Thus, the findings may only hold true based on the results of interviews and
RESEARCH CENTER
15
15
questionnaire given to staff nurses of private wards that would obtain from the
respondents who was selected by convenience.
The study was a non-experimental, quantitative, descriptive design on the
extent of transcultural nursing practices in Manila Doctors Hospital (MDH). In
addition, a purposive sample technique utilized in this study based on the author’s
criteria mentioned above. The author used a surveyed questionnaire with a format
of closed-ended questions which was use to statically measure the extent of
transcultural nursing practice in Manila Doctors Hospital (MDH). Lastly,
questionnaires are answerable with adjectival ratings as follows: fullest extent
(FlE), full extent (FE), moderate extent (ME), lesser extent (LE), and least extent
(LtE); which was used as basis of the degree of extent transcultural nursing
practices corresponding to each questions of each category.
Definition of Terms
The following terms are defined as used in this study in order to provide
clarity of term used.
Communication it refers to exchange of information and instructions
between client and nurse that includes use of verbal and nonverbal communication.
RESEARCH CENTER
16
Environmental Control refers to the totality of an event, situation, or
particular experience that gives meaning to people’s expression, interpretations,
and social interactions, and technologic factors in specific cultural settings.
Extent it is the measurement or the degree of nursing practices render by
nurses to their foreign patients.
Foreign Patient A person who is from other country or a non Filipino or
alien to the Philippines who seek help regarding their health problems.
Space refers to the distance between individuals (client and nurse), body
movement, degree of confront observed or conservation when they (client and
nurse) interact.
Staff Nurses in this study, refers to a registered nurses employed at Manila
Doctors Hospital.
Transcultural Nursing Practices different nursing practices that nurse’s
implements and practice in facing, dealing, and handling foreign patients. Nursing
practices like certain distance they implement when caring for patients which is
included in the factors of space in transcultural nursing.
RESEARCH CENTER
CHAPTER II
REVIEW OF RELATED LITERATURE AND STUDIES
This chapter presents information from articles and studies conducted by
local and foreign researchers, which gave the researchers a wider grasp and full
understand of the study. This summarizes the literature and studies that have
significant bearings on the study.
Local Literature
Culture is not genetically inherited, it is acquired but once learned and
internalize, cultural ways became forms of rationality. Culture provides the
individual and the group to which he belongs with common point and reference for
behavior, enhancing the sharing values, norms, believes and practices. When held
in common the mention elements of behavior becomes establish into pattern that
form the basis of peoples ways of listening, feeling and acting as emphasized by
Linda Jocano(1999).
However Sociological perspective in clinical pastoral care underscores the
sociocultutral context that qualifies a person life, consequently, the context or the
climate when it stifles human life will demand a qualitative change for authentic
human development to happen. It takes the whole social reality economic, politic,
RESEARCH CENTER
18
religion-cultural in order to humanize this for it to sustain people’s total human
development efforts and objective. (Dulnalagan 1997)
According to Mercado, (2002), she said that “the purpose of nursing is to
assist in people attaining a level of health and well being which enable them to live
socially and economically productive life. To achieve this breadth of nursing is
wide from curative to palliative to preventive to promotive. It also function, not in a
vacuum, but increasingly in a socioeconomic political environment, through which
nursing must find its way but do so in maturing independent way.
In the special report of Fabon, Julia. M., (2006) he stated, in this area of
practice the nurse uses her knowledge of the dynamic of human behavior. He is
called upon to make “for purposeful use of the self”. Relationship between the
nurse and the patient is established through therapeutic communication and
interpersonal processes. Communication between two human beings can be
difficult and challenging. The nurse can be guided by the human behavior the
patient exhibits. She need to be sensitive not only to the verbal messages of the
patient but to the nonverbal expression of his abstract thought and feeling that
means he or she must know how to read the body language and hear the nuances of
speech and voice infection.
RESEARCH CENTER
19
Foreign Literature
The ever-increasing multicultural population in the Unite States poses a
significant challenge to nurses providing individualized and holistic care to their
patients (Lorentz, 2008). It requires nurses to recognize and appreciate cultural
differences in healthcare values, beliefs, and customs. Nurses must acquire the
necessary knowledge and skills in cultural competency. Culturally competent
nursing care helps ensure patient satisfaction and positive outcomes. From the
transcultural point of view, healthcare providers must deliver a service that is
culturally sensitive and appropriate. However, for a variety of reasons, there is
growing concern that the cultural healthcare needs of minority ethnic group are not
met adequately (Narayanasamy, 2003).
The extent of transcultural nursing has many determinants or it can cause by
many factors. These determinants can either be verbal or nonverbal factors. The
profile of staff nurses can affect the extent of transcultural nursing practices in
rendering quality care to foreign patients.
According to Leininger, transcultural is defined as the beliefs and
definitions in which cultural groups are compared and contrasted. The theoretical
principle of transcultural nursing guides nurses in providing meaningful and
appropriate care to people of diverse and similar cultures. Transcultural nurses
are academically prepared to serve many cultures by respecting the worth, dignity
RESEARCH CENTER
20
and rights of individuals, families, groups and communities. Most important,
transcultural nurse are prepared to assess the cultural care needs of people and to
skillfully integrate the values, beliefs and lifeways of cultures for the health and
well-being of those served as human rights imperative. Moreover, transcultural
nurse shows compassion and humanistic caring to alleviate cultural conflicts,
cultural imposition, and cultural pain to people of diverse cultures. Knowledge of
nurses of transcultural nursing provides creative ways to maintain, accommodate,
and/or restructure care in meaningful and beneficial ways for people of the world.
Transcultural nursing society believes that nurses and other health care
practitioners should provide and maintain humanistic care for people worldwide.
Focus of care of nurses is on preserving and maintaining the human right of all
people. Theses human rights should not be denied neglected or violated and
deserve protection from acts of injustice. Healthcare practitioners especially
transcultural healthcare practitioner should influence healthcare policy and
practices by individuals and institutions to enhance the care for people worldwide.
Regardless of race, ethnicity, national origin, religious and philosophical beliefs,
gender, sexual orientation, cultural values, age, and other diversities, people have
the following universal human rights. Transcultural nursing society named name
human rights that every person must achieve in providing a holistic care, this were
the following: Access to quality care including qualified healthcare professionals,
organizations and resources; Access to culturally and linguistically competent
RESEARCH CENTER
21
healthcare providers; Respectful care with recognition for personal dignity,
privacy and confidentiality; inform participation in ones’ own healthcare;
Involvement of family members and significant others in healthcare delivery and
decision making if desired by the care recipient; Accept or refuse care and
negotiate with healthcare providers to achieve culturally congruent care; Freedom
form healthcare treatments that involve coercion, bribery, and illicit activities that
place one’s well being at risk; Receive care in an environment in which physical,
psychological, spiritual and cultural safety is assured for the person and his or her
family, and significant others; and Receive care without putting one’s self or
loved ones in jeopardy or harm’s way. In relation to this, foreign patients receive
appropriate care even if they seek medical help outside their country. We as
Filipino nurses, is responsible to provide care that they deserve in order to achieve
optimum health.
Care is the heart of nursing; care is essential to healing or well being; care is
curing; care is or should be the central and dominant focus of nursing and
transcultural nursing decisions and actions. Transcultural nursing promotes and
upholds these ideas because human beings are born, live, work and die within a
culture care context and viewpoint. To neglect cultural factors such as one’s
religion, family ties, and economical, political, educational and technological
factors can lead to non-caring and cultural negligence with often non-beneficial
outcome (Leininger, 1998).
RESEARCH CENTER
22
Culture has a powerful influence on one’s interpretation of and responses to
health and everyone has the right to be respected for his or her uniqueness and
cultural heritage. Caregivers need both general and specific cultural information
to provide sensitive and culturally competent care. Cultural awareness improves
the caregiver’s self-awareness (Purnell, 2002).
To provide culturally congruent care is to provide care that is meaningful
and fits with cultural beliefs and life ways of the client. It refers to the use of
(local cultural knowledge and life ways) in meaningful and tailored ways that fits
with ethic (largely professional outsiders’ knowledge) to help specific cultures,
whether ill, disabled, facing death or other human conditions (Leininger, 1999).
Currently, there are inadequate numbers of health care providers worldwide
who are prepared to provide culturally congruent care. Many providers neither
recognize nor acknowledge the existence of variety of healing and caring
paradigms that are widely valued and used. In addition, health providers are
frequently unwilling or unable to accommodate ways of knowing and healing that
do not fit into their own cultural frameworks of knowledge and experience.
Instead, they impose practices of care on people that are ineffective or harmful,
rather than working collaboratively across paradigms and care systems. Actions
related to ethnocentrism, lack of awareness and moral blindness perpetuate and
exacerbation healthcare inequities (Lauderdale, 2005). Moreover, the inequities,
RESEARCH CENTER
23
discriminations and sufferings must not continue given available resources,
healthcare providers throughout the world have the ability to address and redress
the inequities. Nurses in particular, have the potential to bridge gaps in cultural
knowledge about health and caring that will significantly reduce the impact of
intolerance, in full access, and decrease health inequities locally and globally.
Most of all, collective political action is needed to channel resources into
education and preparation of nurses and other health care provides in order to
systematically address crisis (Lauderdale, 2005).
Culturally competent care is care that is sensitive to the differences
individuals may have in their experiences and responses due to their heritage,
sexual orientation, socioeconomic situation, ethnicity, and cultural background. It
is care that is based on understanding how those differences may inform the
responses of people and the processes of caring for them (Meleis, 1999).
There are seven components of nursing that were identified as the essence
of Native American Nursing Practice at a Summit of Native American Nurses in
1997. The essence was described as being synonymous with nature, core, gist,
substance, spirit, heart, or principle. The following themes were identified as an
essence of Native American Nursing is the following: caring, traditions, respect,
connection, holism or holistic, trust, and spirituality. There is a need to leg go of
the rational mind to bring transformation energy into all aspects of work of nurses.
RESEARCH CENTER
24
However, the literature suggests that Native American Nursing Practice might view
cultural competence on a continuum which is described unconscious incompetence
meaning no awareness that one is lacking cultural knowledge; conscious
incompetence means there is knowledge but still not know how to use it; conscious
competence meaning intentional act of learning about a patient’s culture and
providing culturally responsive nursing interventions; and lastly, unconscious
competence meaning the ability to spontaneously provide culturally responsive care
to individuals from divers cultural backgrounds. The literature suggests that in
order for nurses to become culturally competent, they must identify their personal
values, clarify values of self and client and integrate those values into their own
professional practice. The nurse’s competence can be the basis on the extent of
transcultural nursing practices they perform and provide to their patients.
Purnell model for cultural competence is really built on Leininger’s model
with minor exceptions. Purnell states that a culturally competent healthcare
provider develops the following: an awareness of his or her existence, sensation,
thoughts, and environment; those does not let these factors have an undue effect on
those for whom care is provided. While the major assumptions of the model were
the following: all healthcare providers needs similar information about cultural
diversity; all share the mataparadigm concepts of global society, community,
family, person and health; one culture is not better than another culture; all cultures
RESEARCH CENTER
25
share core similarities; differences exist among, between and within cultures; and
cultures change slowly over time in a stable society.
Transcultural nursing theory is incorporated in the Sunrise Model of Culture
Care of Madeleine Leininger. Nurses who use this theory in nursing care often
referred to us providing culturally competent care, although this term is gaining
popularity outside this framework as well. According to sunrise model, culture
care and similarities between patients and nurses exist in all human cultures
worldwide. Culturally congruent nursing care occur when individual, group,
family, community, or institutional care values, expressions or patterns are known
and use explicitly in appropriate and meaningful ways. The model avoids focus on
medical problems, and fragmenting client and looking at many important variables
affecting client. Giving care is the essence of nursing and distinct, central, and
unifying force.
In addition, Sunrise Model provides a valuable guide to obtain data on
culture to gain cultural knowledge and understanding. In relation, sunrise model
can help a transcultural visitor to discover data about specific individuals, groups,
families, communities or institutions, and can be used in diverse settings (Larson,
2004). It provide an ideal format for building trust in a transcultural context and
offered this observer a comprehensive and holistic view of health through the
examination of cultural and social structures, and care expressions. Each
RESEARCH CENTER
26
dimension of Sunrise Model can readily observe in terms of the present and ancient
culture.
Theory of Culture Care and Sunrise Model were the conceptual and
theoretical guides used to discover the worldview, lifeways, and cultural values.
The Sunrise Model depicts the components of a culture which include worldview,
cultural and environment context, and seven social structure factors (Lee, 1996).
This social factor emphasizes social structure dimensions that include:
Technological Factors, Religious and Philosophical Factors, Kinship and Social
Factors, Cultural Values and Lifeways, Political and Legal Factors, Economic
Factors and Educational Factors (Larson, 2004). Based on the Sunrise Model, the
seven social factors mentioned in under the influences care expression, patterns and
practices. The researcher chose communication, environmental control, and space
that can affect transcultural nursing. Among the three, communication is the most
important since communication is a medium for other people to understand each
other; followed by environmental control and space that could affect the culture of
foreigner whenever they seek medical assistance in the Philippines which nurses
should consider before rendering care.
Establishing an environment where cultural differences are respected begins
with effective communication. Communication is the means by which culture is
transmitted and preserved. In addition, communication can be language spoken;
RESEARCH CENTER
27
voice quality, pronunciation, and use of nonverbal communication not purely rely
on spoken language. Both verbal and nonverbal communications are learned in
one’s culture (Davidhizar and Giger, 1994). Verbal and nonverbal patterns of
communication vary across cultures, and if nurses do not understand the patient’s
cultural rules in communication, the patient’s acceptance of treatment regimen may
be jeopardized (Davidhizar and Giger, 1994). This occurs not just from speaking
the same language, but also through body language and other cues, such as voice,
tone, and loudness. According to Joint Commission on Accreditation of Healthcare
Organizations (JCAHO) they require facilities to have interpreters available. At
times nurses will be on their own interacting with patients and families who do not
speak English tips were provided in order to avoid barriers of communication. To
name a few were greet the patient using his or her last name or complete name;
avoid being to casual or familiar; point to yourself (nurse) say your name and
smile; nurses should proceed in an unhurried manner and pay attention to any effort
the patient or his or her family makes to communicate; speak in a low, moderate
voice and avoid talking loudly because there is a tendency to raise the volume and
pitch of our voice when a listener appears not to understand. In result patient may
think that nurse is angry and shouting. Use short, simple sentences and speak in the
active voice. Use simple words, such as “pain” rather than “discomfort.” Avoid
medical jargon, idioms, and slang. Give instruction in the proper sequence like for
instance, rather than saying, “Before you take the medicine, get into bed,” you
RESEARCH CENTER
28
should say, “Get into your bed, then take your medicine. And lastly, the nurse
should check and see if the patient has another language in common. For instance,
many Indo-Chinese people speak French, and many Europeans know three or four
languages. Try Latin words or phases that if the nurse is familiar with the
language.
To ensure that a mutually respectful relationship is established, nurse should
introduce her self or his self and indicate to the client how they prefer to be called
either by first name, last name, and or title. Nurse should elicit the same formation
from the client because this enables the nurse to address in a manner that is
culturally appropriate (Andrew and Boyle, 2007).
Nonverbal communication pattern vary widely across cultures, nurses must
be alert for cues that convey cultural differences in the use of silence, eye contact,
touch and space distance and facial expression. Wide cultural variation exists in
interpretation of silence. Some individuals find silence extremely uncomfortable
and make every effort to fill conversational lags with words. In contrast, many
native North American consider silence essential to understanding and respecting
the other person (Andrew and Boyle, 2007).
Accurate diagnosis and treatment is impossible if the healthcare
professional cannot understand the patient. When the provider is not understood,
he or she often avoids verbal communication and does not realize the effect of
RESEARCH CENTER
29
nonverbal communication, which is all too often the painful isolation of patients
who do not speak the dominant language and who are in an unfamiliar
environment. Consequently, the patient experiences cultural shock and may react
by withdrawing, becoming hostile or belligerent, or being uncooperative (Spector,
2000). Culture not only determines the appropriateness of the message but also
influences all the components of communication.
The concept of space and distance are significant in cross-cultural
communication. Such behavior by theses clients is probably an attempt to bring
nurse’s close into the space that is comfortable with close physical proximity to
theses client, they are perplexed by nurses distancing behavior and may perceive
nurses as aloof and unfriendly.
Space refers to the distance between individuals when they interact. All
communication occurs in the context of space (Giger and Davidhizar, 2002). Space
includes degree of confront observed (conservation), proximity to others, body
movement, and perception of space. According to Spector, there are four distinct
zones of interpersonal space: inmate zone (extends up to 1 ½ feet), personal
distance (extends from 1 ½ to 4 feet), social distance (extends from 4 to 12 feet),
and public distance (extends 12 feet or more). In relation, rules concerning
personal distance vary from culture to culture. The extreme modesty practiced by
members of some cultural groups may prevent members from seeking preventive
RESEARCH CENTER
30
health care (Spector, 2000). For instance, some Afghans prefer closeness in space
with others and particularly with the same sex. When comfortable with others,
these individuals prefer to be in close proximity to build trusting relationships
(Giger and Davidhizar, 2002). Giger and Davidhizar stated that comfort level is
related to personal space like comfort in conversation, proximity to others, body
movement, perception of space. Eye contact, space, and touch practices may be
very different from one’s sphere of reference.
People tend to regard the space immediately around them as an extension of
themselves. The amount of space they prefer between themselves and others to feel
comfortable are a culturally determined phenomenon. Most people aren't conscious
of their personal space requirements - it's just a feeling about what's comfortable for
them - and you may be unaware of what people from another culture expect. For
example, one patient may perceive your sitting close to him as an expression of
warmth and caring; another may feel that you're invading his personal space.
Research reveals that people from the United States, Canada, and Great
Britain require the most personal space between themselves and others. Those from
Latin America, Japan, and the Middle East need the least amount of space and feel
comfortable standing close to others. Keep these general trends in mind if a patient
tends to position himself unusually close or far from you and be sensitive to his
preference when giving nursing care.
RESEARCH CENTER
31
Touch is a body movement that is culturally determined to a great degree.
For instance, in Hispanic and Arab cultures, male health care providers may be
prohibited from touching or examining certain parts of the female body; similarly,
females may be prohibited from caring for males. While among many Asian
Americans, touching a person's head may be impolite because that's where they
believe the spirit resides. Before assessing an Asian American patient's head or
evaluating a head injury, you may need to clearly explain what you're doing and
why.
As nurses, always consider a patient's culturally defined sense of modesty
when giving nursing care. For example, some Jewish and Islamic women believe
that modesty requires covering their head, arms, and legs with clothing. Respect
their tradition and help them remain covered while in your care.
Various cultural groups have wide-ranging beliefs about man’s relationship
with the environment. A patient’s attitude toward his treatment and prognosis is
influenced by whether he generally believes that man has some control over events
or whether he is more fatalistic and believes that chance and luck determine what
will happen. If your patient holds the former view, you are likely to see good
cooperation with health care regiments; he will see the benefit of developing
behavior that could improve his health. Some American Indians and Asian
Americans are likely to fall into this category. In contrast, Hispanic and
RESEARCH CENTER
32
Appalachian patients tend to be more fatalistic about nature, health, and death,
feeling that they cannot control these things. Patients who believe that they cannot
do much to improve their health through their actions may need more teaching and
reinforcement about how diet and medications can affect their health. Provide
information in a nonjudgmental way and respect their fatalistic beliefs.
Environmental control refers to the ability of the person to control and to
plan and direct factors in the environment. It includes cultural health practices
efficacious neutral dysfunctional uncertain, values, and definition of health and
illness. Some groups perceive man as having mastery over nature; others perceive
humans to be dominated by nature, while others see harmonious relationships
between humans and nature (Giger and Davidhizar, 2002). This particular cultural
phenomenon plays an important role in the way patients respond to health-related
experiences, including the ways in which they define an illness and seek and use
health-care resources and social supports. For instance, Asians and Native
Americans may perceive that illness is a disharmony with other forces and that
medicine is only capable of relieving the symptoms rather that curing the disease.
Theses groups are likely to look for naturalistic solutions, such as herbs and hot and
cold treatments to resolve or cure a cancerous condition (Degazon, 1996).
In addition, environmental context also has significant influence upon the client’s
healthcare practices. Environmental context refers to the totality of an event,
RESEARCH CENTER
MANILA DOCTORS COLLEGE 33
situation, or particular experience that gives meaning to people’s expression,
interpretations, and social interactions, and technologic factors in specific settings
(Leininger, 2006). In relation, that statement holds significance for nurse’s
practitioners in primary care contexts. For instance, the setting of the office such as
are, literature, ambience or decor, client flow design or user friendliness, type or
content of magazines and teaching literature; languaging of forms, staff
composition or posture or language or tone, and means of meeting and greeting all
lend to the totality of the primary care experience of the client. The nurse’s
practitioner’s body language, listening skills, approach to assessment and sharing
of information, flexibility towards modifying professional practices advised, and
attention to privacy and confidentiality during the encounter contribute to the
particular experiences of the patient within the environmental context of the
primary care settings. These contributing factors in interactive totality influence
the client’s perspective of the nurse practitioner, the healthcare encounter, and
indeed, the healthcare system, and significantly affect the individual’s willingness
and ability to use the modalities of care mutually chosen as the plan of care
(McFarland and Eipperie, 2008).
According to Leininger, man is a social being within a culture. Needs are
holistic, and include needs for both care and cure. Health equates to caring and
harmony within culture. It is state of well-being that culturally defined. World
views, social structures, and cultural beliefs cannot be separated from the concepts
RESEARCH CENTER
34
of health, wellness and illness. The environment in which an individual participates
is key in maintaining optimal health. Moreover, Leininger’s broad view of the
environment includes technological, religious, philosophical, kinship, cultural,
political, legal, economical, and educational systems. The disharmony between
each area is causing further stress to optimum level of functioning.
According to Rasmussen (2009), the nurse must place patient in best
possible condition for healing to occur. The environment is all external conditions
and influences affecting the life and development of organisms and capable of
preventing, suppressing, or contributing to disease or death. Florence Nightingale
stated that the art of nursing is to provide an environment in which the patient is in
the best position for nature to act upon, and Martha Rogers, in turn, emphasized
that one part in nursing is to pattern the environment into a place where healing
conditions are optimal.
Caring is the essence of nursing. Nursing care that is not congruent with the
beliefs and values of a patient’s culture will lead to noncompliance and stress. The
healthcare professional therefore has to take into consideration all of the factors that
pertain to each domain. The overall goal is to maintain equilibrium between the
individual’s external stimuli as well as balancing the internal stimuli.
The review of related literature indicates the facts on how culture influences
nursing care. We nurses need to recognize, appreciate and respect cultural
RESEARCH CENTER
35
differences in healthcare values, beliefs, and customs. The study helps us
understand aspects of cultural differences and extent of transcultural nursing
practices that have been studied by different person who studied transcultural
nursing. Also it leads nurses to render appropriate care for certain individuals and
their beliefs for the client's maximum satisfaction. Leininger (1991) notes the main
goal of transcultural nursing is to discover and explain diverse and universal
culturally based care factors influencing the health, well-being, illness or death of
individuals as groups. But before transcultural nursing can be adequately
understood, there must be a basic knowledge of key terminology such as culture,
cultural values, culturally diverse nursing care, ethnocentrism, race, and
ethnography. To be able to attain these goals, we need to treat each client as a
unique individual with unique beliefs and traditions and this promotes nurse-client
interaction, which is the best way to find out his cultural preferences.
This study gives knowledge to the healthcare providers on how to react and
deal when confronted by a situation which deals with the client's cultural
preferences. This is important because some cultures have rigid codes of behavior
that need to be strictly followed whatever the reason may be.
It is said that the main goal of transcultural nursing “is to provide culturally
specific care.” The relevance of that statement reverberates more in our society
more than in any other period in the past. As the world increasingly becomes more
RESEARCH CENTER
36
globalized labor and services consequently become more and more flexible in
terms of location. Economically speaking, countries now ascribe to the “more for
less” maxim; they are now more open and more aggressive in terms of sourcing out
the cheapest labor and services, from any other country, just so long as they could
maintain a competitive advantage. This is very much apparent in the field of
nursing, since nurses can work anywhere and everywhere—their labor and service
is not location-bound. In the Philippines, most nursing graduates aim to land a job
in other countries for the promised higher wages; and the countries that hire them,
in turn, see nurses as better investments as compared to those who trained locally,
for they demand higher salaries. As nurses, it is the conscientious route to take into
account the cultural differences in the country that they work in. It is ideal to have
knowledge of what specific nursing approaches one should employ in a certain
situation, in a certain culture, for them to be able to deliver the most efficient and
effective healthcare possible, one that is in line with the culture that is in place. A
nurse who intends to pursue a job overseas should be aware of the ideas embedded
in the study of transcultural nursing, as this will help him or her acclimatize better
to the work environment of a new culture, and to better provide quality healthcare
services for patients. A good grasp of extent of transcultural nursing practice and
what transcultural nursing entails will go a long the way in terms of nurses being
more capable of providing better services, and in the long run, in fostering a more
comprehensive idea of how certain nursing approaches, applied to the right
RESEARCH CENTER
37
scenarios, can improve the atmosphere in the workplace and the overall satisfaction
with the work done.
Local Study
According to the study of Chit Estella, (2004), the national institute of
health warns that because of migrating nurse are usually the one with training
experiencing and skill, patient in hospital and other health institution in the
Philippines can expect a higher incidence of cross-infection. With the best among
nursing student often leaving as soon as they graduated, the less skilled are taking
the place of senior or relatively more experienced nurses who have also left for
other shores. In a year or two they too would be gone the void could be filled once
more by fresh graduates who would repeat the same cycle: get a few experienced in
a local hospital, apply for work abroad and then leave.
In the relevance to the study of Chit Estella, Soon student nurses will
become professional nurse and will be facing different people not only coming
from different provinces but from other country as well who have a different
culture from Filipino nurses. And for nurses to be globally competitive who has
plan of and planning to go back abroad to practice their profession.
The study of Gadut, Ma. Carmelita et.Al (2006), in every institution there
are values in providing nursing care for their patient, in pursuing the Course of
Bachelor of Science. There are factors that may posses for better understanding
RESEARCH CENTER
38
what nursing is all about, most student took nursing because of other countries
demand for competitive advantage, creative, caring, cultural adapted, competent
and committed nurses.
Foreign Study
According to Youqing Peng, et.al., in recent years, with the deepening of
China’s reform and opening as well as the increasing of international exchanges the
number of foreign patients in Pudong New District in Shanghai is growing
persistently. Nurses face more and more patients from different countries, nations,
with different languages, complexion and cultural background, whose transcultural
needs are obviously upgrading. Because of different social environment and
cultural background, foreign patients’ knowledge, beliefs, values, customs and
habits are also different, it is a tendency to understand comprehension of
transcultural and provide transcultural nursing .The purpose of this study is to
understand the transcultural nursing needs of the foreign patients in Pudong New
District to provide a basis for the implementation of transcultural nursing.
Under the conditions of modern society, transcultural nursing is the
inevitable trend of nursing development. It means that, according to different
patients’ world outlook, value. Religion belief, living habits, nurse should take
different nursing measures to satisfy health care demands with different cultural
background. Madeleine Leininger pointed out that the culture care needs of people
RESEARCH CENTER
39
in the world will be met by nurses prepared in transcultural nursing. She considered
that the culture care is the essence and the central idea of nursing, the motivity of
cultural activities and it is the basic on which nurses provide patients nursing in line
with their cultural background.
Researcher documented an investigation and analysis of transcultural
nursing needs of the foreign patients. It shows there is a lot needs of the nursing
service (the nurse’s English translating service, privacy protection and so on).
Researcher’s data suggest that health care providers and nursing managers should
be improved in the nurse’s spoken English, transcultural nursing theory. And the
training of transcultural nursing application capacity for nurses needs to be
strengthened. The implementation plans need to be formulated and carried out
including the policy of privacy protection and aspect of customs and taboos,
optimized nursing service flow, so as to improve the quality of transcultural nursing
service. The development of the above-mentioned scheme, regulations and process
needs patient's participation. During the implementation, nurses should
continuously listen to the foreign patients’ feedback, so as to make transcultural
nursing measures to satisfy patients’ needs and improve the service quality of
transcultural nursing.
According to Synder (2004), although most nurses are women, there is no
biological reason to assume that women are the only gender suited to the nursing
RESEARCH CENTER
40
profession. Rather, women are nurses because nursing has been socially
constructed and institutionalized as a feminine occupation. In fact, historically
nursing was a male-dominated occupation in many cultures. Nursing, which until
the late nineteenth century was a strictly male occupation, was opened up, albeit
reluctantly, to females largely as a result of Florence Nightingale and her work
during the Crimean War. Men let Florence do her thing, thus turning over to
women hospital dirty work to make it women’s work. Regarded at that time to be a
radical departure from the accepted norm, nursing as a feminine role has acquired
an historical weight. The role of the nurse has been accepted as being especially
congruent with the traditional role of the female in western culture (Etkowitz 1971:
432). Today, nursing is considered to be a nurturing and caring profession -
attributes associated more with women than men.
In relevance to the study of Synder (2004), the researcher wanted to prove
that there is no significant difference in extent of transcultural nursing practices in
Manila Doctors Hospital when grouped according to gender. In fact, historically
nursing is male dominated, in contrast to the population at Manila Doctors Hospital
that the dominated staff nurses are female.
Relevance to the Present Study
From the related literature gathered, the authors were able to derive
variables influencing extent of transcultural nursing practices in Manila Doctors
RESEARCH CENTER
41
Hospital such as communication, space and environmental control. The variables
mentioned will serve as a tool for measuring the extent of transcultural nursing
practices of these staff nurses. The related literature and studies are arranged in
such a way that given the subject matter, this will support author’s study based on
evidence collected from the related literature.
These variables will also serve as a comparison to the author’s study.
Therefore, there is a reason to conduct this study having cited literature as proof
that there is existence of problems related to extent of trancultural nursing
practices.
The studies can be closely related to the topic under investigation. Local
studies will be focused on the demographical data of the population being studied.
The facts gathered clarified the extent of transcultural nursing practices of staff
nurses regarding transcultural nursing. The said studies had an associate
significance with the current study since it gives support to the extent of
transcultural nursing practices.
Lastly, with the help of Madeleine Leininger’s Transcultural Nursing
Theory, the author can relate the extent of transcultural nursing practices in terms
of staff nurses communication, space and environmental control with their foreign
patients. Then, the extent of transcultural nursing practices determines individual’s
adaptation towards existing problems like proper handling of caring for a foreign
RESEARCH CENTER
42
patient. Through this the author can determine measure of significance of their
study.
RESEARCH CENTER
CHAPTER III
METHOD AND P ROCEDURE
This chapter discussed the methodologies and procedures used by the
researchers in answering the specific problems stated. It also tackled the research
design, the subject of the study, the instruments used in gathering the data, and the
statistical method used to check relevance of the data gathered.
Research Method/ Design
The research study is a non-experimental, quantitative, descriptive design. It
was aimed to determine the extent of transcultural nursing practices perform by
staff nurses in providing and giving care to foreign patients. The reasons for extent
of transcultural nursing practice has been described, analyzed, and summarized.
Research Locale
Staff nurses from private floors of Manila Doctors Hospital (MDH) are the
locale of study. Thirty (30) registered staff nurses from different private floors of
old and new building was the area of study. Entry in this hospital is possible
because Manila Doctors Hospital is the base hospital of Manila Doctors College.
Sample and Sampling Technique
A purposive sample technique utilized in this study based on the author’s
criteria. Registered staff nurses selected based on the following criteria: nurses
RESEARCH CENTER
44
should be a registered nurse, should have experienced handling foreign patients,
and at least 20 years of age. Thirty (30) registered staff nurses respondent of
Manila Doctors Hospital (MDH) were the target population, since it was the
permitted number of respondents given by the chief nurse. Thirty registered staff
nurses’ working in private wards of both old and new building of the hospital was
selected in different floors namely, 3rd up to 5th floor of the old building, and from
3rd up to 11th floor of the new building. Using a survey in a form of questionnaire
was distributed to thirty registered staff nurses covering all morning and afternoon
shift nurses on duty during the day.
Questionnaire was divided into three categories namely communication,
space, and environmental control. The sample questionnaire is included in our
appendix (appendix B).
Research Instrument
The author made use of survey questionnaire. The survey questionnaire
used a closed-ended question format, which was use to statistically measure the
extent of transcultural nursing practice in Manila Doctors Hospital (MDH). The
survey questionnaire is composed of two (2) parts, one, profile of respondents; and
second, survey proper with three (3) categories to cover. The profile part is
composed of name which is optional, age, gender, and number of patient handled
by a nurse. The first category of the second part is Communication which
RESEARCH CENTER
45
comprises of language spoken, voice quality, pronunciation, and use of nonverbal
communication. Followed by space which comprises of degree of confront
observed (conservation), proximity to others, body movement, and perception of
space. Lastly, environmental control which comprises of cultural health practices
efficacious neutral dysfunctional uncertain, values, and definition of health and
illness.
Questions from the survey are written in English since a registered nurse is
capable of comprehending different questions ask written in universal language.
Questions are answerable with adjectival ratings based on the degree of extent of
transcultural nursing practices corresponding to each questions of each category.
Adjectival rating is the following: fullest extent (FlE), full extent (FE), moderate
extent (ME), lesser extent (LE), and least extent (LtE).
Validation of the instrument
In preparation of the research questionnaire, the researchers submitted the
first draft to the thesis adviser and lecturer for comments and suggestions. The
researchers considered the comments and suggestions to improve the
questionnaires.
The final draft was prepared with the suggestions integrated. The final draft was
then under validation from experts of the chosen field of study.
RESEARCH CENTER
46
These experts are those who have a mastered degree in arts of nursing
(MAN), a registered nurse who became supervisor in other country, and a professor
who has a profound knowledge in transcultural nursing. Those experts have
examined whether each item of question falls in appropriate category. The
questions had modified incorporating the expert’s comments.
Test for Reliability of Instrument
The instrument had subject to a pilot study in a sample population (n-30) of
registered nurse in mentioned hospital use for the stability reliability analyses.
Results have been computed and interpret by the experts using a Crobach’s Alpha
which gave us a result of .958 with a total pilot population of 30 respondents. With
this result, it supported a high reliability test using the survey questionnaire
presented during pilot study. Respondent from the pilot study have the same
criteria of respondents involved in the actual giving of survey questionnaire. Same
questionnaire had been given to respondents in pilot study but they will not be
included in the respondents of proper implementation of the study to avoid
duplication of answer.
Data Gathering Procedure
A letter of request together with a copy of questionnaire has been sent to the
Nursing Service Office of Manila Doctors Hospital (MDH). Topic and objective of
the study are all stated in the letter. The Nursing Service of the said hospital gave
RESEARCH CENTER
47
an approval for research to conduct the study. A face-to-face contact between the
registered staff nurses and researchers was done in explaining the purpose of the
study and shown permit to head nurse of approved area to certain floors to conduct
survey questionnaire coming from their superior in Nursing Service. The
questionnaire have randomly distributed to those staff nurses on duty during
morning and afternoon shift that pass the criteria set by the author to all private
floors of the hospital. Each respondent asked to self administer the questionnaire.
Nurses answered the questionnaire by themselves. The author gathered and
collected the data after 24 hours or less. The data immediately collated and entered
into statistical software for analysis.
Statistical Treatment of Data
This study has determined the extent of transcultural nursing practices in
Manila Doctors Hospital (MDH) in which it had been resolute by the survey
questionnaire.
In seeking answers to the specific problems, the author used the following
statistical tools with the use of Statistical Package for Social Science (SPSS)
software which validated the findings of the study:
RESEARCH CENTER
48
Frequency and Percentage is the statistical treatment applied to answer the
statement of the problem number one (1) which is about the general profile in terms
of age, gender, and number of foreign patients handled by nurses at Manila Doctors
n x 100
Hospital (MDH). P = was the formula used to answer the
N
statement problem number one where in P represents the percentage, n represents
the number of responses falling under a particular category and lastly, N
corresponds to the total number of respondents. On the other hand, to answer the
problem statement number two (2) which is the extent of transcultural nursing
practices of respondents in terms of communication, space and environmental
control weighted mean is applied. The author used this statistical treatment to
present the answers of the respondent based on the questionnaire. Simple
tabulation is easy to interpret by the readers, and it is simple to crack down codes.
The weighted mean of the response was computed using the formula
X = Efx/N.
Wherein X corresponds to arithmetic mean, f represents the frequency and
N is the total respondents.
The result of respondent’s answer to the questionnaire has been analyzed
based on the adjectival rating which is fullest extent (FlE), full extent (FE),
moderate extent (ME), lesser extent (LE), and least extent (LtE). Each adjectival
RESEARCH CENTER
49
rating has corresponding mean score, range, and interpretation which are presented
on the next page.
Table A
5 Point Likert Scale
Scale Range Interpretation Adjectival

Rating
5 5 and above Always Fullest Extent
(FlE)
4 4.0 to 4.99 Often Full Extent (FE)
3 3.0 to 3.99 Sometimes Moderate Extent

(ME)
2 2.0 to 2.99 Rarely Lesser Extent
(LE)
1 1.0 and below Never Least Extent
(LtE)
However t-test is the statistical tool employed to answer the statement of the
problem number three (3) which was to compare the significant differences in the
extent of transcultural nursing practices when they are grouped according to profile
such as age, gender, and number of foreign patients handled. The formula was
presented below wherein X1= the Mean of sample, X2= Mean of the 2nd sample,
S1= Standard deviation of the 1st sample, S2 = Standard deviation of the 2nd sample,
N1 = Number of items in the 1st sample, and N2 = Number of items in the 2nd
sample; was used to answer statement number three (3).
t=
RESEARCH CENTER
50
Further more, analysis of variance or ANOVA which refers to a comparison
test determined the difference of two or more groups. This study, ANOVA was
used to determine the significant difference in extent of transcultural nursing
practices when respondents are grouped according to number of patients handled
based on communication, space, and environmental control. The equation for
F = MSb
ANOVA test is MSw
where F is the Fisher’s ratio; MS b is mean of squared
variation between groups; and MSw is square variation within group.
The decision criteria of the study were based on the 0.05 level of
significant. If the result of the study is close or lesser than 0.05 level of significant
the study can be rejected. While if the result is greater than 0.05 level of significant,
the study can be accepted by the author.
RESEARCH CENTER
CHAPTER IV
PRESENTATION, ANALYSIS, INTERPRETATION OF DATA
This chapter answers the query in the statement of the problem by
classifying and tabulating the data gathered and analyzing the results. The findings
of the study was presented figuratively in manner of numerical values and rated
adjectively as well.
1. Profile of the Respondents
1.1 Age
Table 1 shows the frequency distribution and percentage distribution of
staff nurses in Manila Doctors Hospital (MDH) in matters of age. This table was
the initial profiling of the respondents. This table merely represents the age
background of the respondents simplified into two which are the 20-29 and the 30-
39.
Table 1
Frequency and Percentage Distribution of Staff Nurses According to Age
Age Frequency (f) Percentage (%)
21-29 25 83
30-39 5 17
Total 30 100
RESEARCH CENTER
52
Table 1 shows that based on the thirty (30) total number of respondents,
there were five (5) respondents who belongs to age of 30-39 years old while there
were twenty-five (25) respondents belongs to 21-29 years old.
Table 1 shows the profile of the respondents based on age. Majority (83%)
of the respondents belongs to the nurses with the age of 21-29 years of age, while
minority (17%) of the respondents belongs to the 30-39 years of age.
Based on findings from the 2004 National Sample Survey of Registered
(NSSR) nurses (RN) in U.S. Department of Health and Human Services
particularly Health Resources and Service Administration (HRSA), the average age
of the RN continuous to climb, increasing to years of age in 2004, compared to
45.2 years in 2000, and 44.3 years in 1996. In relation to the result of the study, the
average age of nurses in Manila Doctors Hospital (MDH) was not under the age of
44.4 rather, it belongs to the younger age which is 21-29 years old. According to
the study, only nine percent (9%) of all registered nurses were under the age of 30
in 2000, while, the percent of nurses over fifty-four (54) years of age increased to
25.4 percent in 2004 which if it is going to compare with the result of nurse
respondent according to profile of age nurses from Manila Doctors hospital were
younger. Only seventeen percent (17%) from the 30 nurse respondents represent
the age of 30-39 years old who is working as staff nurses in the said
RESEARCH CENTER
53
hospital.Therefore, majority of staff nurses in Manila Doctors Hospital are age 21-
29 years old
1.2 Gender
Table 2 shows the frequency distribution and percentage distribution of staff
nurses in Manila Doctors Hospital (MDH) in terms of gender. This was the second
profiling of the respondents.
Table 2
Frequency and Percentage Distribution of Staff Nurses According to Gender
Gender Frequency Percentage

Male 12 40
Female 18 60
Total 30 100
Table 2 shows that out of thirty (30) respondents there were eighteen (18)
female respondents, while there were twelve (12) male respondents.
Table 2 shows the profile of the respondents based on gender. Majority
(60%) of the respondents belong to the female group, while minority (40%) of the
respondents belongs to male group.
Same with the study done by Health Resources and Services Administration
(HRSA), male still comprise a very small percentage of total number of registered
nurses working in their hospital, although according to HRSA number of male
registered nurse is continuously growing.
RESEARCH CENTER
Therefore, majority of staff nurses in Manila Doctors Hospital are female.
1.3 Number of Patients Handled
Table 3 shows the frequency distribution and percentage distribution of
staff nurses in Manila Doctors Hospital (MDH) in terms of number of foreign
patients handled. This was the third profiling of the respondents.
Table 3
Frequency and Percentage Distribution of Staff Nurses According to Number
of Foreign Patients Handled
Number of
Frequency Percentage
patient
1-2 11 37
3-4 10 33
5 and above 9 30
Total 30 100
Table 3 shows that out of thirty (30) respondents there were nine (9)
respondents who handled 5 and above foreign patients; ten (10) respondents who
have handled 3-4 foreign patients, and eleven (11) respondents who have handled
1-2 foreign patients.
Table 3 shows the profile of the respondents based on number of patients
handled. Majority (37%) of the respondents handled 1-2 foreign patients, while
minority (30%) of the respondents belongs to 5 and above handled foreign patients.
Based on Leininger’s Transcultural theory, number of patients is not
important in handling foreign patients. Nurses develop their skills in handling
patients with different cultures or even foreign patients as nurses each day deals
RESEARCH CENTER
and faces different patients. They are equipped and well-versed on proper handling
in caring of patients different to their cultures. With the nature of work of nurses
which they are the one who is with the patient most of the time, they are used to
with dealing and facing different patients while their wok as nurses in providing
and giving optimum care is not at risk but instead, they can still do their job
regardless of number of foreign patients they have handled. Their experiences in
handling local patients which are different with their culture help them to manage
and provide a care that deserves and rightfully should be given to both local and
foreign patients.
2. The Extent of Transcultural Nursing Practices:
2.1 Communication
Table 4 shows the Extent of Transcultural Nursing Practices in terms of
Communication wherein the following 10 items of queries implemented in the
instrument.
RESEARCH CENTER
Table 4
Extent of Transcultural Nursing Practices in Manila Doctors Hospital Based
on Communication
Interpretatio Adjectival
Communication Mean
n Description
1. I greet my foreign patient and his/her family 4.59 Often FE
before doing any procedure.
2. I establish rapport to my foreign patient 4.50 Often FE
3. If my foreign patient could not speak nor 4.60 Often FE
understand English I performed simple action
while verbalizing the instructions.
4. I speak softly and clearly when talking to 4.73 Often FE
my foreign patient.
5. I speak softly and clearly when talking to 4.67 Often FE
my foreign patient.
6. I perform simple action like sign languages 4.27 Often FE
or pantomime whenever my foreign patient
could not understand my instructions.
7. I use simple words rather than complicated 4.57 Often FE
words when talking to my foreign patient.
8. I courteously listen to concerns of my 4.53 Often FE
foreign patient.
9. I courteously listen to concerns of my 4.53 Often FE
foreign patient.
10. I use terminating words upon leaving the 4.13 Often FE
room of my foreign patient.
Composite Mean 4.51 Often FE
Legend: 5 and above Fullest Extent (FlE); 4.0-4.99 Full Extent (FE); 3.0-3.99 Moderate Extent (ME); 2.0-2.99 Lesser Extent
(LE); 1.0 and below Least Extent (LtE)
Table 4 shows that question number ten has a mean of almost four and
quarter (4.13) followed by question number six with a mean above four and
quarter (4.27), question number two with four and half (4.50), same mean of more
than four and half (4.53) in questions number eight and nine, question number five
with 4.57, question number one with 4.59, question number three with 4.60,
question number 5 with 4.67, and last but not the least, question number four with
4.73; with the overall mean of 4.51in which all have the values above four and half.
RESEARCH CENTER
In their rating and interpretation, all questions were in category of full extent and
often respectively including the overall mean or composite mean.
Table 4 shows out of 10 questions in communication 10th question got the
lowest mean of less than four and quarters (4.13) on the contrary, 4th question got
the highest mean of higher than four and half (4.73) with the overall mean of four
and half (4.51).
The above data shows that the staff nurses at Manila Doctors Hospital
always speak softly and clearly to their foreign patients in relation according to
Commission on Accreditation of Healthcare Organization (JCAHO), it is necessary
for the nurses to speak in a low, moderate and avoid talking loudly because there is
tendency to raise the volume and pitch of their voice when a listener appears not to
understand in result patient may think that nurse is angry and shouting. According
to Davidhizar and Giger (1994), verbal and nonverbal patterns in communication
vary across cultures, and if nurses do not understand the patients cultural rules in
communication, the patient’s acceptance of treatment regimen may be jeopardize.
This occurs not just from speaking the same languages, but also through body
language and other cues, such as voice tone, and loudness. In contrary question
number 10 got the lowest mean which states that most of the staff nurses at Manila
Doctors Hospital do not use terminating words upon leaving the room of their
patient.
RESEARCH CENTER
Therefore majority of staff nurses practice transcultural nursing practice
according to communication in the fullest extent.
2.2 Space
Space wherein the following 10 items of queries implemented in the instrument.
Table 5
on Space
Adjectival
Space Mean Interpretation
Description
1. I recognize cultural difference of my foreign patients 4.17 Often FE
before providing care.
2. I talk to my foreign patient with a distance of three (3) 4.10 Often FE
feet away from patient’s bed.
3. I make sure that my foreign patient is relaxed when I 4.40 Often FE
am attending to his or her need.
4. As a nurse, I am aware that touching my foreign 4.40 Often FE
patient without permission is an indicator and can causes
an embarrassment or anger to him or her.
5. I avoid too much body movement when my facing 4.17 Often FE
foreign patients.
6. I avoid too much body movement when my facing 4.47 Often FE
foreign patients.
7. I maximize time and effort when I give care to my 4.60 Often FE
foreign patient.
8. I respect the time according to my foreign patient’s 4.37 Often FE
cultural practices if he or she has preferred time of
receiving care like in providing hygiene care.
9. I secure my foreign patient’s comfort when he or she 4.67 Often FE
is isolated.
10. I rarely touch my foreign patients as an indicator of 4.30 Often FE
respect to him or her.
Legend: 5 and above Fullest Extent (FlE); 4.0-4.99 Full Extent (FE); 3.0-3.99 Moderate Extent (ME); 2.0-2.99
Lesser Extent (LE); 1.0 and below Least Extent (LtE)
RESEARCH CENTER
In this table, question number two with a mean of above four (4.10)
followed by questions number one and five with a common mean of almost four
and quarters (4.17), questions number four and ten have a again the same mean of
more than four and quarters (4.30), question number eight with a mean also more
than four and quarters (4.37), questions number three and four with the same mean
of almosr four and half 4.40 as well, question number seven with a mean of more
than four and half 4.60, question number six and number nine with a mean almost
four and half respectively, (4.47 and 4.67) with an overall mean of greater than
four and quarters (4.36). All of queries in this category with its adjectival rating
and interpretation including the composite mean have the same result of full extent
and often, respectively.
In table 5 out of 10 questions in space category, 2nd question got the lowest
mean of lower than four and quarters (4.10) while 9th question got the highest
mean of more than four and half (4.67) with the overall mean of more than four
and quarters (4.36).
Data shows that the staff nurses at Manila Doctors Hospital practice the
extent of transcultural nursing according to spaces. However out of 10 questions,
the second question got the lowest mean, in relation according to the study of
Davidhizar and Giger (2002), most people aren’t conscious of their personal space
requirements-it’s just a feeling about what is comfortable for them and maybe
RESEARCH CENTER
unaware of what people from other culture expected. When comfortable with
others, these individuals prefer to be in close proximity to build trusting
relationship. In connection, according to Spector (2000), there are four distinct
zone of interpersonal space namely inmate zone, personal distance, social distance
and public distance. In relation, rules concerning personal distance vary from
culture to culture. The extreme modesty practiced by members of some cultural
groups may prevent members from seeking preventive care. This implicates nurses
in Manila Doctor’s Hospital observe proper decorum upon maintaining space
appropriateness towards foreign patients.
according to space in the fullest extent.
2.3 Environmental Control
Environmental Control wherein the following 10 items of queries implemented in
the instrument.
RESEARCH CENTER
Table 6
on Environmental Control
Adjectival
Environmental Control Mean Interpretation
Rating
1. I orient my foreign patient regarding the time, date 4.47 Often FE
even though he / she is unconscious.
2. I give needs of my foreign patient based on their 4.40 Often FE
preference pattern according to his or her culture.
3. I make sure that my foreign patient’s environment is 4.67 Often FE
contributing to his fast recovery by maintaining his room
clean and in order.
4. I make sure that my foreign patient feels comfortable 4.67 Often FE
with his or her room.
5. I assist my foreign patient and his family in all 4.70 Often FE
procedure needed to be done.
6. I explain the illness or health condition of my foreign 4.57 Often FE
patients to him or her as well as to his or her family
members.
7. I explain to my foreign patient the doctor’s order in 4.40 Often FE
order for him or her to have self control.
8. I ensure my foreign patient to maintain a quiet and 4.70 Often FE
peaceful environment.
9. I explain to my foreign patient’s and visitors regarding 4.60 Often FE
visiting hours.
10. I maintain room temperature appropriate for my 4.40 Often FE
foreign patient’s health condition.
Table 6 shows that question number two, seven and ten has the same mean
of almost four and half (4.40) followed by question number one with a mean of
approximately nearly four anf half (4.47), question number six greater than four
and half (4.57), question number nine greater than four and half (4.60), questions
number three and four also with the same mean of greater than four and half 4.67,
and last but not the least, questions number five and eight with the same mean of
approximately five (4.70). The overall mean of table seven is slightly above four
RESEARCH CENTER
62
and half 4.56. The result of adjectival rating and interpretation in this category
were all the same including the composite mean such as full extent and often,
respectively.
Out of all the questions in environmental control, question number two;
seven and ten got the lowest mean of nearly four and half while question number
eight got the highest mean of greater than four and half respectively, (4.40 and
4.70).
According to Rasmussen (2009), the nurse must place patient in best
possible condition for healing to occur. The environment is all external conditions
and influences affecting the life and development of organisms and capable of
preventing, suppressing, or contributing to disease or death. Florence Nightingale
stated that the art of nursing is to provide an environment in which the patient is in
the best position for nature to act upon, and Martha Rogers, in turn, emphasized
that one part in nursing is to pattern the environment into a place where healing
conditions are optimal. Thus, nurses in Manila Doctor’s Hospital provide amicable
environment for recovery to foreign patients.
according to environment in the fullest extent.
RESEARCH CENTER
Table 7
Summary of Categories
Adjectival
Practices Mean Interpretation
Rating
Communication 4.51 Often FE
Space 4.36 Often FE

Environmental 4.56 Often FE
Control
Overall 4.48 Often FE
Table seven (7) shows that space has a mean of above four and quarters
(4.36), followed by communication with a mean of four and half (4.51), and
environmental control with a mean of above four and half (4.56). The overall
mean was almost four and half (4.48). Based on the result of mean in terms of
communication, space, and environment they have an adjectival rating of full
extent with corresponding interpretation of often.
Table seven (7) shows the extent of transcultural nursing practice based on
communication, space, and environment. Environmenal controlt has the greatest
mean with above four and half (4.56) compared to other practices, followed by
communication with four and half (4.51), and lastly, space with above four and
quarters (4.36).
In Leininger’s theory of Sunrise model, nurses should practice all the
factors under the umbrella of her theory in order to provide a competent care.
RESEARCH CENTER
Based on the result of extent of transcultural nursing practices environment got the
highest mean though space and communication have the same adjectival rating, full
extent, still can be observe that nurses in MDH practicing more on environmental
factor. Communication, space and environment should at least have the same mean
in order to prove that Leininger’s Sunrise model in terms of communication, space,
and environment were all practice adequately by staff nurses in MDH.
3. Significant difference in the Extent of Transcultural Nursing Pratice when
grouped according to their profile:
3.1 Age
Table eight (8) shows the significant difference Extent of Transcultural
Nursing Practices when grouped according to age.
Table 8
Difference in the Extent of Transcultural Nursing Practices Grouped
According to Age
Std. t- Decision
Category Age Mean Sig. Interpretation
Deviation value on HO
20-29 4.51 0.42
Communication -0.02 0.99 Accepted Not Significant
30-39 4.52 0.52
20-29 4.35 0.57
Space -0.32 0.75 Accepted Not Significant
30-39 4.44 0.69
Environmental 20-29 4.60 0.41
1.13 0.27 Accepted Not Significant
Control 30-39 4.36 0.54
20-29 4.49 0.42
Overall 30-39 4.44 0.57 0.21 0.83 Accepted Not Significant
(α) Level of Significance = 0.05
RESEARCH CENTER
Table eight (8) shows that communication in age 20-29 has a mean of four
and half (4.51); and one point increased of mean with age 30-39 years old. On the
other hand, space with age 20-29 years old has a mean of four and quarters (4.35)
and close to four and half (4.44) under 30-39 years old. In environmental control
with a mean of above four and half (4.60) under 20-29 years old and above four
and quarters (4.36) in 30-39 years old. In overall those who belong to age 21-29
years old has a mean of approximately four and half (4.49) with adjectival rating
of full extent, while, those who belong to 30-39 years old has a mean of closer to
four and half (4.44) with adjectival rating same with 21-29 years of age.
Table eight (8) shows that the difference extent of transcultural nursing
practices based on age in over-all mean age 20-29 years old has a higher mean of
almost four and half (4.49) while those who belong to 30-39 years old with a mean
of closer to four and half (4.44). In terms of standard deviation, 30-39 years old
has a higher value of almost one (0.57) while 20-29 has a lower standard deviation
of closer to half of one (0.42). In t-value environmental control in terms of age has
a higer value of greater than one (1.13) while space in terms of age has a lower t-
value with less than one (-0.32). In level of significance, communication has a
highest value with approximately one (0.99) while environmental control in terms
of age has the lowest value with less than one (0.27). The overllall t-value lessens
than one (0.21) with the corresponding significant value of closer to one (0.83) is
not significant at 0.05 level of significance.
RESEARCH CENTER
Based on the result of the study, it shows that age does not affect the
transcultural nursing practices of staff nurses in Manila Doctors Hospital (MDH) in
terms of communication, space, and environment. Both ages belongs to 21-29 and
30-39 years old practice the three factors (communication, space, and environment)
covered in this study adequately. Difference in age does not affect their
performance in giving care to foreign patients using communication, space, and
environment.
3.2 Gender
Table nine (9) shows the significant difference Extent of Transcultural
Nursing Practices when grouped according to age.
Table 9
According to Gender
Std. Decision on
Extents Gender Mean t-value Sig. Interpretation
Deviation HO
Communicatio Male 4.49 0.46
-0.21 0.83 Accepted Not Significant
n Female 4.52 0.42
Male 4.31 0.71
Space -0. 42 0.68 Accepted Not Significant
Female 4.40 0.49
Environmental Male 4.52 0.47
-0.41 0.69 Accepted Not Significant
Control Female 4.58 0.41
Male 4.44 0.52 Not
Oveall -0.39 0.70 Accepted
Female 4.50 0.40 Significant
(α) Level of significance = 0.05
In table nine (9) shows that communication in terms of gender in female has
a mean of four and half (4.52); and almost four and half (4.49) in male. On the
other hand, space in male has a mean of four and quarters (4.31) and close to four
RESEARCH CENTER
67
and half (4.40) under female. In environmental control, both male and female with
a mean of above four and half (4.52 and 4.58), respectively. In overall those who
belong to male a mean of approximately close to four and half (4.44) with
adjectival rating of full extent, while, those who belong to female has a mean of
four and half (4.50) with adjectival rating same male.
Table nine (9) shows that difference in extent of transcultural nursing
practices based on gender in over-all mean, female has a higher mean of four and
half (4.50) while those who belong to male with a mean of closer to four and half
(4.44). In terms of standard deviation, male has a higher value of closer to one
(0.52) while female has a lower standard deviation of lower than half of one (0.40).
In t-value communicationl in terms of gender has a higer value of closer to one (-
0.41) while environmental control in terms of gender has a lower t-value with less
than half of one (-0.21). In level of significance, communication has a highest
value with approximately closer to one (0.83) while space in terms of gender has
the lowest value with less than one (0.68). The overllall t-value lessens than one (-
0.39) with the corresponding significant value of closer to one (0.70) is not
significant at 0.05 level of significance.
In Leininger’s transcultural theory, gender is not an issue in giving
competent care. According to Leininger, both male and female should enjoy equal
rights in giving competent care with patients especially with foreign patients except
if it is contraindicated with their culture like for instance, United Arab of Emirates
RESEARCH CENTER
wherein male nurse can only take care of male patients which same rule applies
with female nurses. But if male or female nurses are needed by the patients
whether it is male or female, male or female nurse should attend to their needs.
The rule in giving care is they should ask permission to the patient and as much as
possible avoid closed distance, approximately should be at least 3 feet away from
the patients if it is opposite to the nurses gender, in giving competent care. Males
and females should have been treated with equal respect, rights, and role
opportunities in work place or anywhere. In addition, Leininger also mentioned
that discrimination of task between male and female nurses should be avoided. In
relation to the study, both female and male nurses in Manila Doctors Hospital can
practice transcultural nursing in giving competent care in terms of communication,
space, and environment. Gender does not affect the extent of transcultural nursing
practices. Although based on the result of the study, male nurses have the small
population compared to female nurses in Manila Doctors Hospital (MDH) still they
can practice and perform transcultural nursing practices. Discrimination of doing a
task is not an issue for argumentation as it does not have a significant relationship
with transcultural nursing practices in terms of communication, space, and
environment.
3.3 Number of Foreign Patients Handled
Table ten (10) shows the significant difference Extent of Transcultural
Nursing Practices when grouped according to number of foreign patients handled.
RESEARCH CENTER
69
Table 10
According to Number of Foreign Patient Handled
No. of Std.
F- Decision
Category Patients Mean Deviatio Sig. Interpretation
Value on HO
Handled n
1-2 4.33 0.45
3-4 4.50 0.36
Communication 2.78 0.80 Accepted Not Significant
5 and 4.76 0.39
above
1-2 4.21 0.60
3-4 4.40 0.58
Space 0.69 0.51 Accepted Not Significant
5 and 4.51 0.56
above
1-2 4.45 0.50
Environmental 3-4 4.50 0.35
1.47 0.25 Accepted Not Significant
Control 5 and 4.76 0.39
above
1-2 4.33 0.49
3-4 4.47 0.38
Overall 1.60 0.22 Accepted Not Significant
5 and 4.68 0.41
above
Table 10 shows ANOVA test Extent of Transcultural Nursing Practices
when they are grouped according to Number of Foreign Patients Handled. in
Communication in terms of number of foreign patients handled, 1-2 pateints with a
mean of four and quarters (4.33), 3-4 with four and half (4.50) and 5 and above
with greater than four and half (4.76). While in terms of standard deviation,
communication under 1-2 is closer to haf of one (0.45), 3-4 closer to half of one
(o.36), and 5 and above with more closer (0.39) compared to 3-4 number of foreign
patients handled. In space, 1-2 has a standard deviation of closer to one (0.60), 3-4
with more than half of one (0.58), and 5 and above with less closer to one (0.56).
In environmental control, 1-2 has a standard deviation of half of one (0.50), 3-4
with less than half of one (0.35), and 5 and above with much higher value (0.39)
RESEARCH CENTER
70
compared to 3-4 number of foreign patients handled. The overall standard
deviation is approximately half of one (0.49) in 1-2 number of foreign patients
handled, four and quarters (0.38) in 2-3, and closer to half of one (0.41) in 5 and
above number of foreign patients handled. In F-value, communication is closer to
three (2.78), while space is almost one (0.69), and lastly, environmental control
almost one and half (1.47) with an overall F-value of one and more than half
(1.60). Lastly, the significant value of communication is almost one (0.80), space
with half of one (0.51), environmental control with quarter of one (0.25), and with
an overall value of less than quarter (0.22).
In table 10, communication in handling patients of 5 and above has the highest
mean of approximately five (4.75), while 1-2 foreign patients handled has the
lowest mean of above four and quarters (4.33). In space, still 5 and above foreign
patients handled has the highest mean of four and half (4.51) while the lowest is 1-
2 number of foreign patients handled with less than four and quarters (4.21). In
environmwntal control, 5 and above number of foreign patients handled holds the
highest number of mean with greater than four and half (4.76) while 1-2 foreign
patients is the lowest with a mean of almost four and half. On the other hand, 1-2
number of foreign patients handled is the highest interms of standard deviation in
communication with a value of closer to half of one (0.45), while 3-4 is the lowest
with a value of less than half of one (0.36). In space, 3-4 number of foreign
patients handled is the highest with value of greater than half of one (0.60), while
RESEARCH CENTER
71
5 and above got the lowest with a value of slightly above half of one (0.56). In
environmental control, 5 and above number of foreign patients handled got the
highest value of standars deviation with half of one (0.50), while 3-4 got the lowest
with greater than quarters of one (0.35). In terms of F-value, environmental
control got the highest value of almost one and half (1.47), while space got the
lowest with less than one (0.69). In level of significance, communication has a
highest value with approximately closer to one (0.80) while environmental control
in terms of number of foreign patients handled has the lowest value with less than
half of one (0.25). The overllall F-value greater than one and half (1.60) with the
corresponding significant value of closer to quarters of one (0.25) is not significant
at 0.05 level of significance.
Based on the result of the study, though there is no significant difference in
number of foreign patients handled. Number of foreign patients handled does not
affect the extent of transcultural nursing practices of staff nurses in Manila Doctors
Hospital (MDH). But in terms of their mean, patients who handled 5 and above has
the highest mean which means that those nurse respondents who belongs to that
group more or less practice transcultural nursing practices more or much aware of
different transcultural nursing practices needed to apply in handling foreign
patients. But it does not mean that foreign patients handled in group 1-2 and 3-4
does not practice transcultural nursing practices. Those who belong to 1-2 and 3-4
number of foreign patients also practice transcultural nursing practices but the
RESEARCH CENTER
degree of giving care was affected as they answer the questionnaire because they
might not practice some items in the survey questionnaire adequately for their own
reasons. It might be that they did not perform the task yet or often do not perform
the task that is why they answer a lower degree of extent in giving transcultural
nursing practices in terms of communication, space, and environment
Regardless of number foreign patients handled, it does not affect the extent
of transcultural nursing practices in terms of communication, space, and
environment. All of the group according number of foreign patients handle can
give adequate and competent care to foreign patients. It does not affect in fulfilling
their task as a staff nurse in Manila Doctors College (MDH).
According to Leininger, as a nurse discover the client’s particular cultural
belief and values, they learn way to provide sensitive, compassionate, and
competent care that is beneficial and satisfying to the foreign patient. At the same
time the nurse discovers many nursing insights about her own cultural background
and how to use knowledge appropriately with clients in hospital.
Therefore the there is no significant difference in the extent of transcultural
nursing at Manila Doctors Hospital.
RESEARCH CENTER
CHAPTER V
SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS
This chapter presents the summary of findings, the conclusions and the
recommendations that evolved as a result of the study that was conducted to the staff
nurses at the Manila Doctors Hospital.
This research was conducted to determine the difference in the extent of
transcultural nursing practices of Manila Doctors Hospital when grouped according
to the profile such as age, gender, and number of foreign patients handled. It
presents the summary of findings, conclusion and recommendations related to the
extent of transcultural nursing care practice rendered by the staff nurses in Manila
Doctors Hospital (MDH).
This study aims to answer the following question:
1. What is the profile of the respondents in terms of:
1.1 Age,
1.2 Gender,
1.3 Number of foreign patients handled,?
2. What is the extent of transcultural nursing practices of respondents in
terms of:
RESEARCH CENTER
2.1. Communication,
2.2. Space,
2.3. Environmental Control,?
3. Is there a significant difference in the extent of transcultural nursing
practices of Manila Doctors Hospital when grouped according to the profile?
Summary of Findings
1. Frequency Distribution and Percentage of Respondents according
to:
1.1 Age
Majority of the 30 nurses’ respondents (83%) of the respondents from
Manila Doctors Hospital belongs to 21-29 years old age groups; while the 17%
belongs to 30-39 years old age group.
1.2 Gender
Majority of the 30 nurses respondents (60%) from Manila Doctors Hospital
are females while the remaining 40% are male.
1.3 Number of Patients handled
Majority of the 30 respondents have handled 1-2 foreign patients with
thirty-seven percent (37%) from Manila Doctors Hospital, while thirty-three
RESEARCH CENTER
percent (33%) have handled 3-4 foreign patients, ad lastly, thirty percent (30%)
have handled 5 and above foreign patients.
2. Extent of Transcultural Nursing Practice of Respondents in terms
of
2.1 Communication
In communication, the composite mean value is 4.51. In their adjectival
description and interpretation, all questions were in categorized to full extent and
often, including the composite mean.
2.2 Space
In space, the composite mean value is 4.36. Their adjectival descriptions
and interpretation including the composite mean have the same result of full extent
and often, respectively.
2.3 Environment
In environment, the composite mean value is 4.56. The result of adjectival
rating and interpretation in this category were all the same including the composite
mean such as full extent and often, respectively.
3. Difference in the Extent of Transcultural Nursing practices of
Manila Doctors Hospital when grouped according to their profile
RESEARCH CENTER
76
3.1 Age
The T-test value of 0.213 and the significance of 0.833, accepted the null
hypothesis that there is no significant difference in the extent of transculural
nursing practices when group according to age because the p-value is greater than
0.05 level if significance.
3.2 Gender
The T-test value of 0.386 with the corresponding p-value of 0.702, accepted
the null hypothesis, since the value is greater than 0.05 level of significance,
therefore, there is no significant difference in extent of transcultural nursing
practices in Manila Doctors Hospital when grouped according to gender.
3.3 Number of Foreign Patients Handled
The F-value of 1.600 with the corresponding p-value of 0.221, accepted the
null hypothesis, since the value is greater than 0.05 level of significance, therefore,
there is no significant difference in the extent of transcultural nursing practices I
Manila Doctors Hospital when grouped according to number of foreign patients
handled.
CONCLUSIONS
Generally, Manila Doctors Hospital nurses practices transcultural nursing to
the fullest extent.
Specifically, the following are the
RESEARCH CENTER
1. Most of the respondents from manila Doctors Hospital are female, age
21-29 years old and have handled 1-2 foreign patients.
2. Transcultural nursing practice of respondents in terms of
communication, space, and environment is in full extent.
3. Male or female, in any age group and number of foreign patients
handled, the Trancultural Nursing Practices in Manila Doctors Hospital
is in full extent.
RECOMMENDATIONS
Based on the findings and the conclusions drawn from the findings, the
researchers offer the following recommendations:
1. Staff nurses of Manila Doctors College should continue to develop the
caring attitudes and provide the best quality nursing care as possible to their
patient in spite of culture indifferences. Nurses should explore and read
about different cultures in other country as their additional information and
since the hospital have a greater probability of handling foreign patients.
2. The Nursing Service can provide their own study regarding transcultural
nursing practices that studies other factors like considering the religion,
economic factors, technological factors and others under transcultural
nursing practices for them to know how far and competent their nurses are
in handling foreign patients
RESEARCH CENTER
79
3. Nursing Service can also provide seminars, trainings, symposium, and
exhibit regarding different culture of other countries that they may
encounter.
4. To the future researcher, they can test other factors under the umbrella of
transcultural nursing theory of Leininger particularly the Sunrise model like
economic status, religion and other factors. Since communication, space,
and environment is no significant in this study may be other factors will be
significance. It is also recommended to use a bigger number of respondents
or if possible the total population of nurses in Manila Doctors Hospital to
check the significance of each factor under transcultural nursing practices.
It is also helpful to know the degree of improvement in order to provide a
more competent care not only to local but also to foreign patients. They can
also conduct the same study yearly in order to closely monitor the
knowledge and skills of nurses in said hospital in dealing with both local
and foreign patients.
RESEARCH CENTER
79
REFERENCES
Books
Andrew, M. and Boyle, J. (2007). Transcultural Concept via Nursing Care, 5th
edition.
Erbs and Kozier. Fundamentals of Nursing. vol. 1,
Giger, J. and Davidhizar, R. (1994). Transcultural Nursing: Assessment and

Intervention,
Giger, J. and Davidhizar, R. (1994). Transcultural Nursing: Assessment and

Intervention, 2nd edition.
Lauderdale, Jana. (2005). Transcultural Nursing society, Madomme University
Leininger, M. and Mcfarland. 2006. Theory of Culture Care Diversity and

Universally: a world Wide Nursing Theory.
Leininger, M. and MCfarland. (1978, 1995, 2002).

Transcultural Nursing: Concept, Theories, Research and Practices.
Leukman and Munoz. (2005). Transcultural Communication in Nursing.
Lippincott, W. and Wilkins, Bruner and Sudhart. (2008). Medical Surgical

Nursing, vol. 1, 11th edition
Mcfarland, M. Eippeertte, M. (2008). Contemporary Nurse.
Nieswadomy, R. Fundamentals Nursing Research”, 5th edition, Person

Education, Inc. Publishing as Prentice Hall.
Papadopoulos, I. (2006).Transcultural Health and social Care, Development of

culturally competent practitioner, church Hill Living stone.
Purnell, L. and Paulanka, B. (2002). Transcultural Health Care: A Culturally

Competent Approach.
Quimbao-Udan, J. (2004).Fundamentals of Nursing: Concept and Clinical

Application, 2nd edition.
RESEARCH CENTER
80
Spector, R. (2000). Cultural Diversity in Health and Illness, 4th edition.
Magazines
Atkinson and Hammersely. (2000).Professional and Lay Care in the Tanzanian

Village of Ilembula, chapter 8.
Bellour, R. and Clement, C. Race et Histoire, Paris: Gallimard Revenue

Internationale des Sciences Socials, 23(4).
Juntunen, A. Professional and Lay Care in the Tanzanian Village of ilembula,

Department of Nursing and Health Administration University of Oulu
Finland.
Levi-Strauss, Claude. American Association of Physical Anthropology:

Statement or biological Aspects of Race published.
Maier-Lorentz MM. Transcultural Nursing: its importance in nursing practice,

National University, San Diego, California, USA.
Narayanasamy, Aru. (2003). Transcultural Nursing: How do nurses respond to

cultural Needs?, Vol. 12, issue 3, , page 185-194.
Journals
American Journal of Physical Anthropology, vol. 101, 1996, page 569-570.
Campinha-Bacote. (2003). A Model and Instrument for Addressing Cultural

Competence in health Care, Journal of Nursing Education.
Meleis, A.,(1999). Culturally Competent Care: Journal

of Transcultural Nursing, Washington D.C., American Academy of
Nursing
Leininger, Madeleine. (1999). Journal of Transcultural Nursing, Washington

D.C., American Academy of Nursing.
Lorents-Madeleine. (2008). Home health care Nurse: the Journal for Home |Care
and Hospice professional, vol. 26, page 237-243.
RESEARCH CENTER
81
Electronics Resouces
Chit, Estella. (2004). Nurses Lackhurts Healthcare system.Manila Times.

http//www.manilatimes.net/others/special/2003/may/18/2003
Fernandez, M. and Fernandez, K. (2005). Transcultural nursing: Basic concept

and Case study. http://www.culturediversity.org/
Lippincot, W. and Wilkins. (2008). Understanding Transcultural Nursing

www.nursingcenter.com
Madeleine Leininger. (2008. Transcultural Nursing Society. www.tcns.org
Mercado, Susan Pineda. (2000). MNging Shifts in Nursing Direction

Department of Health. http://www.doh.gov.ph/mmc/issue01/nn.html
Unpublished Materials
Gadut, Ma. Carmelita D. et.al., (2006) 6 C’s as Thrust of Manila Doctors

College: A Basis for Quality Nursing Care
RESEARCH CENTER
82
APPENDIX A
RESEARCH CENTER
83
RESEARCH CENTER
84
RESEARCH CENTER
APPENDIX B
RESEARCH CENTER
86
College of Nursing
Manila Doctors College
Pres. Diosdado Macapagal Blvd., Metropolitan Park, Pasay City
Dear Respondents,
To whom it may concern
Greetings!
We, undersigned, 3rd year Nursing Students from Manila Doctors College is
currently conducting our research as a partial requirement in the Degree of
Bachelor of Science in Nursing entitled “Extent of Transcultural Nursing
Practices in Manila Doctors Hospital”, and this study aims to assess the extent
of transcultural nursing practices in your hospital.
We are asking for your cooperation to answer our survey questionnaire base on
your availability for today. We are hoping for your kind consideration. Thank
you very much and God Bless.
Sincerely Yours,
Group 24-1 of Manila Doctors College
Questionnaire
PART I
Instruction: Kindly put a check ( ) on the following data.
Name (Optional):__________________________________________
Age:
20-29 years old

30-39 years old
40 years old and above
Gender
Male
Female
Number of foreign patients handled?
RESEARCH CENTER
1-2 patients
3-4 patients
5 or more patients
PART II
Instruction: Check ( ) the box corresponds to your answer.
5 – FlE –Fullest Extent
4 – FE – Full Extent
3- ME – Moderate Extent
2 – LE – Lesser Extent
1 – LtE –Least Extent
A. Communication FlE FE ME LE LtE
5 4 3 2 1
A.1. Greets my foreign patient and

his/her family before doing any
procedure.
A. 2. Establishes rapport to my
foreign patient.
A.3. If my foreign patient could not
speak nor understand English I
perform simple actions, and do sign
language for the patient to
understand me while verbalizing the
instructions.
A.4. Speaks softly and clearly when

talking to my foreign patient.
A.5. Make sure that foreign patient

understands my instructions.
A. 6. Performs simple action like sign

languages or pantomime whenever
foreign patient could not understand
my instructions.
RESEARCH CENTER
A.7. Uses simple words rather than
complicated words when talking to
foreign patient.
A.8 Courteously listens to concerns of 88

foreign patient.
A.9. Gives instruction to foreign

patient in proper order.
A.10. Uses terminating words upon

leaving the room of my foreign
patient.
B. Space
B.1. Recognizes cultural difference of

foreign patients before providing care.
B.2. Talks to foreign patient with a

distance of three (3) feet away from
patient’s bed.
B.3. Make sure that my foreign

patient is relaxed when I am
attending to his or her need.
B.4. Aware that touching my foreign

patient without permission can cause
an embarrassment or anger to him or
her.
B.5. Avoids too much body movement

when facing foreign patients.
B.6.Maintains acceptable distance

based on my foreign patient’s culture
preference especially when the he or
she is resting.
B.7. Maximizes time and effort when

giving care to my foreign patient.
B.8. Respects the time according to

foreign patient’s cultural practices if
he or she has a preferred time of
receiving care like in providing
hygiene care.
B.9. Secures my foreign patient’s

comfort when he or she is isolated or
RESEARCH CENTER
alone.
B.10. Touches my foreign patients

rarely as an indicator of respect to his
or her privacy.
C. Environmental Control
C.1. Orients my foreign patient

regarding the time, date even though
he / she is unconscious.
C.2. Provides the needs of my foreign

patient based on their preference
89
pattern according to his or her
culture.
C.3. Make sure that my foreign

patient’s environment is contributing
to his fast recovery by maintaining
his room clean and in order.
C.4. Make sure that my foreign

patient feels comfortable with his or
her room.
C.5. Assists my foreign patient and

his family in all procedure needed to
be done.
C.6. Explains the illness or health

condition of my foreign patients to
him or her as well as to his or her
family members.
C.7. Explains to my foreign patient

the doctor’s order in order for him or
her to have self control.
C.8. Ensures my foreign patient to

maintain a quite and peaceful
environment.
C. 9. Explains to my foreign patient’s

and visitors regarding visiting hours.
C.10. Maintains room temperature

appropriate for my foreign patient’s
health condition.
RESEARCH CENTER
RESEARCH CENTER
90
RESEARCH CENTER
91
RESEARCH CENTER
92
RESEARCH CENTER
93
APPENDIX C
RESEARCH CENTER
94
GROUP 24-1
Frequencies
Statistics
NumberOf
Age Gender Patient
N Valid 30 30 30
Missing 0 0 0
Frequency Table
Age
Cumulative
Frequency Percent Valid Percent Percent
Valid 21-29 25 83.3 83.3 83.3
30-39 5 16.7 16.7 100.0
Total 30 100.0 100.0
Gender
Cumulative
Valid Male 12 40.0 40.0 40.0
Female 18 60.0 60.0 100.0
Total 30 100.0 100.0
NumberOfPatient
Cumulative
Valid 1-2 11 36.7 36.7 36.7
3-4 10 33.3 33.3 70.0
5 and above 9 30.0 30.0 100.0
Total 30 100.0 100.0
RESEARCH CENTER
95
Descriptives
Descriptive Statistics
N Minimum Maximum Mean Std. Deviation

Com1 29 3.00 5.00 4.5862 .56803
Com2 30 3.00 5.00 4.5000 .77682
Com3 30 3.00 5.00 4.6000 .56324
Com4 30 4.00 5.00 4.7333 .44978
Com5 30 4.00 5.00 4.6667 .47946
Com6 30 3.00 5.00 4.2667 .73968
Com7 30 4.00 5.00 4.5667 .50401
Com8 30 3.00 5.00 4.5333 .62881
Com9 30 3.00 5.00 4.5333 .57135
Com10 30 2.00 5.00 4.1333 .93710
OverallCommunication 30 3.50 5.00 4.5126 .42921
Valid N (listwise) 29
Descriptives

Sp1 30 2.00 5.00 4.1667 .79148
Sp2 30 1.00 5.00 4.1000 .99481
Sp3 30 3.00 5.00 4.4000 .77013
Sp4 30 2.00 5.00 4.4000 .89443
Sp5 30 1.00 5.00 4.1667 .98553
Sp6 30 3.00 5.00 4.4667 .57135
Sp7 30 4.00 5.00 4.6000 .49827
Sp8 30 3.00 5.00 4.3667 .71840
Sp9 30 4.00 5.00 4.6667 .47946
Sp10 30 3.00 5.00 4.3000 .74971
OverallSpace 30 3.10 5.00 4.3633 .57684
RESEARCH CENTER
96
Descriptives

EC1 30 3.00 5.00 4.4667 .68145
EC2 30 3.00 5.00 4.4000 .67466
EC3 30 3.00 5.00 4.6667 .60648
EC4 30 3.00 5.00 4.6667 .54667
EC5 30 4.00 5.00 4.7000 .46609
EC6 30 3.00 5.00 4.5667 .56832
EC7 30 3.00 5.00 4.4000 .67466
EC8 30 3.00 5.00 4.7000 .53498
EC9 30 3.00 5.00 4.6000 .62146
EC10 30 3.00 5.00 4.4000 .62146
OverallEnvironmental 30 3.50 5.00 4.5567 .42966
Descriptives

Communication 30 3.50 5.00 4.5126 .42921
Space 30 3.10 5.00 4.3633 .57684
Environmental 30 3.50 5.00 4.5567 .42966
OverallTranscultural
30 3.47 5.00 4.4775 .44095
NursingPractices
T-Test
Group Statistics
Std. Error
Gender N Mean Std. Deviation Mean
OverallTranscultural Male 12 4.4389 .51754 .14940
NursingPractices Female 18 4.5033 .39574 .09328
RESEARCH CENTER
97
I n d e p e n d e n t S a m p le s T e s t
L e v e n e 's T e s t fo r
E q u a lity o f V a r ia n c e s t- t e s t f o r E q u a lity o f M e a n s
9 5 % C o n fid e n c e
In t e r v a l o f th e
M e a n S td . E r r o r D iffe r e n c e
F S ig . t df S ig . ( 2 - ta ile dD) if fe r e n c e D iffe r e n c e L o w e r U p p e r
O v e r a llT r a n s c u ltu r a l E q u a l v a r ia n c e s
1 .4 0 1 .2 4 6 - .3 8 6 28 .7 0 2 - .0 6 4 4 3 . 1 6 6 8 0 - .4 0 6 1 0 .2 7 7 2 3
N u r s in g P r a c tic e s a ssu m ed
E q u a l v a r ia n c e s
- .3 6 6 1 9 .3 4 5 .7 1 8 - .0 6 4 4 3 . 1 7 6 1 3 - .4 3 2 6 3 .3 0 3 7 6
n ot a ssu m e d
T-Test
Group Statistics
Std. Error
Age N Mean Std. Deviation Mean
OverallTranscultural 21-29 25 4.4853 .42449 .08490
NursingPractices 30-39 5 4.4386 .57115 .25543
In d e p e n d e n t S a m p le s T e s t
L e v e n e 's T e s t fo r
E q u a lit y o f V a r ia n c e s t- te s t fo r E q u a lity o f M e a n s
9 5 % C o n fid e n c e
In te r v a l o f th e
M ean S td . E r r o r D iffe r e n c e
F S ig . t df S ig . ( 2 - ta ile dD) iffe r e n c e D iffe r e n c e L o w e r Upper
O v e r a llT r a n s c u ltu r a l E q u a l v a r ia n c e s
1 .9 1 2 .1 7 8 .2 1 3 28 .8 3 3 .0 4 6 7 1 .2 1 9 6 6 - .4 0 3 2 5 .4 9 6 6 8
N u r s in g P r a c tic e s a ss u m e d
E q u a l v a r ia n c e s
.1 7 4 4 .9 2 3 .8 6 9 .0 4 6 7 1 .2 6 9 1 7 - .6 4 8 4 8 .7 4 1 9 1
not assum ed
Oneway
D e s c rip t iv e s
O v e r a llT r a n s c u ltu r a lN u r s in g P r a c tic e s

9 5 % C o n fid e n c e In te r v a l fo r
M ean
N M e a n S td . D e v ia tioSntd . E r r o rL o w e r B o u nUd p p e r B o u n M
d in im u m M a x im u m
1 -2 11 4 .3 2 7 3 .4 8 6 4 4 . 1 4 6 6 7 4 .0 0 0 5 4 .6 5 4 1 3 .4 7 4 .9 0
3 -4 10 4 .4 6 6 0 .3 8 3 9 2 . 1 2 1 4 1 4 .1 9 1 3 4 .7 4 0 6 3 .8 7 4 .9 3
5 an d a bo ve 9 4 .6 7 4 1 .4 1 0 5 5 . 1 3 6 8 5 4 .3 5 8 5 4 .9 8 9 6 3 .7 7 5 .0 0
T o ta l 30 4 .4 7 7 5 .4 4 0 9 5 . 0 8 0 5 1 4 .3 1 2 9 4 .6 4 2 2 3 .4 7 5 .0 0
RESEARCH CENTER
98
ANOVA
OverallTransculturalNursingPractices
Sum of
Squares df Mean Square F Sig.
Between Groups .597 2 .299 1.600 .221
Within Groups 5.041 27 .187
Total 5.639 29
GROUP 24-1
Frequencies
Frequency Table
Gender
Cumulative
Valid Male 12 40.0 40.0 40.0
Female 18 60.0 60.0 100.0
Total 30 100.0 100.0
NumberOfPatient
Cumulative
Valid 1-2 11 36.7 36.7 36.7
3-4 10 33.3 33.3 70.0
5 and above 9 30.0 30.0 100.0
Total 30 100.0 100.0
Descriptives
RESEARCH CENTER
99

Com1 29 3.00 5.00 4.5862 .56803
Com2 30 3.00 5.00 4.5000 .77682
Com3 30 3.00 5.00 4.6000 .56324
Com4 30 4.00 5.00 4.7333 .44978
Com5 30 4.00 5.00 4.6667 .47946
Com6 30 3.00 5.00 4.2667 .73968
Com7 30 4.00 5.00 4.5667 .50401
Com8 30 3.00 5.00 4.5333 .62881
Com9 30 3.00 5.00 4.5333 .57135
Com10 30 2.00 5.00 4.1333 .93710
OverallCommunication 30 3.50 5.00 4.5126 .42921
Descriptives

Sp1 30 2.00 5.00 4.1667 .79148
Sp2 30 1.00 5.00 4.1000 .99481
Sp3 30 3.00 5.00 4.4000 .77013
Sp4 30 2.00 5.00 4.4000 .89443
Sp5 30 1.00 5.00 4.1667 .98553
Sp6 30 3.00 5.00 4.4667 .57135
Sp7 30 4.00 5.00 4.6000 .49827
Sp8 30 3.00 5.00 4.3667 .71840
Sp9 30 4.00 5.00 4.6667 .47946
Sp10 30 3.00 5.00 4.3000 .74971
OverallSpace 30 3.10 5.00 4.3633 .57684
Descriptives
RESEARCH CENTER
100

EC1 30 3.00 5.00 4.4667 .68145
EC2 30 3.00 5.00 4.4000 .67466
EC3 30 3.00 5.00 4.6667 .60648
EC4 30 3.00 5.00 4.6667 .54667
EC5 30 4.00 5.00 4.7000 .46609
EC6 30 3.00 5.00 4.5667 .56832
EC7 30 3.00 5.00 4.4000 .67466
EC8 30 3.00 5.00 4.7000 .53498
EC9 30 3.00 5.00 4.6000 .62146
EC10 30 3.00 5.00 4.4000 .62146
OverallEnvironmental 30 3.50 5.00 4.5567 .42966
Descriptives

Communication 30 3.50 5.00 4.5126 .42921
Space 30 3.10 5.00 4.3633 .57684
Environmental 30 3.50 5.00 4.5567 .42966
OverallTranscultural
30 3.47 5.00 4.4775 .44095
NursingPractices
T-Test
Group Statistics
Std. Error
Gender N Mean Std. Deviation Mean
Communication Male 12 4.4917 .45619 .13169
Female 18 4.5265 .42319 .09975
Space Male 12 4.3083 .70512 .20355
Female 18 4.4000 .49229 .11603
Environmental Male 12 4.5167 .46677 .13475
Female 18 4.5833 .41480 .09777
OverallTranscultural Male 12 4.4389 .51754 .14940
NursingPractices Female 18 4.5033 .39574 .09328
RESEARCH CENTER
101
In d e p e n d en t Sa mp le s T e s t
L even e 's T e st for

Eq u a lity o f Varia n ce s t-te st fo r Eq u ality o f M e a n s
9 5 % Co n fid e n ce
Inte rva l o f th e
M ean Std . Erro r Diffe re n ce
F Sig . t df Sig . (2 -ta ile d) D iffe re n ce Diffe re n ce Lo w e r U p pe r
Co m m u n ica tio n Eq u a l va ria n ce s
.0 1 9 .8 9 0 -.2 1 4 28 .8 3 2 -.0 3 4 88 .1 62 6 5 -.3 6 8 0 6 .2 9 83 1
a ssu m e d
Eq u a l va ria n ce s
-.2 1 1 2 2 .4 5 9 .8 3 5 -.0 3 4 88 .1 65 2 0 -.3 7 7 0 8 .3 0 73 2
n o t a ssu m e d
Sp a ce Eq u a l va ria n ce s
2 .5 8 9 .1 1 9 -.4 2 0 28 .6 7 7 -.0 9 1 67 .2 18 0 9 -.5 3 8 4 1 .3 5 50 8
a ssu m e d
-.3 9 1 1 8 .0 7 6 .7 0 0 -.0 9 1 67 .2 34 3 0 -.5 8 3 7 7 .4 0 04 3
n o t a ssu m e d
En viro n m e n ta l Eq u a l va ria n ce s
.1 2 1 .7 3 1 -.4 1 0 28 .6 8 5 -.0 6 6 67 .1 62 4 7 -.3 9 9 4 8 .2 6 61 4
a ssu m e d
-.4 0 0 2 1 .7 3 3 .6 9 3 -.0 6 6 67 .1 66 4 8 -.4 1 2 1 7 .2 7 88 4
n o t a ssu m e d
O ve ra llT ra nscultura l Eq u a l va ria n ce s
1 .4 0 1 .2 4 6 -.3 8 6 28 .7 0 2 -.0 6 4 43 .1 66 8 0 -.4 0 6 1 0 .2 7 72 3
Nu rsin g Pra ctice s a ssu m e d
-.3 6 6 1 9 .3 4 5 .7 1 8 -.0 6 4 43 .1 76 1 3 -.4 3 2 6 3 .3 0 37 6
n o t a ssu m e d
Oneway
D e s c rip tiv e s
9 5 % C o n fid e n c e In te rva l fo r
M ean
N M e a n S td . D ev ia tio nS td . E rro r L o w e r B o u n dU p p e r B o u n d M in im u m M a xim u m
C o m m u n ica tio n 1 -2 11 4 .3 2 7 3 .4 5 1 8 6 .1 3 6 2 4 4 .0 2 3 7 4 .6 3 0 8 3 .5 0 4 .9 0
3 -4 10 4 .4 9 7 8 .3 6 3 1 8 .1 1 4 8 5 4 .2 3 8 0 4 .7 5 7 6 3 .9 0 5 .0 0
5 and above 9 4 .7 5 5 6 .3 8 7 6 6 .1 2 9 2 2 4 .4 5 7 6 5 .0 5 3 5 4 .0 0 5 .0 0
T o ta l 30 4 .5 1 2 6 .4 2 9 2 1 .0 7 8 3 6 4 .3 5 2 3 4 .6 7 2 9 3 .5 0 5 .0 0
Space 1 -2 11 4 .2 0 9 1 .5 9 9 0 9 .1 8 0 6 3 3 .8 0 6 6 4 .6 1 1 6 3 .1 0 4 .9 0
3 -4 10 4 .4 0 0 0 .5 8 3 1 0 .1 8 4 3 9 3 .9 8 2 9 4 .8 1 7 1 3 .2 0 5 .0 0
5 and above 9 4 .5 1 1 1 .5 6 2 2 4 .1 8 7 4 1 4 .0 7 8 9 4 .9 4 3 3 3 .5 0 5 .0 0
T o ta l 30 4 .3 6 3 3 .5 7 6 8 4 .1 0 5 3 2 4 .1 4 7 9 4 .5 7 8 7 3 .1 0 5 .0 0
E n viro n m e n ta l 1 -2 11 4 .4 4 5 5 .4 9 8 7 3 .1 5 0 3 7 4 .1 1 0 4 4 .7 8 0 5 3 .5 0 5 .0 0
3 -4 10 4 .5 0 0 0 .3 4 9 6 0 .1 1 0 5 5 4 .2 4 9 9 4 .7 5 0 1 3 .8 0 5 .0 0
5 and above 9 4 .7 5 5 6 .3 9 4 0 5 .1 3 1 3 5 4 .4 5 2 7 5 .0 5 8 5 3 .8 0 5 .0 0
T o ta l 30 4 .5 5 6 7 .4 2 9 6 6 .0 7 8 4 5 4 .3 9 6 2 4 .7 1 7 1 3 .5 0 5 .0 0
O v e ra llT ra n s cu ltu ra l 1 -2 11 4 .3 2 7 3 .4 8 6 4 4 .1 4 6 6 7 4 .0 0 0 5 4 .6 5 4 1 3 .4 7 4 .9 0
N u rsin g P ra c tice s 3 -4 10 4 .4 6 6 0 .3 8 3 9 2 .1 2 1 4 1 4 .1 9 1 3 4 .7 4 0 6 3 .8 7 4 .9 3
5 and above 9 4 .6 7 4 1 .4 1 0 5 5 .1 3 6 8 5 4 .3 5 8 5 4 .9 8 9 6 3 .7 7 5 .0 0
T o ta l
30 4 .4 7 7 5 .4 4 0 9 5 .0 8 0 5 1 4 .3 1 2 9 4 .6 4 2 2 3 .4 7 5 .0 0
RESEARCH CENTER
102
ANOVA
Sum of
Squares df Mean Square F Sig.
Communication Between Groups .911 2 .456 2.776 .080
Total 5.342 29
Space Between Groups .472 2 .236 .694 .508
Total 9.650 29
Environmental Between Groups .524 2 .262 1.465 .249
Total 5.354 29
OverallTranscultural Between Groups .597 2 .299 1.600 .221
NursingPractices Within Groups 5.041 27 .187
Total 5.639 29
RESEARCH CENTER
APPENDIX D
RESEARCH CENTER
104
RESEARCH CENTER
105
RESEARCH CENTER
106
RESEARCH CENTER
107
RESEARCH CENTER
108
RESEARCH CENTER
109
RESEARCH CENTER
110
APPENDIX E
RESEARCH CENTER
111
RESEARCH CENTER
112
RESEARCH CENTER
113
RESEARCH CENTER
114
RESEARCH CENTER
115

COLLEGE OF NURSING
RESEARCH CENTER
CERTIFICATE OF REVISION
(PROPOSAL DEFENSE)
This is to certify that Group ______ has revised/modified the final paper
defended last _____________________ according to the suggestions of the
members of the panel.
______________________
Adviser
Date ____________
Noted & Approved:
_____________________ ___________________
Panel Member Panel Member
Date ___________________ Date ______________________
RESEARCH CENTER
Research and Publication Department
Pres. Diosdado Macapagal Blvd., Metropolitan Park, Pasay City
CERTIFICATION
This is to certify that the thesis entitled “Extent of Transcultural Nursing

Practices in Manila Doctors Hospital” of Group 24-1 has been analyzed and treated
statistically using the SPSS (Statistical Package for the Social Sciences) software. The
results that were released conformed to the data gathered and research questions
formulated by the concerned group.
This certification is issued upon the request of members of Group 24-1 for
whatever purpose it may serve them best.
Certified by:
Emervic Gargoles
In-house Statistician
117
RESEARCH CENTER
APPENDIX F
117
RESEARCH CENTER
118
LINE ITEM BUDGET
Research Title: Extent ogf Transcultural Nursing Practices in Manila

Doctors Hospital.
Researchers: CAMBALLA, Christy Ann S.
FLORES, Joshua Andrew D.
GUEVARA, Ronalyn S.
IBASE, Francis D.
MADERAZO, Nina Rose C.
MEJIA, Kristine Mae D.
ORTEGA, Yessa P.
Period Covered: January 4, 2009 – October 28, 2009
Items Amount
Transportation Expenses 1500
Communication Expenses 500
(Cellphone, internet prepaid etc.)
Supplies and Materials Expenses
a. Bond Papers 395
b. Printer inks 1320
c. Pencils, ballpens, erasers 150
d. Transparencies 120
e. Token for respondents 100
f. Survey forms 240
Professional expenses
a. Token for validators 300
b. Token for panel members
Snacks 900
Binding Expenses 450
Statistician 3000
Total 8975
RESEARCH CENTER
APPENDIX G
120
RESEARCH CENTER
….after defense…
With our beautiful adviser Mam Armel Gonzalez
121
RESEARCH CENTER
Editing after the defense…
from the hard work of each of the members….
122
RESEARCH CENTER
APPENDIX H
123
Curriculum Vitae
RESEARCH CENTER
CHRISTY ANN S. CAMBALLA
PERSONAL DETAILS:
Address: Blk. 23 Lot 2 Camia St.,Villa de Primarosa, Brgy. Buhay na

Tubig, Imus, Cavite, 4103
Age: 27 years old Date of Birth: December 27, 1981
Civil Status: Single Place of Birth: Manila
Nationality: Filipino Religion: Roman Catholic
Email Add.: tyannver@yahoo.com Mobile No.: 0915-3109928
EDUCATIONAL BACKGROUND:
Primary:
Malate Catholic School 1988-1994
1030 A. Mabini St., Malate, Manila, 1017
Secondary:
Malate Catholic School 1994-1998
1030 A. Mabini St., Malate, Manila, 1017
124
Tertiary:
BSBA Major in Marketing 1998-1999
University of the Philippines – Manila
Claro M. Recto, Manila
RESEARCH CENTER
Bachelor of Arts in Development Study 1999-2004
Padre Faura St., Ermita, Manila, 1017
Bachelor of Science in Nursing (BSN) 2006-present

Pres. Diosdado Macapagal Blvd.,
Metropolitan Park, Pasay City
Achievement / Awards / Organization
College Scholar (Deans Lister) 2nd Semester SY 2001-2002

Department of Social Sciences
College of Arts and Sciences
Candidate for Representative at 2nd Sem SY 2001-2002

Large (Rep-at-Large)
Publicity and Documentation
Unyon ng Progresibong Mag-aaral (UPM)
College of Arts and Sciences
Completion Award for Tutorials 1st Semester SY 1999-2000

Ugnayan ng Pahinungod
University of the Philippines - Manila
Member of Committee on SY 2002-2003

Vice-President External
Development Study Society
Department of Arts and Social Sciences
Vice-Chairperson SY 2001-2003
Youth for Nationalism and Democracy
University of the Philippines – Manila 125
Secretary General SY 2000-2001
RESEARCH CENTER
Finance Officer SY 1999-2000
University of the East
Achievement Award (Marketing) 2nd Semester SY 1998-1999

Faculty of Business Administration
University of the East – Manila
Malate Catholic School
Loyaty Award 1997-1998

Full Scholar 1996-1997
3rd Honor 1st and 3rd Grading 1995-1996
Biologu Quiz Bee Candidate 1995-1996
Most Obedient of the Class 1995-1996
Consistent Top 10 of the Class 1994-1998
Cheer Dancer 1994-1996
Others
Champion January 1997

Battle of the Brains
Brgy. 805 Zone 87
San Andress Bukid, Manila, 1017
SEMINARS ATTENDED
Emerging and Re-Emerging Infectious 5th of February 2009

Diseases in the Philippines
College of Nursing
Conference on the Cause of War in Middle East (Iraq) Sept. 2002

University of the Philippines – Diliman
Diliman, Quezon City
126
Leadership Training June 2001
Candidates of Unyon ng Progresibong Mag-aaral
RESEARCH CENTER
Acting and Drama Workshop April 2001
Cultural Group of Youth for Nationalism and Democracy
Quezon City
Leadership Training Mar. 31-Apr. 2, ‘01

Candidates of Unyon ng Progresibong Mag-aaral
Tuition Fee Increase Press Conference March 2001

Speaker
Max’s Restaurant, Mandaluyong City
Expectation of GMA Administration March 2001

Symposium Organizer
Photo Exhibit February. 2001

Team Leader
Where to, EDSA 2? January 2001

Symposium Organizer
RESEARCH CENTER
127
JOSHUA ANDREW D. FLORES
PERSONAL DETAILS:
Address: Camella North Springvilee, Molino, Bacoor, Cavite
Age: 19 years old Date Of Birth: December 16, 1989
Civil Status: Single Place Of Birth: Manila City
Nationality: Filipino Religion: Christian
Telephone: (046)5027899 Cell Phone No.: 09155633437
Email Address: tekkentagg@yahoo.com
Primary:
Friendship Learning Center 1995-1999
Angeles City
Mother Theresa School 1999-2001
Molino, Bacoor, Cavite
Secondary:
Don Bosco Technical Institute 2001-2002
Makati City
RESEARCH CENTER
128
Nazarene Academy 2002-2005
Salapungan, Angeles City
Tertiary:
Manila Doctors College 2006- Present
Bachelor Of Science In Nursing
Interest:
Bodybuilding, Cooking
RESEARCH CENTER
129
RONALYN S. GUEVARA
PERSONAL DETAILS:
Address: #5 Pili St. Zone 1 Plaza NueveSignal Village Taguig City
Age: 19 years old Date of Birth: January 28, 1990
Civil Status: Single Place of Birth: Gasan, Marinduque
Telephone number: none Cellphone number: 09159464340
E-mail address: grabe_u@yahoo.com
Primary:
Royal Era Academy 1996-2002
10th Ave. HSG, Sgnal VillageTaguig City,
Metro Manila
Secondary:
Sto. Nino Catholic School 2002-2006
Sampaloc St. Signal Village Taguig City
Tertiary:
Manila Doctors College 2006-present
Bachelor of Science in Nursing 130
President Diosdado Macapagal Boulevard
RESEARCH CENTER
AWARDS AND HONORS:
Cape Awardee (Sto. Nino catholicSchool)
INTEREST:
Likes to watch TV and movies. Listening to good music and also spend most of
her time surfing the net and reads books. She loves to draw, sing and hanging out
with friends.
RESEARCH CENTER
131
FRANCIS D. IBASE
PERSONAL DETAILS:
Address: 1665 Zamora Street, Paco, Manila
Age: 20 Years Old Date of Birth: December 10, 1988
Civil Status: Single Place of Birth: Manila
Telephone Number: (02) 4675106 Cellphone Number: 0916-7614791
Email Address: francis_ibase@yahoo.com
Primary:
Celedonio Salvador Elementary School 1996 - 2001
Merced St, Paco, Manila
Secondary:
Manuel A. Roxas Highschool 2001- 2005
Quirino Ave Ext, Paco, Manila
Tertiary:
Arellano University 2005 – 2006
RESEARCH CENTER
132
Taft Avenue, Gil. Puyat, Manila
Manila Doctors College 2006 - Present

Awards And Honors

Best In Math And Science ( Sy 2003 -2004)
4th Honorable Mention ( Sy 2004 – 2005)
Loyalty Awardee (Sy 2004 – 2005)
Leadership Award (Sy 2002 – 2003)
Mr. Freshmen (Sy 2001– 2002)
Interests
Music, Arts, Watching Movies, Playing Computer Games
RESEARCH CENTER
133
NINA ROSE C. MADERAZO
PERSONAL DETAILS:
Age: 19 Date of Birth: December 21, 1989
Civil Status: Single Place of Birth: Angat, Bulacan
Telephone: (044) 671-0919 Cellphone No.: 09165172437
Email Address: ninamaderazo_21@yahoo.com
Primary:
Colegio De Sta. Monica De Angat 1996-2002
Poblacion Angat, Bulacan
Secondary:
Colegio De Sta. Monica De Angat 2002-2006
Poblacion Angat, Bulacan
Tertiary:
RESEARCH CENTER
134
Interest:
Singing In Karaoke, Reading Pocket Books, Watching T.V, Eating
RESEARCH CENTER
135
KRISTINE MAE D. MEJIA
PERSONAL DETAILS:
Age: 20 years old Date Of Birth: April 15, 1989
Civil Status: Single Place Of Birth: Quezon City
Telephone: (046)9700824 Cell Phone No.: 09164939420
Email Address: Bluecast_15@Yahoo.Com.Ph
Primary:
Elizabeth Seton-South 1996-2002
Anabu Ii-D Imus, Cavite
Secondary:
Statefields School Inc. 2002-2006
Molino Iii Bacoor, Cavite
Tertiary:
RESEARCH CENTER
136
Interest:
Singing In Karaoke, Reading Pocket Books, Watching T.V, Eating
RESEARCH CENTER
137
YESSA P. ORTEGA
PERSONAL DETAILS:
Age: 19 Date of Birth: February 13, 1990
Civil Status: Single Place of Birth: Lobo, Batangas
Telephone: 8541766 Cellphone No.: 09223683883
Email Address: yessablue@yahoo.com
Primary:
Baclaran Elementary School Central 1996-2002
Secondary:
Manila High School 2002-2006
Victoria St. Intramuros Manila
Tertiary:
Manila Doctors College 2006-Present
Bachelor of Science in Nursing
RESEARCH CENTER
138
Related Extra-Curricular Activities:

Purple Hearts Club
Interest:
Surfing Net, Cooking and Watching Television
RESEARCH CENTER

Sir Castelo Edited

Hochgeladen von

Dokumentinformationen

Originalbeschreibung:

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Sir Castelo Edited

Hochgeladen von

Copyright:

Verfügbare Formate

MANILA DOCTORS COLLEGE

EXTENT OF TRANSCULTURAL NURSING PRACTICES IN MANILA

Christy Ann S. Camballa

In partial fulfillment of the requirements for the degree of BACHELOR OF

Approved by the Committee on Oral Examination with the grade of

Accepted and approved in partial fulfillment of the requirements for the

support us to make this research possible:

us the permission to counduct our study in the respective areas.

love and guidance and making everything possible.

hardships, we exerted effort, and time to make this study feasible.

This study is heartfully dedicated to all the people whose unwavering

friends for their time and motivation.

Research Title : EXTENT OF TRANSCULTURAL NURSING

Researchers : CAMBALLA, CHRISTY ANN S.

Adviser : MRS. ARMEL GONZALEZ, RN MHN MAN

School : MANILA DOCTORS COLLEGE

Degree Conferred : BACHELOR OF SCIENCE IN NURSING

Date Completed : October 2009

No. of pages : 138 pages

This quantitative analytical research assessed the Extent of Transcultural

A purposive sampling technique was used in distributing the questionnaire

participated as respondents to this survey. The quantitative data obtained were

for Social Science (SPSS) software.

gender, and number of patients handled. To assess the extent of transcultural

chosen Sunrise Model (environmental, communication and space) from Madeleine

As result, the study shows that there is no significant difference in the

In the light of the findings and conclusions, the following recommendations

as possible t their patient in spite of culture indifferences. Secondly, to the College

of Nursing to suggest and encourage Commission on Higher Education to include

Transcultural Nursing Practices patterned according to Leininger’s Sunrise Model

in the curriculum of Bachelor of Science in Nursing to help nurses prepare

themselves as they have a greater chance and possibility of working abroad.

themselves regarding different cultures needed to consider before giving care.

included in the umbrella of Sunrise Model of Leininger. Furthermore, they could

1 THE PROBLEM AND ITS BACKGROUND

Background of the Study 3

Statement of the Problem 10

Significance of the Study 11

Scope and Delimitation of the Study 14

2 REVIEW OF RELATED LITERATURE AND STUDIES

Relevance to the Present Study 40

3 METHOD AND PROCEDURE

Sample and Sampling Technique 43

Validation of the Instrument 45

Test for Reliability of the Instrument 46

Data Gathering Procedure 46

Statistical Treatment of Data 47

4 PRESENTATION, ANALYSIS AND

3 Frequency and Percentage Distribution of 54

4 Extent of transcultural Nursing Practices in 56

5 Extent of transcultural Nursing Practices in 58

6 Extent of transcultural Nursing Practices in 61

9 Difference in the Extent of Transculural 66

10 Difference in the Extent of Transculural 69

A Recommendations and Suggestions of the Panel 83

THE PROBLEM AND ITS BACKGROUND

Pain is experienced by people of all cultures, communities and economic

consider in providing an optimum care in each client.

In year 2005, according to a senior Taiwanese Department of Health (DOH)

and emergency patients. Increase in payment in medical services will be effective

can avail wellness not mentioning the global competitiveness of medical

practitioners and equipment available. Nurse prepares their selves in handling

practices, and even with their superstitious beliefs.