Transcultural Theory and Health Belief Model in Geriatric Care
This paper examines how two theoretical frameworks — Leininger's Transcultural (Culture Care) Theory and the Health Belief Model — can be integrated to address the growing challenge of providing palliative care to a diverse and aging geriatric population in emergency room settings. The paper reviews the origins and applications of the Health Belief Model, discusses how it informs nursing practice by surfacing individual patient beliefs and expectations, and then synthesizes it with Leininger's culturally centered framework. The resulting combined approach is compared to the Giger and Davidhizar Transcultural Assessment Model, arguing that nurses equipped with both frameworks are better positioned to deliver effective, culturally competent geriatric care.
- Introduction: Demographic shifts driving culturally aware geriatric care
- The Health Belief Model Theory: Origins, evidence base, and core assumptions of HBM
- How It Would Change the Nursing Practice: HBM application reshaping ER nursing interactions
- Synthesis and Conclusion: Merging both theories for comprehensive geriatric care
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What makes this paper effective
- The paper pairs two distinct theoretical frameworks — one cultural, one behavioral — and builds a clear argument for why each alone is insufficient and together they are more powerful.
- It grounds abstract theory in a concrete, real-world clinical scenario (diverse geriatric patients presenting to the ER), which keeps the analysis focused and applicable.
- The synthesis section explicitly connects the combined approach to a recognized model (Giger and Davidhizar), lending credibility and showing awareness of the wider scholarly conversation.
Key academic technique demonstrated
The paper demonstrates theoretical synthesis — taking two independently validated frameworks from different disciplinary traditions (social science behavioral theory and nursing transcultural theory) and arguing for their complementary use. It supports each theory's value with cited empirical studies before proposing their integration, which is a sound graduate-level move in applied nursing scholarship.
Structure breakdown
The paper opens with a problem statement grounded in demographic data, then introduces Leininger's theory as the cultural lens. It devotes a dedicated section to the Health Belief Model — covering its origins, history, and empirical support — before analyzing how that model would concretely alter nursing practice. A final synthesis section merges both frameworks and draws a conclusion. This four-part structure (problem → theory → practice implications → synthesis) is a reliable and clear format for applied nursing theory papers.
Introduction
Geriatric care is a challenge in most emergency rooms today, as this is where many elderly patients seek regular treatment. Making this challenge all the more difficult is the fact that the U.S. population is simultaneously aging and diversifying. The CDC has reported that over the next 15 years, the U.S. elderly population will consist of more non-Hispanic whites, Asians, and non-Hispanic blacks than ever before. Considering that geriatrics will make up approximately 20% of the population during this period, it is especially important to know how to provide care for elderly persons who are likely to be sensitive to cultural and ethnic cues that have become deeply rooted in their identities over the course of their long lives. Thus, for health care providers it is necessary to be culturally aware of attitudes and perceptions that might affect the patient and that could serve as barriers to the proper palliative care he or she needs.
The application of Leininger's Transcultural middle-range theory is helpful in addressing this challenge because it provides a framework for establishing a culturally sensitive approach to treating diverse patients. Leininger's "Culture Care Theory" places culture at the heart of palliative care by pointing out how ethnicity and care expectations are intertwined within the patient and illustrating the need to approach patients with an awareness of how culture and care are related. Care providers who are sensitive to and accommodating of cultural and ethnic beliefs are perceived as more caring, knowledgeable, and effective than providers who do not consider ethnic or cultural perspectives (Luna, 1998). While Leininger's theory is helpful for pointing out the need to establish a meaningful cultural connection with patients, the Health Belief Model can also be applied because it shows that individual perceptions are a crucial factor in determining a patient's willingness to accept or deny treatment.
The Health Belief Model Theory
The Health Belief Model is a borrowed theory that was developed in the mid-20th century in the field of social science. Its purpose was to provide a better understanding of why some people failed to utilize prevention strategies for the spread of disease. What the Health Belief Model identified was the concept that individual beliefs impacted the way in which a person approached treatment. If an individual's beliefs were negative in relation to the threat of disease and the value of treatment, that individual was less likely to participate in a prevention program. If the individual's beliefs were positively associated with the threat of disease — that is, the individual believed the threat was real — and with the value of treatment — viewing it as effective and beneficial — that person was more likely to participate in a prevention program (Rosenstock, 1974). Rooted in behavioral theory, the Health Belief Model is based on the assessment that an individual will act according to his or her perceptions of what is in his or her best interest. It is appropriate to the particular problem of geriatric palliative care because it provides a way to examine the personal beliefs of individual patients and to take those beliefs into consideration within a health care environment.
The Health Belief Model has been applied since the 1950s in a number of ways. In 1984, a study analyzed more than 40 previous studies on the impact of the Health Belief Model and concluded that the model is inherently robust in terms of predicting perceptions of behavior and outcomes (Janz & Becker, 1984). Carpenter's (2010) study found that there are many variables the Health Belief Model does not account for in its predictive method; yet Carpenter's application also showed that the model can be used as an intervention that promotes education within the nursing environment, fostering a more health-conscious atmosphere and better facilitating the patient-nurse relationship. Similarly, the study by Che, Barrett, Velez, Conn, Heinert, and Qiu (2014) used the Health Belief Model to examine the way in which women view risks to their pregnancies and how that view is demonstrated in their behavior. The study showed that with education, the perception of risk where none exists can be overcome, and the model is helpful in establishing that finding.
References
Carpenter, C. (2010). A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health Communication, 25(8), 661–669.
Che, S., Barrett, E., Velez, M., Conn, K., Heinert, S., & Qiu, X. (2014). Using the Health Belief Model to illustrate factors that influence risk assessment during pregnancy and implications for prenatal education about endocrine disruptors. Policy Futures in Education, 12(7), 961–974.
Giger, J., & Davidhizar, R. (2002). The Giger and Davidhizar Transcultural Assessment Model. Journal of Transcultural Nursing, 13(3), 185–188.
Janz, N., & Becker, M. (1984). The Health Belief Model: A decade later. Health Education Behavior, 11(1), 1–47.
Luna, L. (1989). Culturally competent health care: A challenge for nurses in Saudi Arabia. Journal of Transcultural Nursing, 9(2), 8–14.
Rosenstock, I. (1974). Historical origins of the Health Belief Model. Health Education Behavior, 2(4), 328–335.
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