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Leininger (1995) identified the main features of
the Cultural Diversity and Universality Theory
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The first nurse researcher to point out the
importance of culture in explaining individual health and caring behaviors.
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She developed transcultural care as one domain
of nursing science.
Leininger (1999) defined
transcultural nursing as “a legitimate and formal area of study, research, and
practice, focused on culturally based care, values, and practices to help
cultures or subcultures maintain or regain their health and face disabilities or death in
culturally congruent and beneficial caring ways” (Leininger, 1999).
Leininger (1999) notes that the
main goal of transcultural nursing is to provide culturally specific care.
Leininger Defined Theory…
A systematic and creative way to discover knowledge about
something or to account for some vaguely known phenomenon.
(Nursing theory must take into account the cultural beliefs,
caring, behaviors, and values of individuals, families, and groups to provide
effective, satisfying, and culturally congruent nursing care).
Transcultural nursing is a
substantive area of study and practice focused on comparative cultural care
(caring) values, beliefs, and practices of individuals or groups of similar or
different cultures with the goal of providing culture-specific and universal
nursing care practices in promoting health or well-being or to help people face
unfavorable human conditions, illness, or death in culturally meaningful ways.
Eight Factors that influenced
Leininger to establish Transcultural Nursing
1. The
migration of people within and between countries worlwide had markedly
increased. Transcultural nursing is needed because of the growing diversity
that characterizes national and global populations.
2. There
has been a rise in cultural identities, with people expecting their cultural
beliefs, values, and lifeways to be understood and respected by nurses and
other health care providers.
3. The
increased use of healthcare technology sometimes conflicts with cultural values
of patients.
4. There
are cultural conflicts, clashes and violence worldwide that have effected
healthcare as more cultures interact with one another.
- There
was an increased in the number of people traveling and working in many
different parts of the world.
- There
was an increase in legal suits resulting from cultural conlfict,
negligence, ignorance, and imposition of health care practicesConsistent
with the focus of her theory,
- There has been a rise in feminism and gender
issues, with new demands on health care systems to meet the needs of women and children.
- There has been an increased demand for
community and culturally based health care services in diverse
environments.
Leininger defined the metaparadigm
concepts of nursing in a manner that causes the nurse to specifically consider culture
in the delivery of competent nursing care (Table 2-12).
Metaparadigm Concepts as Defined in Leininger’s Theory
Person - Human
being, family, group, community, or institution
Environment - Totality of an event,
situation, or experience that gives meaning to human expressions,
interpretations, and social interactions in physical, ecological,
sociopolitical, and/or cultural settings (Leininger, 1991)
Health - A state of well-being that is
culturally defined, valued, and practiced. The concept of health is not
distinct to nursing as many disciplines use the term.
Nursing - Activities directed toward
assisting, supporting, or enabling with needs in ways that are congruent with
the cultural values, beliefs, and lifeways of the recipient of care
According to Leininger (2001),
three modalities guide nursing judgments, decisions, and actions to provide
culturally congruent care that is beneficial, satisfying, and meaningful to the
persons the nurse serves.
These three modes include
1. cultural
care preservation or maintenance,
2. cultural
care accommodation or negotiation, and
3. cultural
care repatterning or restructuring.
Culture care preservation or
maintenance refers to those assistive, supportive, facilitative, or
enabling professional actions and decisions that help people of a specific
culture to maintain meaningful care values for their well-being, recover from
illness, or deal with a handicap or dying.
Culture care accommodation or
negotiation refers to those assistive, supportive, facilitative, or
enabling professional actions and decisions that help people of a specific
culture or subculture adapt to or negotiate with others for meaningful,
beneficial, and congruent health outcomes.
Culture care repatterning or
restructuring refers to the assistive, supportive, facilitative, or
enabling professional actions and decisions that help patients reorder, change,
or modify their lifeways for new, different, and beneficial health outcomes
(Leininger & McFarland, 2006).
The nurse using Leininger’s
theory plans and makes decisions with clients with respect to these three modes
of action. All three care modalities require coparticipation of the nurse and
client working together to identify, plan, implement, and evaluate nursing care
with respect to the cultural congruence of the care (Leininger, 2001).
Leininger developed the sunrise
model, which she revised in 2004. She labeled this model as “an enabler,” to
clarify that although it depicts the essential components of the Cultural
Diversity and Universality Theory , it is a visual guide for exploration of
cultures.
Major Concepts in Leininger’s
Theory:
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Culture
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Cultural values
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Culturally diverse nursing care
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Ethnocentrism
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Generalization
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Stereotype
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Cultural congruence
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Ethno-nursing, Transcultural nursing
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