Madeleine Leininger’sMadeleine Leininger’s

Culture Care Culture Care TheoryTheory

Madeliene Leininger- Madeliene Leininger- Culture Care Diversity & Culture Care Diversity & UniversalityUniversality• Dr. Leininger is the founder of transcultural Dr. Leininger is the founder of transcultural

nursing.nursing.

• Initiated this field of nursing in the mid-Initiated this field of nursing in the mid-1950s.1950s.

• Born in Sutton, Nebraska, lived on a farm Born in Sutton, Nebraska, lived on a farm with two brothers and sisters.with two brothers and sisters.

• Attended Sutton High School, Scholastica Attended Sutton High School, Scholastica College, the Catholic University of America in College, the Catholic University of America in DC, and the University of Washington, SeattleDC, and the University of Washington, Seattle

Madeleine Leininger, PhD, Madeleine Leininger, PhD, LHD, DS, CTN, RN, FAAN, LHD, DS, CTN, RN, FAAN, FRCNAFRCNA• Dr. Leininger was the first professional nurse Dr. Leininger was the first professional nurse

with a graduate preparation to complete a PhD with a graduate preparation to complete a PhD in anthropology.in anthropology.

• She brought nursing and anthropology together She brought nursing and anthropology together and coined the term transcultural nursing as an and coined the term transcultural nursing as an essential formal area of study and practice.essential formal area of study and practice.

• Her Culture Care Diversity & Universality theory Her Culture Care Diversity & Universality theory was one of the earliest nursing theories and it was one of the earliest nursing theories and it remains the only theory focused specifically on remains the only theory focused specifically on transcultural nursing with a culture care focus. transcultural nursing with a culture care focus. Her theory is used worldwide.Her theory is used worldwide.

Culture Care Diversity & Culture Care Diversity & UniversalityUniversality• Dr. Leininger established the first Caring Dr. Leininger established the first Caring

Research Conference in 1978. She developed Research Conference in 1978. She developed the theory of Culture Care with thethe theory of Culture Care with the ethnonursingethnonursing method. method.

• The The ethnonursingethnonursing method was the first method was the first nursing research method and has been used nursing research method and has been used for decades.for decades.

• She conducted the She conducted the first transcultural nursing first transcultural nursing field studyfield study in early 1960s as she lived alone in early 1960s as she lived alone with the Gadsup of Eastern Highlands of New with the Gadsup of Eastern Highlands of New Guinea.Guinea.

Accomplishments of Dr. Accomplishments of Dr. LeiningerLeininger• Dr. Leininger wrote the first books on transcultural Dr. Leininger wrote the first books on transcultural

nursing. nursing.

• She developed and launched the first She developed and launched the first undergraduate and graduate courses and undergraduate and graduate courses and programs in transcultural nursing beginning in the programs in transcultural nursing beginning in the 1970s.1970s.

• Introduced the idea of studying emic generic (folk) Introduced the idea of studying emic generic (folk) and etic professional care differences and and etic professional care differences and similarities to reduce the care gaps and conflict similarities to reduce the care gaps and conflict areas that can be non therapeutic to clients.areas that can be non therapeutic to clients.

• Conceived and saw the need to establish the Conceived and saw the need to establish the Transcultural Nursing Society as the official Transcultural Nursing Society as the official organization of the new discipline in 1974.organization of the new discipline in 1974.

Accomplishments (cont’d)Accomplishments (cont’d)• Conceived and saw the need to establish the Conceived and saw the need to establish the

Transcultural Nursing Society as the official Transcultural Nursing Society as the official organization of the new discipline in 1974.organization of the new discipline in 1974.

• The TCN society today is the major organization in The TCN society today is the major organization in this discipline with theory and research to advance this discipline with theory and research to advance transcultural nursing science.transcultural nursing science.

• Dr. Leininger established and was the first editor of Dr. Leininger established and was the first editor of the the Journal of Transcultural Nursing.Journal of Transcultural Nursing.

• Dr. Madeleine Leininger has received many Dr. Madeleine Leininger has received many outstanding awards and honors and has been outstanding awards and honors and has been nominated for the Nobel Prize for her significant nominated for the Nobel Prize for her significant and worldwide breakthrough encouraging health and worldwide breakthrough encouraging health disciplines to study and practice transcultural disciplines to study and practice transcultural health care.health care.

The TheoryThe Theory

• The Culture Care Diversity and Universality The Culture Care Diversity and Universality theory, according to Dr. Leininger, focuses on theory, according to Dr. Leininger, focuses on describing, explaining and predicting nursing describing, explaining and predicting nursing similarities and differences focused primarily on similarities and differences focused primarily on human care and caring in human cultures. human care and caring in human cultures.

• The Culture Care Diversity & Universality theory The Culture Care Diversity & Universality theory does not focus on medical symptoms, disease does not focus on medical symptoms, disease entities or treatments.entities or treatments.

• It is instead focused on those methods of It is instead focused on those methods of approach to care that means something to the approach to care that means something to the people to whom the care is given.people to whom the care is given.

Development of the theoryDevelopment of the theory

• Developed in the mid-1950s and early 1960s.Developed in the mid-1950s and early 1960s.

• Developed particularly to discover the meanings Developed particularly to discover the meanings and ways to give care to people who have and ways to give care to people who have different values and lifeways.different values and lifeways.

• Designed to guide nurses to provide nursing care Designed to guide nurses to provide nursing care that fits with those that are being cared for.that fits with those that are being cared for.

• Culture Care theory not only focuses on nurse-Culture Care theory not only focuses on nurse-client interaction but the focus also includes care client interaction but the focus also includes care for families, groups, communities, cultures and for families, groups, communities, cultures and institutions.institutions.

The Sunrise EnablerThe Sunrise Enabler

• The theory includes an enabler ( Dr.Leininger The theory includes an enabler ( Dr.Leininger prefers it not be called a model), serves as a prefers it not be called a model), serves as a conceptual guideconceptual guide or or cognitive mapcognitive map to guide to guide nurses in the systematic study of all dimensions nurses in the systematic study of all dimensions of the theory.of the theory.

• This map or guide is called the This map or guide is called the Sunrise EnablerSunrise Enabler..

Application of the theoryApplication of the theory

• Key elements of a method of application in Key elements of a method of application in Practice Methodology have been identified by Dr. Practice Methodology have been identified by Dr. Leininger and they are (1) goals of nursing which Leininger and they are (1) goals of nursing which address practices,clients (2) cultural assessment ( address practices,clients (2) cultural assessment ( using the Sunrise Enabler) and (3) nursing using the Sunrise Enabler) and (3) nursing judgments, decisions and actions.judgments, decisions and actions.

• Research findings are used to develop protocols Research findings are used to develop protocols for cultural-congruent care that blends with the for cultural-congruent care that blends with the particular cultural values, beliefs and lifeways of particular cultural values, beliefs and lifeways of the client.the client.

Four metaparadigm Four metaparadigm conceptsconcepts

• Leininger criticizes the four nursing Leininger criticizes the four nursing metaparadigm concepts of person, metaparadigm concepts of person, environment, health, and nursing.environment, health, and nursing.

• Furthermore, she defines these Furthermore, she defines these concepts in her theoryconcepts in her theory

Metaparadigm concepts Metaparadigm concepts defineddefined• Nursing: Nursing: carecare has the greatest meaning has the greatest meaning

which explains nursingwhich explains nursing

• Person: should refer to families, groups, Person: should refer to families, groups, and communitiesand communities

• Health: not distinct to nursing as many Health: not distinct to nursing as many disciplines use this termdisciplines use this term

• Environment: included events with Environment: included events with meanings and interpretations given to meanings and interpretations given to them in particular physical, ecological, them in particular physical, ecological, sociopolitical or cultural setting.sociopolitical or cultural setting.

Application of TheoryApplication of Theory

• Care always occurs in a cultural contextCare always occurs in a cultural context

• Culture is viewed as framework people Culture is viewed as framework people use to solve human problemsuse to solve human problems

• Culture is “the lifeways of an individual Culture is “the lifeways of an individual or a group with reference to values, or a group with reference to values, beliefs, norms, patterns, and practices” beliefs, norms, patterns, and practices” (Leininger, 1997, p. 38)(Leininger, 1997, p. 38)

Assessment of ClientAssessment of Client

• Information on culture is essential for Information on culture is essential for holistic assessment of an individual, holistic assessment of an individual, family, or communityfamily, or community

• The assessment process must be The assessment process must be comprehensive, accurate, and comprehensive, accurate, and systemicsystemic

• Individual’s, family’s, or community’s Individual’s, family’s, or community’s perspective of their culture is needed perspective of their culture is needed for an accurate assessment.for an accurate assessment.

Leininger’s Assessment Leininger’s Assessment ProcessProcess• Nurse approaches an individual, Nurse approaches an individual,

family, or community with the intent family, or community with the intent to gain understanding of the to gain understanding of the expressions, patterns of health, and expressions, patterns of health, and carecare

• Nurse obtains knowledge about the Nurse obtains knowledge about the dynamic cultural and social structural dynamic cultural and social structural dimensions influencing health.dimensions influencing health.

Leininger’s Assessment Leininger’s Assessment ProcessProcess

• Nurse invites an individual, family, or Nurse invites an individual, family, or community to describe their own community to describe their own experience about health and caringexperience about health and caring

• Nurse documents the description of Nurse documents the description of an individual’s, family’s, or an individual’s, family’s, or community’s cultural and social community’s cultural and social structure that influence health structure that influence health patterns and concernpatterns and concern

Conclusion Conclusion

We live in a city that is rich in diversity. We live in a city that is rich in diversity. How, then, should we treat one How, then, should we treat one another? We should value diversity. We another? We should value diversity. We have the capacity to perform a cultural have the capacity to perform a cultural self-assessment. We should be self-assessment. We should be conscious of the dynamics inherent conscious of the dynamics inherent when cultures interact and we should when cultures interact and we should exercise cultural awareness. Being exercise cultural awareness. Being culturally competent is essential to culturally competent is essential to being an efficient nurse. being an efficient nurse.