CULTURE  CARE:  DIVERSITY  AND  UNIVERSALITY  THEORY  

MADELEINE  LEININGER  

MADELEINE  LEININGER  •  Madeleine  Leininger  was  born  in  SuAon,  Nebraska.    •  In  1948,  she  received  her  diploma  in  Nursing  from  St.  Anthony’s  School  of  Nursing  in  Denver,  Colorado.  

•  In   1950,   she   earned   a   B.S.   from   St.   ScholasUca  (BenedicUne   College)   in   Atchison,   Kansas,   and   in  1954   earned   an   M.S.   in   Psychiatric   and   Mental  Health   Nursing   from   the   Catholic   University   of  America  in  Washington,  D.C.    

•  In   1965,   she   was   awarded   a   Ph.D.   in   Cultural   And  Social   Anthropology   from   the   University   of  Washington,  SeaAle  (Tomey  and  Alligood,  2001).  

MADELEINE  LEININGER  

TRANSCULTURAL  NURSING  

Defined   as   a   substanUve   area   of   study   and  pracUce  focused  on  comparaUve  cultural  care  (caring)   values,   beliefs,   and   pracUces   of  individuals   or   groups   of   similar   or   different  cultures   with   the   goal   of   providing   culture-­‐specific  and  universal  nursing  care  pracUces  in  promoUng   health   or   well-­‐being   or   to   help  people  to  face  unfavorable  human  condiUons,  illness,  or  death  in  culturally  meaningful  ways.  

Leininger’s   theory   is   to   provide   care  measures   that   are   in   harmony   with   an  individual   or   group’s   cultural   beliefs,  pracUces,   and   values.   In   the   1960’s,   she  c o i n e d   t h e   t e rm   CUL TURA L L Y  CONGRUENT  CARE,  which  is  the  primary  goal   of   TRANSCULTURAL   NURSING  PRACTICE.  

Leininger  developed  new  terms  for  the  basic  tenets  of  her  theory:  

Ø CARE   is   to   assist   others  with   real   or   anUcipated  needs  in  an  effort  to  improve  a  human  condiUon  of  concern  or  to  face  death.  

Ø CARING   is  an  acUon  or  acUvity  directed   towards  providing  care.  

Ø CULTURE   refers   to   learned,   shared,   and  transmiAed   values,   beliefs,   norms,   and   lifeways  of   a   specific   individual   or   group   that   guide   their  thinking,   decisions,   acUons,   and   paAerned   ways  of  living.  

Leininger  developed  new  terms  for  the  basic  tenets  of  her  theory:  

Ø CULTURAL   CARE   refers   to   mulUple   aspects   of  culture   that   influence   and   enable   a   person   or  group   to   improve   their   human   condiUon   or   to  deal  with  illness  or  death.  

Ø CULTURAL   CARE   DIVERSITY   refers   to   the  differences   in   meanings,   values,   or   acceptable  modes   of   care   within   or   between   different  groups  of  people.  

Ø CULTURAL   CARE   UNIVERSALITY   refers   to  common   care   or   similar   meanings   that   are  evident  among  many  cultures.  

Leininger  developed  new  terms  for  the  basic  tenets  of  her  theory:  

Ø NURSING   is   a   learned   profession   with   a  disciplined  focused  on  care  phenomena.  

Ø WORLDVIEW   refers   to   the   way   people   tend   to  look   at   the   world   or   universe   in   creaUng   a  personal  view  of  what  life  is  about.  

Ø HEALTH   refers   to   a   state   of   well-­‐being   that   is  culturally   defined   and   valued   by   a   designated  culture.  

Leininger  developed  new  terms  for  the  basic  tenets  of  her  theory:  

CULTURAL   AND   SOC IA L   S TRUCTURE  DIMENSIONS   include   factors   related   to  religion,   social   structure,   poliUcal/legal  concerns,   economics,   educaUonal   paAerns,  the   use   of   technologies,   cultural   values,   and  ethnohistory  that  influence  cultural  responses  of  human  beings  within  a  cultural  context.  

Leininger  developed  new  terms  for  the  basic  tenets  of  her  theory:  

Ø Cultural  care  preservaUon  or  maintenance  refers  to   nursing   care   acUviUes   that   help   people   of  parUcular  cultures  to  retain  and  use  core  cultural  care   values   related   to   healthcare   concerns   or  condiUons.  

Ø Cultural   care   accommodaUon   or   negoUaUon  refers   to   creaUve   nursing   acUons   that   help  people   of   a   parUcular   culture   adapt   to   or  negoUate   with   others   in   the   healthcare  community   in  an  effort  to  aAain  the  shared  goal  of   an   opUmal   health   outcome   for   client(s)   of   a  designated  culture.  

Leininger  developed  new  terms  for  the  basic  tenets  of  her  theory:  

CULTURAL   CARE   REPATTERN ING   OR  RESTRUCTURING  refers  to  therapeuUc  acUons  taken   by   culturally   competent   nurse(s)   or  family.  These  acUons  enable  or  assist  a   client  to  modify   personal   health   behaviors   towards  beneficial   outcomes   while   respecUng   the  client’s  cultural  values.  

Leininger’s  assumpUons  derived    from  her  theory:  

ü Care   is   the   essence   and   central   focus   of  nursing.  

ü Caring   is   essenUal   for   health   and   well-­‐being,  healing,   growth,   survival,   and   also   for   facing  illness  or  death.  

ü Culture  care   is  a  broad  holisUc  perspecUve  to  guide  nursing  care  pracUces.  

Leininger’s  assumpUons  derived    from  her  theory:  

ü Nursing’s   central   purpose   is   to   serve   human  beings  in  health,  illness,  and  if  dying.  

ü There  can  be  no  curing  without  the  giving  and  receiving  of  care.  

ü Culture  care  concepts  have  both  different  and  similar   aspects   among   all   cultures   of   the  world.  

Leininger’s  assumpUons  derived    from  her  theory:  

ü Every   human   culture   has   folk   remedies,  professional  knowledge,  and  professional  care  pracUces   that   vary.   The   nurse   must   idenUfy  and   address   these   factors   consciously   with  each   client   in   order   to   provide   holisUc   and  culturally  congruent  care.  

Leininger’s  assumpUons  derived    from  her  theory:  

ü Cultural  care  values,  beliefs,  and  pracUces  are  influenced  by  worldview  and  language,  as  well  as   religious,   spiritual,   social,   poliUcal,  educaUonal,   economic,   technological,  ethnohistorical,  and  environmental  factors.  

ü Beneficial,   healthy,   saUsfying   culturally   based  nursing   care   enhances   the   well-­‐being   of  clients.  

Leininger’s  assumpUons  derived    from  her  theory:  

ü Culturally   beneficial   nursing   care   can   only  occur  when  cultural  care    values,  expressions,  or  paAerns  are  known  and  used  appropriately  and  knowingly  by  the  nurse  providing  care.  

ü Clients  who  experience  nursing  care  that   fails  to   be   reasonably   congruent   with   the   client’s  cultural   beliefs   and   values   will   show   signs   of  stress,   cultural   conflict,   noncompliance,   and  ethical  moral  concerns.  

A  Culturally  Competent  Nurse  

Consciously   addresses   the   fact   that   culture   affects  nurse–client  exchanges……………  

ü With   compassion   and   clarity,   asks   each   client  what  their  cultural  pracUces  and  preferences  are.  

ü Incorporates   the   client’s   personal,   social,  environmental,   and   cultural   needs/beliefs   into  the  plan  of  care  wherever  possible.  

ü Respects   and   appreciates   cultural   diversity,   and  strives   to   increase   knowledge   and   sensiUvity  associated  with  this  essenUal  nursing  concern.  

In  summary:  

v Culturally   competent   nursing   care   can   only  occur   when   client   beliefs   and   values   are  thougheully   and   skillfully   incorporated   into  nursing  care  plans.    

v Caring  is  the  core  of  nursing.    v Culturally  competent  nursing  guides  the  nurse  to   provide   opUmal   holisUc,   culturally   based  care.  

Think  about  this:  

“You   really   can   change   the   world   if   you   care  enough.”  —  Marian  Wright  Edelman  

Marian  Wright   Edelman   (born   June   6,   1939)   is  an  American  acUvist  for  the  rights  of  children.  She  is  president  and  founder  of  the  Children's  Defense  Fund.