Madeleine Leininger’sMadeleine Leininger’s Culture Care Theory Culture Care Theory

Dileep KumarDileep Kumar MSc. N StudentMSc. N Student

College of Nursing, JPMC, Karachi College of Nursing, JPMC, Karachi

ObjectivesObjectives

Today’s my presentation objectives are to;

• Introduce the Theorist Madeleine Leininger• Define culture care theory and Sun Rise model• List the purpose and goals of the culture care

theory• Define major assumptions of culture care theory• Describe the Metaparadigm of theory• Discuss about the nursing implications of theory

Credentials & Background of TheoristCredentials & Background of Theorist

• Madeleine Leininger is a Founder of Transcultural Nursing and Human Care Theory

• First professional Nurse with graduate preparation in nursing to hold a PhD

• Was born in Sutton, Nebraska in 1920

• 1948 Diploma in Nursing, Was in US army Nurse corps, while pursuing the basic nursing program

• 1950 BS in Biological Sciences

• 1954 obtained master degree in psychiatric nursing

• Initiated and directed the 1st Graduated Nursing Program in Psychiatric Nursing at University of Cincinnati

Credentials & Background of TheoristCredentials & Background of Theorist• 1966 offered 1st course in Transcultural Nursing in

University of Colorado

• 1969 appointed as Dean and Professor of Nursing and Lecturer in Anthropology

• Studied 14 major cultures in depth and has had experience with many different additional cultures.

• Authored or edited more than 27 books

• Published more than 200 articles and 45 chapters plus numerous research projects focused on transcultural nursing, human care and health phenomena.

• 1974, initiated National Transcultural Nursing Society org:

• 1989, initiated Journal of Transcultural Nursing

Her other Areas of InterestBesides transcultural nursing with care as a

central focus her other areas of interest are;• Comparative education and administration• Nursing theories• Politics• Ethical dilemmas of nursing and health care• Qualitative research methods• Future of nursing and health care• Nursing leadership

Theoretical sourcesTheoretical sources

• Derived from disciplines of anthropology and nursing but is reformulated to be transcultural nursing with human care perspective

• She has defined the transcultural nursing as a major area of nursing that focuses on a comparative study and analysis of different cultures and subcultures in the world with respect to their caring values, expressions, and health-illness beliefs and pattern of behavior with the goal to develop a scientific and humanistic knowledge to provide culture specific and/or culture universal nursing care practice.

Development of the theory

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

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

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

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

The TheoryThe Theory Culture Care: Diversity and Universality

• Focuses on describing, explaining and predicting nursing similarities and differences focused primarily on human care and caring in human cultures.

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

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

Central Purpose of the TheoryCentral Purpose of the Theory

• To discover and explain diverse and universal culturally based care factors influencing the health, well being , illness or death of individuals or groups

Goals Goals

• To give culturally congruent care• To discover the meanings and ways to give care to

people with different values• To promote well-being, growth & development,

healthy lifestyles and recovery from illness• To work & function effectively with people having

different values, beliefs, and ideas about nursing, health, caring, wellness, illness, death & disability

Major AssumptionsMajor Assumptions

1.Care is the essence of nursing and a distinct, dominant, central and unifying focus.

2.Care (caring) is essential for well-being, health, growth, survival and to face handicaps or death.

3.Culturally based care is the broadest holistic means to know, explain, interpret and predict nursing care phenomena and to guide nursing decisions and actions

4. Nursing is a transcultural humanistic and scientific care discipline and profession with the central purpose of serving individuals, groups, communities or institutions worldwide.

Major AssumptionsMajor Assumptions

5. Care (caring) is essential to curing and healing, for there can be no curing without caring

6. Culture care concepts, meanings, expressions, patterns, processes, and structural forms of care vary transculturally with diversities and some universalities

7. Every human culture has generic (lay, folk or indigenous) care knowledge and practices which vary transculturally

Major AssumptionsMajor Assumptions

8. Culture care values, beliefs, and practices are influenced by and tend to be imbedded in the worldview, language, philosophy, religion (and spirituality), kinship, social, political, legal, educational, economic, technological, ethno historical, and environmental context of cultures

9. Beneficial, healthy and satisfying culturally-based care influences the health and well-being of individuals, families, groups, and communities within their environmental context

10. Culturally congruent or beneficial nursing care can only occur when individual, group, family, community, or institutional care values, expressions, or patterns are known and used explicitly in appropriate and meaningful ways

Major AssumptionsMajor Assumptions11. Culture care differences and similarities between

professionals and client participants exists in all human cultures worldwide

12 Culture conflicts, imposition practices, cultural stresses and pain reflect the lack of professional care knowledge to provide culturally congruent, responsible,

and sensitive care

13. The ethnonursing qualitative research method provides an important means to discover and accurately interpret emic and etic embedded, complex and diverse culture care factors

The Sunrise Model (developed in1970)

• Serves as a conceptual guide or cognitive map to guide nurses in the systematic study of all dimensions of theory.

• Symbolize “rising of the sun(care)”

• Upper half of the circle depicts component of the social structure and world view factors that influence care and health through language, ethnohistory and environmental context.

• These factors also influence the folk, professional and nursing system(s), which are in the middle part of the model.

Sun Rise Model

• Nursing act as a bridge between the folk generic and the professional system

• Three kinds of nursing care & decisions and actions are predicted in theory1. Cultural care preservation and maintenance

2. Cultural care accommodation and/or negotiation

3. Cultural care repatterning and/or restructuring

ScopeScope• She includes care/caring beyond the interpersonal level to

include families, groups & cultures.

• She is searching for worldwide human meanings

• Theory has multiple levels of scope dealing with human cultures and nursing worldwide

– Broad macro level (etic analysis)

– Middle range (emic analysis)

– Concrete empirical level

• Sunrise model pictorially depicts the multiple theoretical levels

• 90 cultures in Western and non-Western worlds have been studied with the theory and 185 care constructs have been identified

Metaparadigm concepts definedMetaparadigm concepts defined• Nursing: care has the greatest meaning which

explains nursing• Person: should refer to families, groups, and

communities• Health: not distinct to nursing as many disciplines

use this term• Environment: included events with meanings and

interpretations given to them in particular physical, ecological, sociopolitical or cultural setting.

Nursing Implications

• Nurse can asses, understand and plan care for patient in tradition way

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

• Leininger’s theory does not focus on medical symptoms, disease, or treatment, it focuses on the nurse’s approach to care (this is truly a holistic nursing idea!)

Nursing Implications

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

– Modify your nursing care to your patients with the goal of improving their comfort and response to care

– Utilize this theory for holistic assessments of the patient

ConclusionConclusion

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

References• Basvanthappa, B.T.(2007). “Nursing Theories” 1st Edition,

Jaypee Brothers, New Delhi

• Leininger, M. (2002) “Culture Care Theory: A Major Contribution to Advance Transcultural Nursing Knowledge and Practices”, Journal of Transcultural Nursing, Vol. 13 No. 3, 189-192. retrieved on 25-12-2009 from http://tcn.sagepub.com/cgi/reprint/13/3/189.pdf

• Tommy, A. M., & Alligood, M. R. (1998). “Nursing theorists and their works” 4th edition, A Harcourt Health Sciences Company. Mosby

ThanksFor your Attention

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