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CULTURAL CARE DIVERSITY AND UNIVERSALITY THEORY�� MADELEINE M. LEININGER ST. LUKE’S COLLEGE OF NURSING TRINITY UNIVERSITY OF ASIA

MADELEINE LEININGER Born in Sutton, Nebraska July 13, 1925 Received her Basic Nursing Education from St. Anthony’s School of Nursing in 1948 Received her Bachelor of Science from Mount St. Scholastica College in 1950 Received her Master of Science in Psychiatric-Mental Health Nursing from The Catholic University of America in 1954 Received her Ph.D. in Cultural and Social Anthropology from the University of Washington in 1965

MADELEINE LEININGER Dr. Leininger is the founder of Transcultural Nursing She is a fellow in the American Academy of Nursing She was named a “Living Legend” by the American Academy of Nursing in 1998 She is Professor Emeritus in the College of Nursing, Wayne State University and Adjunct Professor at the University of Nebraska Medical Center, College of Nursing, Omaha

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 to face unfavorable human conditions, illness or death in culturally meaningful ways. DEFINITION OF TRANSCULTURAL NURSING

The study of nursing care beliefs, values and practices as cognitively perceived and known by a designated culture through their direct experience, beliefs and value system. DEFINITION OF ETHNONURSING

Humans are believed to be caring and to be capable of being concerned about the needs, well-being and survival of others. Human care is universal, that is, seen in all cultures. Humans are universally caring beings who survive in a diversity of cultures through their ability to provide the universality of care in a variety of ways according to differing cultures, needs and settings. HUMAN BEINGS

Defined as a ‘state of well-being that is culturally defined, valued and practiced, and which reflects the ability of individuals (or groups) to perform their daily role activities in culturally expressed, beneficial and patterned lifeways’. HEALTH

Society or environment are not terms that are defined by Leininger but she instead speaks of worldview, social structure and environmental context. The concept of culture is closely related to society or environment and is considered as a central theme in her theory. ENVIRONMENT

Defined as ‘a learned humanistic and scientific profession and discipline focused on human care phenomena and caring activities in order to assist, support, facilitate or enable individuals or groups to maintain or regain their health or well-being in culturally meaningful and beneficial ways, or to help individuals face handicaps or death’. NURSING

Professional nursing care is defined as ‘formal and cognitively learned professional care knowledge and practice skills, obtained through educational institutions, that are expected to provide assistive, supportive, enabling or facilitative acts to or for another individual or group in order to improve a human health condition (or well-being), disability, lifeway or to work with dying clients’. NURSING

Culturally congruent (nursing) care is defined as ‘those cognitively based assistive, supportive, facilitative or enabling acts or decisions that are tailor-made to fit with individual, group or institutional cultural values, beliefs and lifeways in order to provide or support meaningful, beneficial and satisfying health care or well-being services’. NURSING

The term Transcultural Nursing is used today to refer to the evolving knowledge and practices related to this new field of study and practice. Leininger stresses the importance of knowledge gained from direct experience or directly from those who have experienced and labels such knowledge as emic or people-centered. This is in contrast with etic knowledge or professional perspective. TRANSCULTURAL NURSING

Leininger contends that emically derived care knowledge is essential to establish nursing’s epistemological ( the branch of philosophy that studies the nature of knowledge, in particular its foundations, scope, and validity) and ontological ( the most general branch of metaphysics, concerned with the nature of being) base for practice. TRANSCULTURAL NURSING

Leininger built her theory of transcultural nursing on the premise that the peoples of each culture can not only know and define the ways in which they experience and perceive their nursing care world but also relate these experiences and perceptions to their general health beliefs and practices. TRANSCULTURAL NURSING

Leininger presented assumptions that support her prediction that ‘different cultures perceive, know, and practice care in different ways, yet there are some commonalities about care among all cultures of the world’. She refers to the commonalities as universality and to the differences as diversity. TRANSCULTURAL NURSING

Culture is the ‘learned, shared and transmitted knowledge of values, beliefs, norms and lifeways of a particular group that guides an individual or group in their thinking, decisions and actions in patterned ways’��. TRANSCULTURAL NURSING

Subculture is ‘closely related to culture and refers to a group that deviates in certain areas from the dominant culture in values, beliefs, norms, moral codes and ways of living with some distinctive features of its own’. TRANSCULTURAL NURSING

Culture care is defined as ‘the subjectively and objectively learned and transmitted values, beliefs and patterned lifeways that assist, support, facilitate or enable another individual or group to maintain well-being and health, to improve the human condition and lifeway or to deal with illness, handicaps or death’. TRANSCULTURAL NURSING

Culture Care Diversity indicates ‘the variabilities and/or differences in meanings, patterns, values, lifeways or symbols of care within or between collectives that are related to assistive, supportive or enabling human care expressions’. TRANSCULTURAL NURSING

Culture Care Universality indicates ‘the common, similar, or dominant uniform care meanings, patterns, values, lifeways or symbols that are manifest among many cultures and reflect assistive, supportive, facilitative or enabling ways to help people’. TRANSCULTURAL NURSING

Worldview is the way in which people look at the world, or at the universe, and form a picture or value stance about the world and their lives. TRANSCULTURAL NURSING

Cultural and social structure dimensions are defined as involving ‘the dynamic patterns and features or interrelated structural and organizational factors of a particular culture which includes religious, kinship, political, economic, educational, technologic and cultural values, ethnoshistorical factors and how these factors may be interrelated and function to influence human behavior in different environmental contexts’. TRANSCULTURAL NURSING

Environmental context is ‘the totality of an event, situation or particular experiences that give meaning to human expressions, interpretations and social interactions in particular physical, ecological, sociopolitical, and/or cultural setting’. TRANSCULTURAL NURSING

Ethnohistory includes ‘those past facts, events, instances and experiences of individuals, groups, cultures and institutions that are primarily people-centered (ethno) and which describe, explain, and interpret human lifeways within particular cultural contexts over short or long periods of time’. TRANSCULTURAL NURSING

Generic (folk or lay) care systems are ‘culturally learned and transmitted, indigenous (or traditional), folk (home-based) knowledge and skills used to provide assistive, supportive enabling or facilitative acts toward or for another individual, group or institution with evident or anticipated needs to ameliorate or improve a human lifeway, health condition (or well-being) or to deal with handicaps and death situations’. TRANSCULTURAL NURSING

Professional care systems are defined as ‘formally taught, learned and transmitted professional care, health, illness, wellness and related knowledge and practice skills that prevail in professional institutions, usually with multidisciplinary personnel to serve consumers’. TRANSCULTURAL NURSING

Care as a noun is defined as those ‘abstract and concrete phenomena related to assisting, supporting, or enabling experiences or behaviors toward or for others with evident or anticipated needs to ameliorate or improve a human condition or lifeway’. TRANSCULTURAL NURSING

Care as a gerund is defined as ‘actions and activities directed toward assisting, supporting or enabling another individual or group with evident or anticipated needs to ameliorate or improve a human condition or lifeway or to face death’. TRANSCULTURAL NURSING

Culture care preservation, also known as maintenance, includes those ‘assistive, supportive, facilitative or enabling professional actions and decisions that help people of a particular culture to retain and/or preserve relevant care values so that they can maintain their well-being, recover from illness or face handicaps and/or death’. TRANSCULTURAL NURSING

Culture care accommodation, also known as negotiation, includes those ’assistive, supporting, facilitative or enabling creative professional actions and decisions that help people of a designated culture adapt to or negotiate with others for a beneficial or satisfying health outcome with proffesional care providers’. TRANSCULTURAL NURSING

Culture care repatterning, also known as restructuring, includes those ’assistive, supporting, facilitative or enabling professional actions and decisions that help clients eorder, change or greatly modify their lifeways for new, different and beneficial health care patterns while respecting client’s cultural values and beliefs and providing a lifeway more beneficial or healthier than before the changes were co-established with the clients’. TRANSCULTURAL NURSING

“ Education is an ornament in prosperity and a refuge in adversity.” �� Aristotle (384 BC – 322 BC)�� Greek��philosopher, a student of��Plato��and teacher of��Alexander the Great Think about this………………………

George, Julia B., 2008, Nursing Theories: The Base for Professional Nursing Practice. Fifth Edition. Prentice Hall REFERENCE

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Madeleine leininger

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