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JOURNAL OF TRANSCULTURAL NURSING / JULY 2002Leininger / CULTURE CARE THEORY

Culture Care Theory: A Major Contribution to Advance Transcultural Nursing Knowledge and Practices

MADELEINE LEININGER, PhD, LHD, DS, CTN, FAAN, FRCNA

This article is focused on the major features of the Culture Care Diversity and Universality theory as a central contrib- uting theory to advance transcultural nursing knowledge and to use the findings in teaching, research, practice, and consul- tation. It remains one of the oldest, most holistic, and most comprehensive theories to generate knowledge of diverse and similar cultures worldwide. The theory has been a powerful means to discover largely unknown knowledge in nursing and the health fields. It provides a new mode to assure culturally competent, safe, and congruent transcultural nursing care. The purpose, goal, assumptive premises, ethnonursing research method, criteria, and some findings are highlighted.

This article is focused on the 2001 Pittsburgh Precon- ference theme “Major Contributions of Book Authors to Transcultural Nursing Knowledge and Practices.” As the founder of the discipline and author of 28 books and 220 pub- lished articles, I hold that my Culture Care Diversity and Uni- versality theory has made a significant contribution to estab- lish and advance transcultural nursing research knowledge and practice since the mid-1950s. This article is a brief synop- sis of culture care theory with its unique features and major contributions to support transcultural nursing as a discipline and practice field.

In establishing this new discipline, different lines of think- ing and practice were essential. It necessitated futuristic vision, risk taking, commitment, patience, and leadership to challenge many traditional nursing ideas and practices. Unquestionably new knowledge and practices were essential for nurses to function in a rapidly changing multicultural

world. Substantive theory-based research knowledge was greatly needed with a global and comparative focus to care for people of diverse cultures. Culturally based care knowledge was the major missing area in nursing in the mid-20th century and still is in some places in the world. I coined the construct of culturally congruent care, which is the central goal of the theory.

In my first two books,Nursing and Anthropology(1970) and Transcultural Nursing: Concepts, Theories, Research, and Practice(1978), the nature, rationale, need, and theoreti- cal base were given to establish transcultural nursing. Nurses needed in-depth knowledge of cultures with an anthropologi- cal view and in-depth, culturally based care phenomena. I held that care was the essence of nursing and had meaning within cultural contexts. Care was not fully known and valued in nursing, and so it was a challenge to get nurses interested in the Culture Care theory in the 1950s and 1960s as the medical mind-body treatments and symptoms held nurses’ interests and practices (Leininger, 1991). Moreover, many nurses believed care was “too soft, feminine, and nonscientific” and “culture was irrelevant and unnecessary.” With my persis- tence and enthusiasm for the theory, some nurses began to support the idea.

In 1991, the theory bookCulture Care Diversity and Uni- versalitytook hold and was a great breakthrough in caring for the culturally different. This book has been the primary and definitive resource to discover largely unknown and limitedly valued culture care knowledge and practical uses in client care. My second edition ofTranscultural Nursing(1995) con- tributed a wealth of new research-based knowledge on 30 Western and non-Western cultures, plus refinements in research methods, teaching, clinical practices, and adminis- tration. The third edition ofTranscultural Nursingby Leininger and McFarland (2002) provides theory-based research and practice by transcultural nurse scholars in many