Transcultural nursing concepts theories and practices madeleine leininger

TRANSCULTURAL NURSING

Transcultural Nursing Culture of Care by Madeleine Leininger

Gabrel Crabb, Koleen Dumindin, Deborah Edokpayi,

Javier Enriquez, Simone Gordon, & Heather Hammaker

South University

NSG5002- Advanced Theoretical Perspectives for Nursing

Week 4, Assignment 2

Dr. Crystal Fuller, DNP

February 28, 2017

PowerPoint Outline

I. Dr. Madeleine Leininger A. Brief Overview of the Background B. The Sunrise Model

II. Four Metaparadigms

A. Nurse

B. Patient

C. Environment

D. Health

III. Two Unique Concepts to Transcultural Nursing A. Care B. Culture

IV. The Theoretical Assertions and Propositions A. Care B. Culture

V. Leininger’s Culture Care Theory Critique and Analysis A. Description of Model B. Strengths C. Weaknesses

VI. Leininger Bullets A. Theory's Implications

VII. References

References

Leininger, M. (2002, July 3). Culture care theory: A major contribution to advance transcultural nursing knowledge and practices. Journal of Transcultural Nursing, 13, 189-192.

Purnell, L. (2009). Transcultural Health Care: A Culturally Competent Approach (3rd ed.). [Digital Bookshelf]. Retrieved from https://digitalbookshelf.southuniversity.edu/#/books/9780803620735/

Transcultural Nursing Theory Article Review 1

The Culture care theory: a major contribution to advance transcultural nursing knowledge and practice article by Madeleine Leininger elaborated about the importance and evolvement of culture based nursing and how it can affect the future of nursing. Culturally competent healthcare professionals are the major factors in increasing patient satisfaction and reducing the different causes of disparities such as gender, races and health complications (Purnell, 2009). Have you ever wondered how much intricacy in healthcare we can avoid and cost we can save if we equipped our healthcare personnel to be competent in caring a diverse population?

The article focused on the major and unique features of the culture care diversity and universality theory as a major reinforcement to increase advance transcultural nursing knowledge and to use the results in education, practice, research and collaboration. The theory has remained one of the oldest, most holistic and most comprehensive to produce wisdom to differentiate and recognize the similarities of cultures worldwide. The theory has been a great tool to explore the unknown knowledge in the world of nursing and health care. The assurance to provide transcultural congruent nursing care, competent and safe was made possible by the theory. The central purpose of the theory is to explore and understand various and common culturally based circumstance affecting the health, well-being, illness, or death of people (Leininger, 2002). Some of the feature of the theory is that it is the most holistic and multidimensional to discover specific culturally based care practices. It has abstract and practical features to deliver culturally congruent care.

Conclusion

With the many tragic events happening around the world, the importance of understanding of transcultural violence, racism, hatred and killing of innocent people should be a priority. The amount of troubles we can avoid would be significant if we have the knowledge to care for the diverse society. The article has proven strong correlation about the transcultural theory and patient satisfaction.

References

Gustafson, D. (2005). Transcultural Nursing Theory from a Critical Cultural Perspective. Advances in Nursing Science, 28, 2-16.

Purnell, L. D. (2014). GUIDE TO Culturally Competent Health Care (3rd ed.). Retrieved from Digital Bookshelf. Retrieved from: https://digitalbookshelf.southuniversity.edu/#/books/9780803641181/cfi/0!/4/2/2@0:74.4

Transcultural Nursing Theory Article Review 2

“Culture is defined as a composite of multiple differences producing, individual identity” (Gustafson, 2005, p. 2). We have established in many situations especially in nursing that being culturally competent is important to reach a successful outcome. Culturally competent is an individual who possess a set of skills, attitudes and communication ability to work harmonically with clients and families from diverse backgrounds. A health care professional who has a good understanding of her own culture, beliefs, values and their clients is in a good position to increase opportunity to promote health and wellness, prevent injuries and restore health and wellbeing (Purnell, 2014).

The article “Transcultural Nursing Theory from a Critical Cultural Perspective” by Diana Gustafson, identified two problems of the transcultural nursing theory. The author believes that the transcultural nursing theory works from a liberal perspective. It concentrates on a broadly defined limited concept of culture. Although the transcultural nursing theory shapes the nursing program and institutional policy, the author identified two problems in the theory. First the social and political framework of transcultural nursing theory misrepresent the suitable nursing care in a broadly defined but narrow concept of culture. Secondly, it is inaccurate because it roots from a liberal and depoliticizing point of view that maintains rather than separate the primary ways of approaching the human irregularities.

Conclusion

It is important to treat client in a holistic way; addressing all their needs in every aspect. The physical, mental, social, spiritual and cultural demands of patients and families will vary from one another. Self-awareness of our own values, beliefs and culture and a better understanding of multicultural diversities will assist us in promoting health, wellness and a state of equilibrium.

Reference

Busher Betancourt, Daniel A. 2015. Madeleine Leininger and the Transcultural Theory

of Nursing. The Downtown Review, Volume 2 Issue 1 Article 1. Retrieved from

http://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1020&context=tdr.

Transcultural Nursing Theory Article Review 3

In 2015, Daniel Busher Betancourt’s article for The Downtown Review, he examined Madeleine Leininger’s Theory of Transcultural Nursing. He explored her principles and how they are relevant to past present and future nursing. Within his article he also determined how this theory affected his current nursing practice.

Betancourt explains that Leininger’s theory helps to layout the nurse patient relationship more thoroughly. The nurse is at the bedside with the patient more often than any other medical personnel and is the one who implements the care of the patient. The objective for a nurse is for him or her to engulf him or herself into acquiring a thorough knowledge of cultures and the diversities that exist. Following the acquisition of this knowledge, the nurse must implement care that follows the cultural practices of the patient and to the patient’s standards.

The author further states that with the globalization of healthcare the importance of transcultural nursing is growing rapidly. Nurses have the benefit of meeting people from many different countries and backgrounds. While patients get benefit from the nursing care, the nurse also gains benefit from giving culturally sensitive care. Nurse provide interventions that cause curing but there can be no curing without care, and no care without being culturally sensitive to the patient’s needs. When a patient requires care outside the usual realm of care, nurse need to communicate with the patient and provide and accommodate what they can.

The author of this article clearly states and explains the Theory of Transcultural Nursing by Madeleine Leininger. He identifies the key feature and a clear understanding of her message about the advantages of providing care congruent with the cultural needs of the patient. Since Betancourt is of Puerto Rican descent, he could provide a personal perspective of the significance of living in an environment that is not of his cultural majority.

Conclusion

I believe it is critical for nurses to gain knowledge of their patients’ cultural realities to provide the very best care for their patients. I believe we are living in a world that enables us to encounter patients of many different cultural back grounds, and that our sensitivities to the patients must include acknowledgements of cultural needs to meet not only physical needs of the patients but also emotional needs.

Reference

Murphy, Sharon C. 2006. Mapping the Literature of Transcultural Nursing. Journal of the

Medical Library Association, Volume 94. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1463039/.

Transcultural Nursing Theory Article Review 4

Cultural care is not simply being aware of the need for culturally sensitive care but engaging in understanding and educating yourself to this care. Knowing as a nurse you need to provide holistic care is not enough. We, as nurses, must never stop educating ourselves and other nurses on the importance and existence of different cultural practices. We must know, largely know, and vaguely know cultural practices.

The author of this article, Sharon C. Murphy, identifies the need to implement a process for educating and expanding nurse’s knowledge of transcultural care; the basis for Madeleine Leininger’s theory. This article identifies the role of transcultural nurses. According to Murphy, nurses are open to new and current cultural care symbols, expressions, and meanings. Murphy proposes in her article that transcultural care has become recognized as one of the most rapidly growing and important aspects as the global community as it becomes more closely tied and complex. In the past thirty years nursing leaders and educators have identified this as a major part of education for nurses, as well as an urgent need for expansion. The article referenced the lack of citations relevant to transcultural nursing with the bulk of citations being during the years 1982-2000. The author also refers to the major contributors as being from the United States. This shows the recent trend in acceptance to cultural nursing, but it also identifies the need to expand both locally in the United States but also in other nations.

Conclusion

Murphy clearly states the need for transcultural nursing as well as those dedicated to the expansion of this theory in practice and education in her article. I believe that we must further develop research as well as implementation of transcultural nursing into course work for new and current nurses. The dedication of understanding the cultures is, in my opinion, pivotal to our care of patients. I also believe that this article is extremely important in identifying the need to establish further education of nurses into the need for this holistic care approach. Research is gaining popularity into this field, but it is easy to see that expansion of this theory is needed to further provide our practice with best care methods.

References

Dougerty, Molly C. 1979. Transcultural Nursing Concepts, Theories, and Practices. Medical

Anthropology Newsletter, Vol. 10, No. 4 (Aug., 1979), pp. 23-25. Retrieved from

https://www.jstor.org/stable/648185?seq=1#page_scan_tab_contents.

Transcultural Nursing Theory Article Review 5

Transcultural nursing is not debated on importance in nursing care. With this being said, as nurses we must never accept one theory’s model and need to look at all available models and develop improved versions of current knowledge. Madeleine Leininger’s theory of Transcultural Nursing is a building block for furthering nursing care but will need building as more is understood about diverse cultures and how they continue to evolve.

Molly Dougerty, in Transcultural Nursing Concepts, Theories, and Practices article, reviewed Madeleine Leininger’s theory of Transcultural nursing and agreed about the importance of the concept but states her belief of the need to further its model. She identifies the practical use of its application for undergraduate and beginning graduate nursing students. She states in Leininger’s book that the chapters provide insights by other writers, and she thinks there is a clear lack of correspondence into their publishing’s. Dougerty believes that a greater continuity is needed between the groups of authors. She does state that there is good data about the multiple cultural groups within the United States and the relevance of this data to caring for a diverse population, but she points out that much of the data is old and needs to continually be updated. She acknowledges Leininger’s role in the nursing community and regards her and her theory as the originator of transcultural nursing and culturally sensitive care.

Conclusion

This article reminds us as nurses that we must always continue to build and mold theory and practices to fit the ever-changing needs of our patients. I believe this article has extreme importance for nurses in remembering to critique nursing theory. We must not just accept what is placed in front of us. As one of my nursing professors stated in my undergrad “trust but verify” what we are given as practice. Often it is difficult to go against leaders in the field, but we will not become leaders without questioning and building current practice. Transcultural practice as stated, is relevant to positive patient outcomes, but there is an ever-changing need to grow all current practices.

Chart

Definitions

1. Care- assistive, supportive, and enabling experiences or ideas towards others with evident or anticipated needs to ameliorate or improve a human condition or lifeway. Caring refers to actions, attitudes and practices to help others with healing and wellbeing (Leininger, 2008).

2. Culture- Leininger 2008, defined culture as “...the learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular culture that guides thinking, decisions, and actions in patterned ways and often intergenerationally."

3. emic and etic care- The term emic refers to the local, indigenous, or insider’s cultural knowledge and view of the phenomena; whereas, etic refers to the outsiders view and the health professional's view and knowledge of the phenomena (Leininger, 2008).

4. Ethnohistory- past facts, events, instances, and experiences of human beings, groups, cultures, and institutions that occur over time that help explain past and current views on cultural care influencers of health and wellbeing (Leininger, 2008).

5. Culture Care Universality- the commonly shared or similar culture care phenomena features of human beings or a group with recurrent meanings that serve as a guide for care givers to provide assistive, supportive, facilitative, or enabling people for healthy outcomes (Leininger, 2008).

PowerPoint Handout

Slide 1

Slide 2

Madeleine Leininger started her nursing career at St. Anthony’s School of Nursing in Denver Colorado in 1948. In 1950 she earned her B.S. from Benedictine College. In 1954 she earned her M.S. degree in psychiatric and mental health nursing from Catholic University of America in Washington D.C. Finally, in 1965 she completed her PhD in cultural and social anthropology at the University of Washington.

Slide 3

Dr. Leininger recognized the need for culture care early in her career and started to work on the concepts to build the theory of culture care and universality for many years with many publications and trips abroad to assist and promote research with her ethnonursing technique. She was recognized for her achievements and cultural diversity is taught in healthcare worldwide. She was awarded the living legend award in 1998 by the American Academy of Nursing. Her life and work can be viewed at www.Madeleine-Leininger.com

Slide 4

The four metaparadigms of nursing, nurse, patient, health and environment, are essential concepts that are mutual to all areas of nursing and nursing theories. (Butts & Rich, 2015).

These common concepts, though maybe spoken of differently in all the nursing theories, are all addressed at some point or another. One such nursing theory is the “Transcultural Nursing” developed by Madeleine Leininger in the 1950s. Understanding the differences and similarities of values, beliefs and practices of individuals or a group by studying their culture with the aim of providing nursing care that is universal and culture-specific to promote health and well-being is the premise of the Transcultural Nursing theory described by Kraut (2013).

According to Petiprin (2016), Madeleine Leininger’s theory of Transcultural Nursing practice encompasses the nurse, the patient, the patient’s environment, and the patient’s approach to health and healthcare. Consideration of the patient’s culture is the focus of the nursing practice. The nurse performs an assessment of the patient’s healthcare perceptions and the cultural environment. This assessment allows the nurse to apply holistic and complimentary nursing care to the resources that the patient might access through his/her faith and culture. Each metaparadigm has been addressed in her theory. The “nurse” is the professionally trained individual with the knowledge and skills who will offer assistance and support to the “patient”, person, human being, with the focus on their cultural “environment”, values and practice in mind to promote the well-being of their “health” familiar to their cultural lifestyle.

Slide 5

Two other unique concepts that Madeleine addresses are care and culture. She spoke of the essence of nursing being care. Caring makes a human being human. Caring gives humans self-worth and inspiration to help others and get well. Leininger further went on to say that caring can exist without curing, but you cannot cure without caring. (Leininger, 2008). Culture was another unique concept that was discussed by Leininger. Leininger (2008) believed that the most comprehensive, holistic, broadest, and universal feature of any human being is culture. The phenomenon of cultural care is vital to the understanding and discovery of nurses as it relates to healing, advance nursing, and health care on a whole. (Leininger, 2008). As per Leininger (2008), the two most powerful hypothetical constructs vital to the survival, wellbeing and health of any human are care and culture. She further stated that to unlock the affluence of knowledge of health and nursing practices, an in-depth understanding of specific beliefs, culture care values, and human beings life experiences should be of the utmost importance.

Slide 6

Slide 7

Slide 8

Leininger, M., & McFarland, M.R. (2002). Transcultural Nursing: Concepts, theories, research,

& practice (3rd ed.). New York: McGraw Hill Medical Publishing Division.

Slide 9

Slide 10

Slide 11

Slide 12

Slide 13

References

Leininger, M. (2008). Overview of Leininger’s Theory of Culture Care Diversity and Universality. Retrieved from http://www.madeleine-leininger.com/cc/overview.pdf

Sitzman, K., & Eichelberger, L. W. (2015). Understanding the Work of Nurse Theorists. United States: Jones and Bartlett Publishers. Retrieved from http://nursing.jbpub.com/sitzman/ch15pdf.pdf

Slide 14

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Slide 17

References

Leininger, M. (2008). Overview of Leininger’s Theory of Culture Care Diversity and

Universality. Retrieved from http://www.madeleine-leininger.com/cc/overview.pdf

Presented by: G. Crabb, K. Dumindin, D. Edokpayi, J. Enriquez, S. Gordon & H. HammerSouth University NSG 5002March 2017TRANSCULTURAL NURSINGCULTURE OF CARE BYMADELEINE LEININGER

Presented by: G. Crabb, K. Dumindin, D. Edokpayi, J. Enriquez, S. Gordon & H. Hammer South University NSG 5002 March 2017

Transcultural nursing culture of care by Madeleine Leininger

1

•Born July 13, 1925•Educated as a nurse at Anthony's Hospital School of Nursing•Undergraduate degrees: Benedictine College and Creighton University•Graduate degree: Catholic University of America•Doctorate degree: University of Washington•Faculty positions at University of Cincinnati and University of Colorado•Dean of Nursing at University of Utah and University of WashingtonDR. MADELEINE LEININGER

Born July 13, 1925

Educated as a nurse at Anthony's Hospital School of Nursing

Undergraduate degrees: Benedictine College and Creighton University

Graduate degree: Catholic University of America

Doctorate degree: University of Washington

Faculty positions at University of Cincinnati and University of Colorado

Dean of Nursing at University of Utah and University of Washington

Dr. Madeleine Leininger

Madeleine Leininger started her nursing career at St. Anthony’s School of Nursing in Denver Colorado in 1948. In 1950 she earned her B.S. from Benedictine College. In 1954 she earned her M.S. degree in psychiatric and mental health nursing from Catholic University of America in Washington D.C. Finally in 1965 she completed her PhD in cultural and social anthropology at the University of Washington.

2

•1955 –1975 developed and promoted transcultural nursing •1975 Published the Sunrise Model to promote the concept•1998 Received Living Legend Award from American Academy of NursingDR. MADELEINE LEININGER

1955 – 1975 developed and promoted transcultural nursing

1975 Published the Sunrise Model to promote the concept

1998 Received Living Legend Award from American Academy of Nursing

Dr. Madeleine Leininger

Dr. Leininger recognized the need for culture care early in her career and started to work on the concepts to build the theory of culture care and universality for many years with many publications and trips abroad to assist and promote research with her ethnonursing technique. She was recognized for her achievements and cultural diversity is taught in healthcare worldwide. She was awarded the living legend award in 1998 by the American Academy of Nursing. Her life and work can be viewed at www.Madeleine-Leininger.com

3

•The four metaparadigms of nursing, nurse, patient, health and environment, are essential concepts that are mutual to all areas of nursing and nursing theories. (Butts & Rich, 2015).•According to Petiprin(2016), Madeleine Leininger’stheory of Transcultural Nursing practice encompasses the nurse, the patient, the patient’s environment, and the patient’s approach to health and healthcare.•The “nurse” is the professionally trained individual with the knowledge and skills who will offer assistance and support to the “patient”, person, human being, with the focus on their cultural “environment”, values and practice in mind to promote the well-being of their “health” familiar to their cultural lifestyle. FOUR METAPARADIGMS

The four metaparadigms of nursing, nurse, patient, health and environment, are essential concepts that are mutual to all areas of nursing and nursing theories. (Butts & Rich, 2015).

According to Petiprin (2016), Madeleine Leininger’s theory of Transcultural Nursing practice encompasses the nurse, the patient, the patient’s environment, and the patient’s approach to health and healthcare.

The “nurse” is the professionally trained individual with the knowledge and skills who will offer assistance and support to the “patient”, person, human being, with the focus on their cultural “environment”, values and practice in mind to promote the well-being of their “health” familiar to their cultural lifestyle.

Four MetaParadigms

The four metaparadigms of nursing, nurse, patient, health and environment, are essential concepts that are mutual to all areas of nursing and nursing theories. (Butts & Rich, 2015).

These common concepts, though maybe spoken of differently in all the nursing theories, are all addressed at some point or another. One such nursing theory is the “Transcultural Nursing” developed by Madeleine Leininger in the 1950s. Understanding the differences and similarities of values, beliefs and practices of individuals or a group by studying their culture with the aim of providing nursing care that is universal and culture-specific to promote health and well-being is the premise of the Transcultural Nursing theory described by Kraut (2013).

According to Petiprin (2016), Madeleine Leininger’s theory of Transcultural Nursing practice encompasses the nurse, the patient, the patient’s environment, and the patient’s approach to health and healthcare. Consideration of the patient’s culture is the focus of the nursing practice. The nurse performs an assessment of the patient’s healthcare perceptions and the cultural environment. This assessment allows the nurse to apply holistic and complimentary nursing care to the resources that the patient might access through his/her faith and culture. Each metaparadigm has been addressed in her theory. The “nurse” is the professionally trained individual with the knowledge and skills who will offer assistance and support to the “patient”, person, human being, with the focus on their cultural “environment”, values and practice in mind to promote the well-being of their “health” familiar to their cultural lifestyle.

4

Care•Essence of nursing being care•Caring makes a human being human•Caring gives humans self-worth and inspiration to help others and get well.•Caring can exist without curing, but you cannot cure without caring. (Leininger, 2008)Culture•The most comprehensive, holistic, broadest, and universal feature of any human being is culture.•Phenomenon of cultural care is vital to the understanding healing, advance nursing, and health care•Knowledge of health and nursing practices, an in-depth understanding of specific beliefs, culture care values, and human beings life experiences should be of the utmost importance.TWO UNIQUE CONCEPTS TO TRANSCULTURAL NURSING

Two Unique concepts to Transcultural nursing

Two other unique concepts that Madeleine addresses are care and culture. She spoke of the essence of nursing being care. Caring makes a human being human. Caring gives humans self-worth and inspiration to help others and get well. Leininger further went on to say that caring can exist without curing, but you cannot cure without caring. (Leininger, 2008). Culture was another unique concept that was discussed by Leininger. Leininger (2008) believed that the most comprehensive, holistic, broadest, and universal feature of any human being is culture. The phenomenon of cultural care is vital to the understanding and discovery of nurses as it relates to healing, advance nursing, and health care on a whole. (Leininger, 2008). As per Leininger (2008), the two most powerful hypothetical constructs vital to the survival, wellbeing and health of any human are care and culture. She further stated that to unlock the affluence of knowledge of health and nursing practices, an in-depth understanding of specific beliefs, culture care values, and human beings life experiences should be of the utmost importance.

5

Care

Caring makes a human being human

Culture

The most comprehensive, holistic, broadest, and universal feature of any human being is culture.

Knowledge of health and nursing practices, an in-depth understanding of specific beliefs, culture care values, and human beings life experiences should be of the utmost importance.

Phenomenon of cultural care is vital to the understanding healing, advance nursing, and health care

Caring gives humans self-worth and inspiration to help others and get well.

Caring can exist without curing, but you cannot cure without caring. (Leininger, 2008)

Essence of nursing being care

•Care is the essence and the central dominant, distinct, and unifying focus of nursing. •Humanistic and scientific care is essential for human growth, wellbeing, health, •survival, and to face death and disabilities. •Care (caring) is essential to curing or healing for there can be no curing without •caring. (This assumption was held to have profound relevance worldwide.) •Culture care is the synthesis of two major constructs which guides the researcher to discover, explain, and account for health, wellbeing, care expressions, and other human conditions. THE THEORETICAL ASSUMPTIONS

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

Humanistic and scientific care is essential for human growth, wellbeing, health,

survival, and to face death and disabilities.

Care (caring) is essential to curing or healing for there can be no curing without

caring. (This assumption was held to have profound relevance worldwide.)

Culture care is the synthesis of two major constructs which guides the researcher to discover, explain, and account for health, wellbeing, care expressions, and other human conditions.

The theoretical Assumptions

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•Culture care expressions, meanings, patterns, processes and structural forms are diverse but some commonalities (universals) exist among and between cultures. •Culture care values, beliefs, and practices are influenced by and embedded in the worldview, social structure factors (e.g. religion, philosophy of life, kinship, politics, economics, education, technology, and cultural values) and the ethnohistoricaland environmental contexts.•Every culture has generic [lay, folk, naturalistic; mainly emic] and usually some professional [etic] care to be discovered and used for culturally congruent care practice.THE THEORETICAL ASSUMPTIONS

Culture care expressions, meanings, patterns, processes and structural forms are diverse but some commonalities (universals) exist among and between cultures.

Culture care values, beliefs, and practices are influenced by and embedded in the worldview, social structure factors (e.g. religion, philosophy of life, kinship, politics, economics, education, technology, and cultural values) and the ethnohistorical and environmental contexts.

Every culture has generic [lay, folk, naturalistic; mainly emic] and usually some professional [etic] care to be discovered and used for culturally congruent care practice.

The theoretical Assumptions

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•Culturally congruent and therapeutic care occurs when culture care values, beliefs, expressions, and patterns are explicitly known and used appropriately, sensitively, and meaningfully with people of diverse or similar cultures. •Leininger’sthree theoretical modes of care offer new, creative, and different therapeutic ways to help people of diverse cultures. •Qualitative research paradigmatic methods offer important means to discover largely embedded, covert, epistemic, and ontological culture care knowledge and practices. •Transcultural nursing is a discipline with a body of knowledge and practices to attain and maintain the goal of culturally congruent care for health and wellbeing.THE THEORETICAL ASSUMPTIONS

Culturally congruent and therapeutic care occurs when culture care values, beliefs, expressions, and patterns are explicitly known and used appropriately, sensitively, and meaningfully with people of diverse or similar cultures.

Leininger’s three theoretical modes of care offer new, creative, and different therapeutic ways to help people of diverse cultures.

Qualitative research paradigmatic methods offer important means to discover largely embedded, covert, epistemic, and ontological culture care knowledge and practices.

Transcultural nursing is a discipline with a body of knowledge and practices to attain and maintain the goal of culturally congruent care for health and wellbeing.

The theoretical Assumptions

Leininger, M., & McFarland, M.R. (2002). Transcultural Nursing: Concepts, theories, research,

& practice (3rd ed.). New York: McGraw Hill Medical Publishing Division.

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•Leininger’sCCT is a significant framework in the nursing field; it is largely responsible for facilitating the shift from a unilateral cultural perspective of nursing to a multilateral form (Leininger, 2008, p. 1). •Being that the theory was established over half a century ago, it has had plenty of opportunity to be well-integrated into nursing practice and education, which it did. The theory is based on practical experience, which is a strong component of any theoretical framework. In order for a theory to be beneficial to a discipline, it must have practical advantages. •Nursing as a professional field is already under a lot of pressure, and generally does not spend time working out theoretical aspects that have no practical basis or measure. •The fact that Leininger’stheory also seeks to answer nursing issues that were relevant to that period in nursing further supports this idea (Sitzman, 2015, p. 93). So there is not a shadow of a doubt that CCT is a cornerstone of modern nursing practice, in which cultural diversity is an increasingly influential factor in healthcare.LEININGER’SCULTURE CARE THEORY CRITIQUE AND ANALYSIS

Leininger’s CCT is a significant framework in the nursing field; it is largely responsible for facilitating the shift from a unilateral cultural perspective of nursing to a multilateral form (Leininger, 2008, p. 1).

Being that the theory was established over half a century ago, it has had plenty of opportunity to be well-integrated into nursing practice and education, which it did. The theory is based on practical experience, which is a strong component of any theoretical framework. In order for a theory to be beneficial to a discipline, it must have practical advantages.

Nursing as a professional field is already under a lot of pressure, and generally does not spend time working out theoretical aspects that have no practical basis or measure.

The fact that Leininger’s theory also seeks to answer nursing issues that were relevant to that period in nursing further supports this idea (Sitzman, 2015, p. 93). So there is not a shadow of a doubt that CCT is a cornerstone of modern nursing practice, in which cultural diversity is an increasingly influential factor in healthcare.

Leininger’s Culture Care theory Critique and Analysis

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•In general, there is not much to criticize in terms of inefficiencies, specifically those that might be due to any lack of practical perspective on the theorist’s part. Leiningeris well-intentioned and articulate in her approach to transcultural care, providing a general summary of the theory with 13 essential tenets of the framework, and 11 inherent assumptions that support its integration with practice (Sitzman, 2015, p. 95). •These things have sufficiently served as the foundation of transcultural nursing as it is today, and Leiningerhas even made several attempts to keep the concept up to date by revising the theory and adding to it as necessary (Leininger, 2008; Sitzman, 2015). •Yet at the same time, the theory seems a bit general in some places, and in others even seems a bit off. For instance, Leininger(2008) holds that “culture is the broadest, most comprehensive, holistic and universal feature of human beings,” which she further extrapolates to mean that culture is the primary mechanism of health care (p. 2)•To support this point, we should consider the role of culture in society. In complex societies like America, culture’s role is much harder to define, because a singular culture itself is less clear. However, a natural tendency of people as humans is to form relationships with each other. LEININGER’SCULTURE CARE THEORY CRITIQUE AND ANALYSIS

In general, there is not much to criticize in terms of inefficiencies, specifically those that might be due to any lack of practical perspective on the theorist’s part. Leininger is well-intentioned and articulate in her approach to transcultural care, providing a general summary of the theory with 13 essential tenets of the framework, and 11 inherent assumptions that support its integration with practice (Sitzman, 2015, p. 95).

These things have sufficiently served as the foundation of transcultural nursing as it is today, and Leininger has even made several attempts to keep the concept up to date by revising the theory and adding to it as necessary (Leininger, 2008; Sitzman, 2015).

Yet at the same time, the theory seems a bit general in some places, and in others even seems a bit off. For instance, Leininger (2008) holds that “culture is the broadest, most comprehensive, holistic and universal feature of human beings,” which she further extrapolates to mean that culture is the primary mechanism of health care (p. 2)

To support this point, we should consider the role of culture in society. In complex societies like America, culture’s role is much harder to define, because a singular culture itself is less clear. However, a natural tendency of people as humans is to form relationships with each other.

Leininger’s Culture Care theory Critique and Analysis

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•The way that these relationships are categorized can be said to give rise to various cultures. For example, people of a common culture would form strong, supportive relationships, while two of a less common culture might identify with each other much less due to a difference in values. •Consider, for example, civil rights. In the U.S., this movement caused a swelling of “black pride,” a unique culture in its own right.•Although the goal was to achieve a unification of society, its mechanism was to highlight the differences in quality between black and white lifestyles, which in turn gave rise to the notion of two separate cultures, even within the same social institution. •As such, how can we truly suggest that culture is the most universal of humanistic traits that would serve to benefit health care? Again, it should not be taken to mean that culture is useless in understanding care perspectives, but rather that culture is secondary to the relationships that we as people establish with each other based on our common humanity.LEININGERSCULTURE CARE THEORY CRITIQUE AND ANALYSIS

The way that these relationships are categorized can be said to give rise to various cultures. For example, people of a common culture would form strong, supportive relationships, while two of a less common culture might identify with each other much less due to a difference in values.

Consider, for example, civil rights. In the U.S., this movement caused a swelling of “black pride,” a unique culture in its own right.

Although the goal was to achieve a unification of society, its mechanism was to highlight the differences in quality between black and white lifestyles, which in turn gave rise to the notion of two separate cultures, even within the same social institution.

As such, how can we truly suggest that culture is the most universal of humanistic traits that would serve to benefit health care? Again, it should not be taken to mean that culture is useless in understanding care perspectives, but rather that culture is secondary to the relationships that we as people establish with each other based on our common humanity.

Leiningers Culture Care theory Critique and Analysis

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•To further support this criticism, let us look at how the culture of the United States has developed as a single unit, as opposed to the multitude of factions that it is actually comprised of.•If we consider the history of the U.S.’s culture as beginning from its foundation, there is no clear point of origin, as the first settlers were from all over the world. •The culture of the U.S. became largely based on race and sex, as the social structure strongly favored Anglo Saxon males. Even so, the country continued to be built on immigrants, who brought their own unique health challenges that were not considered to be of significant interest to the primary culture. •Although Leininger’stheory is comprehensive to say the least, my biggest concern is that the theory cannot be adapted quickly enough to accommodate changes that a single culture itself may undertake. •This becomes an even larger problem when we consider that we must account for numerous intersecting cultural influences. I understand that such is the nature of the theory, but I further argue that its implications are far different from when it was devised. LEININGERSCULTURE CARE THEORY CRITIQUE AND ANALYSIS

To further support this criticism, let us look at how the culture of the United States has developed as a single unit, as opposed to the multitude of factions that it is actually comprised of.

If we consider the history of the U.S.’s culture as beginning from its foundation, there is no clear point of origin, as the first settlers were from all over the world.

The culture of the U.S. became largely based on race and sex, as the social structure strongly favored Anglo Saxon males. Even so, the country continued to be built on immigrants, who brought their own unique health challenges that were not considered to be of significant interest to the primary culture.

Although Leininger’s theory is comprehensive to say the least, my biggest concern is that the theory cannot be adapted quickly enough to accommodate changes that a single culture itself may undertake.

This becomes an even larger problem when we consider that we must account for numerous intersecting cultural influences. I understand that such is the nature of the theory, but I further argue that its implications are far different from when it was devised.

Leiningers Culture Care theory Critique and Analysis

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•While this framework has been excellent for establishing some critical nursing precepts for the culturally diverse society we live in now, the origins of the theory were based in a time where cultural growth and identification was not subject to so many factors like media, and certainly not on such a wide scale. •Now, as culture becomes more and more ambiguous, the transcultural theory will likely have a harder time determining exactly what cultures need to be transcended. •American culture has different health implications than Latino culture, but what about Latin American culture? •How do we approach when someone’s beliefs indicate that they subscribe to one culture, but their behaviors reflect the values of another? •Then, how do we apply that approach on a wider scale, in the face of an increasingly ambiguous yet common cultural identity?•By focusing on the commonalities of the humans within the culture, and their specific humanity, rather than the differences in their cultures.LEININGER’SCULTURE CARE THEORY CRITIQUE AND ANALYSIS

While this framework has been excellent for establishing some critical nursing precepts for the culturally diverse society we live in now, the origins of the theory were based in a time where cultural growth and identification was not subject to so many factors like media, and certainly not on such a wide scale.

Now, as culture becomes more and more ambiguous, the transcultural theory will likely have a harder time determining exactly what cultures need to be transcended.

American culture has different health implications than Latino culture, but what about Latin American culture?

How do we approach when someone’s beliefs indicate that they subscribe to one culture, but their behaviors reflect the values of another?

Then, how do we apply that approach on a wider scale, in the face of an increasingly ambiguous yet common cultural identity?

By focusing on the commonalities of the humans within the culture, and their specific humanity, rather than the differences in their cultures.

Leininger’s Culture Care theory Critique and Analysis

References

Leininger, M. (2008). Overview of Leininger’s Theory of Culture Care Diversity and Universality. Retrieved from http://www.madeleine-leininger.com/cc/overview.pdf

Sitzman, K., & Eichelberger, L. W. (2015). Understanding the Work of Nurse Theorists. United States: Jones and Bartlett Publishers. Retrieved from http://nursing.jbpub.com/sitzman/ch15pdf.pdf

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•Leininger’sCCT is a very significant framework.•It is well-integrated into nursing practice and education.•The theory is based on practical experience.•Nursing as is already under a lot of pressure.•Nursing does not work out theoretical aspects that have no practical basis.•There is no doubt CCT is a cornerstone of modern nursing practice.•There is not much to criticize in terms of inefficiencies.•Leiningeris well-intentioned and articulate in her approach to transcultural care.LEININGER BULLETS:

Leininger’s CCT is a very significant framework.

It is well-integrated into nursing practice and education.

The theory is based on practical experience.

Nursing as is already under a lot of pressure.

Nursing does not work out theoretical aspects that have no practical basis.

There is no doubt CCT is a cornerstone of modern nursing practice.

There is not much to criticize in terms of inefficiencies.

Leininger is well-intentioned and articulate in her approach to transcultural care.

LEININGER BULLETS:

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•Leiningerprovides a summary of the theory with 13 essential tenets.•Leiningerhas made several attempts to keep the concept up to date.•The theory seems a bit general in some places.•Culture is the broadest feature of human beings.•We should consider the role of culture in society.•The goal was to achieve a unification of society.•It should not mean that culture is useless in understanding care perspectives.•The culture of the United States has developed as a single unit.•The U.S.’s culture as beginning from its foundation.LEININGER BULLETS:

Leininger provides a summary of the theory with 13 essential tenets.

Leininger has made several attempts to keep the concept up to date.

The theory seems a bit general in some places.

Culture is the broadest feature of human beings.

We should consider the role of culture in society.

The goal was to achieve a unification of society.

It should not mean that culture is useless in understanding care perspectives.

The culture of the United States has developed as a single unit.

The U.S.’s culture as beginning from its foundation.

LEININGER BULLETS:

15

•The culture of the U.S. became largely based on race and sex.•Leininger’stheory is comprehensive to say the least.•We must account for numerous intersecting cultural influences.•This framework has been excellent for establishing some critical nursing precepts.•Culture becomes more and more ambiguous.•American culture has different health implications than Latino cultureLEININGER BULLETS:

The culture of the U.S. became largely based on race and sex.

Leininger’s theory is comprehensive to say the least.

We must account for numerous intersecting cultural influences.

This framework has been excellent for establishing some critical nursing precepts.

Culture becomes more and more ambiguous.

American culture has different health implications than Latino culture