Theoretical Framework in Nursing Process - Middle Range Nursing Theories

Theoretical Framework for Nursing Practice – Module 9

A. Perform an analysis/evaluation of Leininger’s theory using the criteria presented in module 4. How relevant is it to nursing?

Background of the Theorist Madeleine Leininger was born on July 13, 1925 in Sutton, Nebraska. She earned several degrees, including a Doctor of Philosophy, a Doctor of Human Sciences, a Doctor of Science, and is a Registered Nurse. She is a Certified Transcultural Nurse, a Fellow of the Royal College of Nursing in Australia, and a Fellow of the American Academy of Nursing. (http://nursingtheory.org, retrieved April 25, 2012)

Philosophical underpinnings of the theory Transcultural nursing is a comparative study of cultures to understand similarities (culture universal) and difference (culture-specific) across human groups. While working in a child guidance home I the mid-1950s, Leininger identified in the staff a lack of understanding of cultural factors (Basavanthappa, 2007). The theory was derived from the discipline of anthropology but she conceptualized the theory to be relevant in nursing.

Major assumptions, concepts, and relation 1. Illness and wellness are shaped by a various factors including perception and coping skills, as well as the social level of the patient. 2. Cultural competence is an important component of nursing. 3. Culture influences all spheres of human life. It defines health, illness, and the search for relief from disease or distress. 4. Religious and Cultural knowledge is an important ingredient in health care. 5. The health concepts held by many cultural groups may result in people choosing not to seek modern medical treatment procedures. 6. Health care provider need to be flexible in the design of programs, policies, and services to meet the needs and concerns of the culturally diverse population, groups that are likely to be encountered. 7. Most cases of lay illness have multiple causalities and may require several different approaches to diagnosis, treatment, and cure including folk and Western medical interventions. 8. The use of traditional or alternate models of health care delivery is widely varied and may come into conflict with Western models of health care practice. 9. Culture guides behavior into acceptable ways for the people in a specific group as such culture originates and develops within the social structure through inter personal interactions. 10. For a nurse to successfully provide care for a client of a different cultural or ethnic to background, effective intercultural communication must take place.

11. Every human culture has folk remedies, professional knowledge, and professional care practices that vary. The nurse must identify and address these factors consciously with each client in order to provide holistic and culturally congruent care. 12. Cultural care values, beliefs, and practices are influenced by worldview and language, as well as religious, spiritual, social, political, educational, economic, technological, ethnohistorical, and environmental factors. 13. Beneficial, healthy, satisfying culturally based nursing care enhances the well-being of clients. 14. Culturally beneficial nursing care can only occur when cultural care values, expressions, or patterns are known and used appropriately and knowingly by the nurse providing care. 15. 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.

Usefulness Leininger’s transcultural theory aims to foster understanding, respect and appreciation for the individuality and diversity of patient’s beliefs, values, spirituality and culture regarding illness, its meaning, cause, treatment, and outcome. Nurses are now gradually realizing the importance of cultural nursing and the need to understand cultures, especially Filipino nurses who are working overseas that are ever increasing in number. Nursing is in a new phase of health emphasis where there is an increased display of cultural identity, accompanied by increased demands for culture specific care and general health services. I believe that Filipino nurses are in demand abroad for being culturally open and caring regardless of their clients’ cultural orientation. The world is strongly multicultural and that we, as health personnel are anticipated to respond to our clients’ diverse cultural needs.

Parsimony Theories should be relatively simple yet generalizable. Leininger’s theory is essentially parsimonious in that the necessary concepts are incorporated in such a manner that the theory and its model can be applied in many different settings (Basavanthappa, 2007). The theory and model are not simple in terms of being easily understood upon the first contact. However, Leininger’s presentations of her theory and model support the need for each of the concepts and demonstrate how the concepts are interrelated. Once the interrelationships are grasped, simplicity is more appartent (Basavanthappa, 2007). The theory is generalizable in such a way that the concepts presented are at a level of abstraction which allows them to be applied in many different situations.

Value in extending nursing science Theories can be the bases for hypotheses that can be tested or for the theory to be expanded. During the development of the Culture Care Diversity and Universality theory, many studies have been conducted to demonstrate that the theory can be the basis for research. A number of these studies were presented for national transcultural conferences held from 1975 to 1978 (Basavanthappa, 2007). It is important to note that the theory is based upon, and calls for qualitative rather than quantitative research.

B. Write/develop a term paper showing the integration of concepts you have learned in this course using your own middle range theory and definition of nursing.*

*Please refer to the term paper submitted as hard copy sent by mail to the address indicated. Thank you and God bless!

References:

Transcultural Nursing, http://currentnursing.com, retrieved, April 25, 2012

Nursing Theory, Madeleine Leininger, http://nursing-theory.org, retrieved April 25, 2012

Leininger’s Theory of Culture Care, http://leiningertheory.blogspot.com, retrieved April 25, 2012

B.T. Basavanthappa (2007), Nursing Theories, JP Brothers Medical Publishers, New Delhi, India, p.257-260

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.

References: Transcultural Nursing, http://currentnursing.com, retrieved, April 25, 2012 Nursing Theory, Madeleine Leininger, http://nursing-theory.org, retrieved April 25, 2012 Leininger’s Theory of Culture Care, http://leiningertheory.blogspot.com, retrieved April 25, 2012 B.T. Basavanthappa (2007), Nursing Theories, JP Brothers Medical Publishers, New Delhi, India, p.257-260 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.