Madeleine Leininger’s Culture Care: Diversity and Universality Theory
Madeleine Leininger, born in Sutton, Nebraska, received her diploma in nursing in 1948 from St. Anthony’s School of Nursing in Denver Colorado. She then went on and continued her education and received a B.S. and an M.S. in psychiatric and mental health nursing in 1954. After she continued even further, she was given a Ph.D. in cultural and social anthropology in 1965 from the University of Washington, Seattle. Early on in her career she recognized and focused on the importance of caring and made it her central component in nursing. While working in a child guided home, Leinginer realized that recurrent behavioral patterns in children seem to have a cultural foundation. She recognized that the lack of cultural care knowledge of a nurses causes deficiency of support compliance, healing and wellness. Trancultural nursing is defined as 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 a culturally meaningful way (Sitzman, K. & Eichelberger, 2011, p. 101).
Concepts Central to the Discipline of Nursing
There are four basic concepts to the discipline of nursing: person, environment, health and nursing. These concepts form the basis of the way a nurse should interact and provide treatment for his or her patients.
During an individual’s life span, each person develops a personal system of values that give meaning and purpose to life. Madeleine Leininger represents this in her theory by explaining that when providing care, a harmony of the individual or groups cultural beliefs, practices, and values must be integrated (Sitzman, K. & Eichelberger, 2011, p. 102). Chaminade University recognizes that a person possesses physiological, psychological, socio-cultural, developmental and spiritual needs and that as a nurse we must provide care to meet these needs. Similar to Chaminade’s School of Nursing concepts, Leininger’s theory says that cultural and social structure dimensions include factors related to religion, social structure, political/legal concerns, economics and ethnohistory, influencing cultural responsesof humans within a cultural context. Leininger also believes in the total picture, a holistic and comprehensive approach, which led to a more extensive nursing practice. Although culture care concepts have similarities and differences among cultures around the world, Leininger ‘s theory illustrates that every human culture has a folk remedies professional knowledge, and profession care practices that vary (Sitzman, K. & Eichelberger, 2011, p. 104). A nurse must address each patient differently and consciously to provide holistic and culturally congruent care. Thus, the mind, body, and spirit are inseparable and should be looked at in a holistic way.
Environment influences the health of individuals, families, groups, and communities. Biological, psychological, social, and political factors and conditions are the causes that affect the life and development of a person. Similar, Leininger’s culture aspect of her theory refers to the learned, shared, and transmitted values, beliefs, norms, and lifeways of a specific individual or group that guide their thinking, decisions, actions, and patterned ways of living. She specifies the importance that a nurse provide care where the cultural beliefs, practices and values are congruently harmonious to assisting others with needs to improve the human condition or to face death. She beliefs that failure to provide care that is closely tied to a patients culture could end in the patient showing signs of stress, cultural conflict, noncompliance, and ethically moral concerns (Sitzman, K. & Eichelberger, 2011, p. 103). Individuals that are exposed to a personal and comfortable environment for them are more likely to display better health then those who are exposed to environments that fail to demonstrate their culture appropriately.
Quality of life helps allow people to work effectively and reach their highest level of potential and satisfaction. A nurse’s responsibly could be to identify where patients might be in life and to help him or her to take steps to improve their life by improving their health. In order for some people to take bigger steps towards a healthy self some rituals and cultural activities must be performed. Not only does a nurse have to be sensitive towards this but research and help perform some of these tasks that a patient is asking of the nurse. Leininger’s theory says that a culturally competent nurse must ask each client what their cultural practices and preferences are and must incorporate this client’s personal, social, environmental, and cultural needs/beliefs into the plan of care wherever possible (Sitzman, K. & Eichelberger, 2011, p. 105). Respecting and appreciating cultural diversity is also extremely important and helps increase knowledge and sensitivity associated with this.
Nursing is not only a profession; it’s a science as well as an art. Nurses provide meaningful patient-centered health care when nurses modify their own techniques in order to provide personal and individualized care to patients. Individual and cultural congruent health care is important in Leininger’s theory. She says that understanding and valuing the practice of cultural care allows positive changes in healthcare practices for clients of designated cultures. Its important for the nurse to research and understand a client’s beliefs and values thoughtfully and skillfully and to incorporate in routine care plans. Being committed to learning and practicing what the nurse learns from clients gives the patient great satisfaction and support. Leininger also reflects the importance of the nurse-client exchanges and relationship because there would be no curing without giving and receiving care (Sitzman, K. & Eichelberger, 2011, p. 104). It’s a unique profession because nurses often interact with patients that come from diverse populations with diverse cultures. Leininger’s theory of culture care explains that although there are many similarities among cultures around the world there are also a lot of differences (Sitzman, K. & Eichelberger, 2011, p. 103-104). The nurse must address these differences with each client and provide individualized care. Nurses focus on the care of individuals, families, groups, and communities through the knowledge and skills they posses from nursing school. Caring for self is also extremely important because in order to care for others, one must care for themselves. Leininger’s theory teaches a patient to care for himself (Sitzman, K. & Eichelberger, 2011, p. 105).
Figure 1. Intertwined Trees Oak Cherry By Voidqueenelishiva On Deviantart. (n.d.). Tattoo Donkey. Retrieved October 11, 2011, from http://www.tattoodonkey.com/intertwined-trees-oak-cherry-by-voidqueenelishiva-on-deviantart/fc08.deviantart.net*fs71*i*2010*087*8*9*Intertwined_Trees__Oak_Cherry_by_VoidQueenElishiva.jpg/
This intertwining cherry blossom tree represents Leininger’s model of culture care. Leininger explains that care is the essence and central focus of nursing (Sitzman, K. & Eichelberger, 2011, p. 104). In this model the roots of the tree are all the caring aspect of her theory. The individualized care that a nurse gives to a patient is where the branches separate. According to Leininger’s theory culture care concepts have both different and similar aspects among all the cultures of the world (Sitzman, K. & Eichelberger, 2011, p. 103). Even though the branches are individualized care they intertwine because of the similarities that a lot of cultures have. Thus, this tree explaining cultural care diversity and universality. The ends of the branches each sprout a flower, this demonstrating the healthy individual that received individualized and basic care with a nurse’s broadened worldview.
Leininger’s theory is about the nurses understanding value and practice of culturally competent care (Sitzman, K. & Eichelberger, 2011, p. 101). The four concepts of nursing at Chaminade University are all interconnected and build upon each other. It is important that a nurse understands and comprehends each of the four concepts and to incorporate caring into all of them. Promoting a proper healing environment, developing personal and trusting relationships and recognizing and respecting a patients culture is important factors of Leininger’s theory (Sitzman, K. & Eichelberger, 2011, p. 103). Researching, learning, and practicing culturally competent care gives a patient satisfaction, other rewards and provides holistic care (Sitzman, K. & Eichelberger, 2011, p. 102). Understanding someone’s culture helps the nurse understand the patient better, which can create a better healing environment and speed along the process. All Chaminade University Nursing students should come out of nursing school understanding the importance of cultural care and Madeleine Leininger’s diversity and universality theory.
Intertwined Trees Oak Cherry By Voidqueenelishiva On Deviantart. (n.d.). Tattoo Donkey. Retrieved October 11, 2011, from http://www.tattoodonkey.com/intertwined-trees-oak-cherry-by-voidqueenelishiva-on deviantart/fc08.deviantart.net*fs71*i*2010*087*8*9* Intertwined_Trees__Oak_Cherry_by_VoidQueenElishiva.jpg/
Sitzman, K. & Eichelberger, L. W. (2004). Understanding the work of nurse theoritsts: A creative beginning. Boston, MA: Jones and Bartlett.