Madeleine Leininger’s
Culture Care Theory
        Dileep Kumar
                      MSc. N Student
College of Nursing, JPMC, Karachi
                Objectives
Today’s my presentation objectives are to;
• Introduce the Theorist Madeleine Leininger
• Define culture care theory and Sun Rise model
• List the purpose and goals of the culture care
  theory
• Define major assumptions of culture care theory
• Describe the Metaparadigm of theory
• Discuss about the nursing implications of theory
 Credentials & Background of Theorist
• Madeleine Leininger is a Founder of Transcultural Nursing
  and Human Care Theory
• First professional Nurse with graduate preparation in nursing
  to hold a PhD
• Was born in Sutton, Nebraska in 1920
• 1948 Diploma in Nursing, Was in US army Nurse corps, while
  pursuing the basic nursing program
• 1950 BS in Biological Sciences
• 1954 obtained master degree in psychiatric nursing
• Initiated and directed the 1st Graduated Nursing Program in
  Psychiatric Nursing at University of Cincinnati
Credentials & Background of Theorist
• 1966 offered 1st course in Transcultural Nursing in
  University of Colorado
• 1969 appointed as Dean and Professor of Nursing and
  Lecturer in Anthropology
• Studied 14 major cultures in depth and has had experience
  with many different additional cultures.
• Authored or edited more than 27 books
• Published more than 200 articles and 45 chapters plus
  numerous research projects focused on transcultural
  nursing, human care and health phenomena.
• 1974, initiated National Transcultural Nursing Society org:
• 1989, initiated Journal of Transcultural Nursing
     Her other Areas of Interest
Besides transcultural nursing with care as a
central focus her other areas of interest are;
• Comparative education and administration
• Nursing theories
• Politics
• Ethical dilemmas of nursing and health care
• Qualitative research methods
• Future of nursing and health care
• Nursing leadership
            Theoretical sources
• Derived from disciplines of anthropology and nursing but
  is reformulated to be transcultural nursing with human care
  perspective
• She has defined the transcultural nursing as a major area of
  nursing that focuses on a comparative study and analysis of
  different cultures and subcultures in the world with respect
  to their caring values, expressions, and health-illness
  beliefs and pattern of behavior with the goal to develop a
  scientific and humanistic knowledge to provide culture
  specific and/or culture universal nursing care practice.
      Development of the theory
• Developed in the mid-1950s and early 1960s.
• Developed particularly to discover the meanings and ways
  to give care to people who have different values and life
  ways.
• Designed to guide nurses to provide nursing care that fits
  with those that are being cared for.
• Culture Care theory not only focuses on nurse-client
  interaction but the focus also includes care for families,
  groups, communities, cultures and institutions.
                  The Theory
  Culture Care: Diversity and Universality
• Focuses on describing, explaining and predicting
  nursing similarities and differences focused primarily
  on human care and caring in human cultures.
• The Culture Care Diversity & Universality theory
  does not focus on medical symptoms, disease entities
  or treatments.
• It is instead focused on those methods of approach to
  care that means something to the people to whom the
  care is given.
 Central Purpose of the Theory
• To discover and explain
  diverse and universal
  culturally based care factors
  influencing the health, well
  being , illness or death of
  individuals or groups
                       Goals
• To give culturally congruent care
• To discover the meanings and ways to give care to
  people with different values
• To promote well-being, growth & development,
  healthy lifestyles and recovery from illness
• To work & function effectively with people having
  different values, beliefs, and ideas about nursing,
  health, caring, wellness, illness, death & disability
               Major Assumptions
1.Care is the essence of nursing and a distinct, dominant,
    central and unifying focus.
2.Care (caring) is essential for well-being, health, growth,
    survival and to face handicaps or death.
3.Culturally based care is the broadest holistic means to
    know, explain, interpret and predict nursing care
    phenomena and to guide nursing decisions and actions
4. Nursing is a transcultural humanistic and scientific care
    discipline and profession with the central purpose of
    serving individuals, groups, communities or
    institutions worldwide.
             Major Assumptions
5. Care (caring) is essential to curing and healing,
   for there can be no curing without caring
6. Culture care concepts, meanings, expressions,
   patterns, processes, and structural forms of care
   vary transculturally with diversities and some
   universalities
7. Every human culture has generic (lay, folk or
   indigenous) care knowledge and practices which
   vary transculturally
                Major Assumptions
8. Culture care values, beliefs, and practices are influenced by
   and tend to be imbedded in the worldview, language,
   philosophy, religion (and spirituality), kinship, social,
   political, legal, educational, economic, technological, ethno
   historical, and environmental context of cultures
9. Beneficial, healthy and satisfying culturally-based care
   influences the health and well-being of individuals, families,
   groups, and communities within their environmental context
10. Culturally congruent or beneficial nursing care can only
   occur when individual, group, family, community, or
   institutional care values, expressions, or patterns are known
   and used explicitly in appropriate and meaningful ways
              Major Assumptions
11. Culture care differences and similarities between
  professionals and client participants exists in all human
  cultures worldwide
12 Culture conflicts, imposition practices, cultural stresses
  and pain reflect the lack of professional care
  knowledge to provide culturally congruent, responsible,
  and sensitive care
13. The ethnonursing qualitative research method
  provides an important means to discover and accurately
  interpret emic and etic embedded, complex and diverse
  culture care factors
 The Sunrise Model (developed in1970)
• Serves as a conceptual guide or cognitive map to guide
  nurses in the systematic study of all dimensions of theory.
• Symbolize “rising of the sun(care)”
• Upper half of the circle depicts component of the social
  structure and world view factors that influence care and
  health through language, ethnohistory and environmental
  context.
• These factors also influence the folk, professional and
  nursing system(s), which are in the middle part of the
  model.
              Sun Rise Model
• Nursing act as a bridge between the folk generic
  and the professional system
• Three kinds of nursing care & decisions and
  actions are predicted in theory
   1. Cultural care preservation and maintenance
   2. Cultural care accommodation and/or negotiation
   3. Cultural care repatterning and/or restructuring
                         Scope
• She includes care/caring beyond the interpersonal level to
  include families, groups & cultures.
• She is searching for worldwide human meanings
• Theory has multiple levels of scope dealing with human
  cultures and nursing worldwide
   – Broad macro level (etic analysis)
   – Middle range (emic analysis)
   – Concrete empirical level
• Sunrise model pictorially depicts the multiple theoretical
  levels
• 90 cultures in Western and non-Western worlds have been
  studied with the theory and 185 care constructs have been
  identified
Metaparadigm concepts defined
• Nursing: care has the greatest meaning which
  explains nursing
• Person: should refer to families, groups, and
  communities
• Health: not distinct to nursing as many disciplines
  use this term
• Environment: included events with meanings and
  interpretations given to them in particular physical,
  ecological, sociopolitical or cultural setting.
         Nursing Implications
• Nurse can asses, understand and plan care for
  patient in tradition way
• Nurse documents the description of an individual’s,
  family’s or community’s cultural social structure
  that influence health patterns and concern
• Leininger’s theory does not focus on medical
  symptoms, disease, or treatment, it focuses on the
  nurse’s approach to care (this is truly a holistic
  nursing idea!)
       Nursing Implications
– Nurse invites an individual, family or
  community to describe their own experience
  about health and caring
– Modify your nursing care to your patients with
  the goal of improving their comfort and
  response to care
– Utilize this theory for holistic assessments of
  the patient
             Conclusion
We live in a city that is rich in diversity. How,
then, should we treat one another? We
should value diversity. We have the capacity
to perform a cultural self-assessment. We
should be conscious of the dynamics
inherent when cultures interact and we
should exercise cultural awareness. Being
culturally competent is essential to being an
efficient nurse.
                      References
• Basvanthappa, B.T.(2007). “Nursing Theories” 1st Edition,
  Jaypee Brothers, New Delhi
• 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. retrieved on 25-12-2009 from
  http://tcn.sagepub.com/cgi/reprint/13/3/189.pdf
• Tommy, A. M., & Alligood, M. R. (1998). “Nursing theorists
  and their works” 4th edition, A Harcourt Health Sciences
  Company. Mosby
  Thanks
For your Attention
Any ????