Culture Care Diversity and Universality

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Culture Care Diversity and Universality

• A Theory of Nursing
• By Dr. M Leininger

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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

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Goal of Nursing

• To give culturally congruent care
• To discover the meanings and ways to give care to
  people with different values

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Goal of Nursing

• To promote well-being, growth development,
  healthly 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

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Assumptive Premises of the Theory

• 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

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Assumptive Premises of the Theory

• 4. Nursing is a transcultural humanistic and
  scientific care discipline and profession with
  the central purpose of serving individuals,
  groups, communities or institutions worldwide.
• 5. Care (caring) is essential to curing and
  healing, for there can be no curing without caring

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Assumptive Premises of the Theory

• 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

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Assumptive Premises of the Theory

• 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,
  ethnohistorical, and environmental context of
  cultures

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Assumptive Premises of the Theory

• 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

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Assumptive Premises of the Theory

• 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

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Orientational Theory Definitions

• 1. Care
• 2. Culture
• 3. Culture care
• 4. Culture care diversity
• 5. Culture care universality
• 6. Worldview
• 7. Cultural social structure dimensions

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Orientational Theory Definitions

• 8. Environmental context
• 9. Ethnohistory
• 10. Emic
• 11. Etic
• 12. Health
• 13. Nursing

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Orientational Theory Definitions

• 14. Culture care preservation or maintenance
• 15. Culture care accommodation or negotiation
• 16. Culture care repatterning or restructuring
• 17. Culturally congruent nursing care

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Relational Statements or Hypotheses

• Identifiable differences in caring values and
  behaviours between and among cultures lead to
  differences in the nursing care expectations of
  careseekers

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Relational Statements or Hypotheses

• As professional nurses work in strange
  cultures with different values about nursing care
  or caring behaviours, there will be overt signs
  of cultural conflicts and problems

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Relational Statements or Hypotheses

• The greater the dependence of nursing personnel
  on technological tasks and activities, the
  greater the signs of interpersonal distance and
  the fewer the client satisfactions

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Relational Statements or Hypotheses

• Cultures that highly value individualism with
  independence modes will show signs of self-care
  practices and values whereas cultures that do
  not value individualism with independence modes
  will show limited signs of self-care practices
  and more signs of other care practices

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Relational Statements or Hypotheses

• Clients from different cultures can identify
  caring and noncaring behaviours and attitudes of
  nurses

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Relational Statements or Hypotheses

• Symbolic forms and ritual functions of nursing
  care behaviours and practices have different
  meanings and outcomes in different cultures

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Relational Statements or Hypotheses

• Where there is marked evidence of nurturant
  caring behaviours or the use of culture-specific
  care constructs, there will be more signs of well
  being or health and fewer signs of illness

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Ethnonursing Research

• A qualitative nursing research method focused
  on naturalistic, open discoveries and largely
  inductive modes to document, describe explain
  interpret informants worldviews, meanings,
  symbols and life experiences as they bear upon
  actual or potential nursing phenomena

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Ethnonursing Research

• This method supports the goal to become as
  knowledgeable as possible about the informants
  emic worldview but also remain attentive to etic
  knowledge related to world view, professional
  attitudes, biases, racial and gender views.

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Purpose of Ethnonursing Research

• To discover largely unknown or vaguely known
  phenomena bearing upon nursing knowledge
• To enter peoples world with an open mind and
  learn from them about their lifeways, experiences
  and current or past perspectives

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Purpose of Ethnonursing Research

• To study how outsiders views contrast with the
  local culture and areas of conflict and need
• To gain in-depth knowledge about the meanings,
  expressions, symbols, metaphors and practices
  related to care, health, human life, human
  conditions
• To be able to gently tease out covert or embedded
  care and nursing knowledge related to the theory
  of cultural care with the different dimensions
  depicted in the sunrise model

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Purpose of Ethnonursing Research

• To discover ways to obtain accurate, credible,
  confirmable, meaningful data which reflects
  mainly the informants cultural lifeways and
  insights about health well being.
• To identify knowledge that is diverse or similar
  about human care and health along with other
  knowledge and experiences influencing care and
  health in different life contexts

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Enablers

• Leiningers observation-participation-reflection
  enabler
• Leiningers stranger to trusted friend enabler
• Leiningers acculturation enabler
• Specific enabler r/t domain of inquiry

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Scope

• Leiningers scope is broad to include worldwide
  care
• She includes care/caring beyond the interpersonal
  level to include families, groups cultures.
• She is searching for worldwide human meanings

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Scope

• 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

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Scope

• Selected care constructs are suitable worldwide
  and in any clinical situation.
• Other research has been given direction from her
  conceptual model
• 90 cultures in Western and non-Western worlds
  have been studied with the theory and 185 care
  constructs have been identified

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Top Ten Reasons to Use Leiningers Theory of
Nursing

• 10. You can participate in and publish an
  ethnonursing qualitative research study

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Top Ten Reasons to Use Leiningers Theory of
Nursing

• 9. You can eliminate the phrases nursing
  intervention and patient problems from your
  vocabulary since these terms may be viewed as a
  cultural imposition

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Top Ten Reasons to Use Leiningers Theory of
Nursing

• 8. You get to spend quality time with fellow
  nurse theorists

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Top Ten Reasons to Use Leiningers Theory of
Nursing

• 7. You can use the Sunrise Model as a cognitive
  map to tease out emic or etic phenomena in
  different historical, cultural, and environmental
  contexts

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Top Ten Reasons to Use Leiningers Theory of
Nursing

• 6. You can become a clinical nurse specialist in
  transcultural nursing in the culture of your
  choice

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Top Ten Reasons to Use Leiningers Theory of
Nursing

• 5. You will have a systemic and focused way to
  develop new knowledge and insights from examining
  the worldview, social structure factors,
  environmental contexts, ethnohistory and language
  usage of different cultures

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Top Ten Reasons to Use Leiningers Theory of
Nursing

• 4. You can attend conferences in far away exotic
  places

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Top Ten Reasons to Use Leiningers Theory of
Nursing

• 3. The theory will expand nurses thinking from a
  unicultural to a multicultural, holistic and
  comparative perspective

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Top Ten Reasons to Use Leiningers Theory of
Nursing

• 2. You can establish a Transcultural Nursing
  Society chapter in a town near you.

Dr. A Page President, Great Lakes
Chapter Transcultural Nursing Society
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Top Ten Reasons to Use Leininger

• 1. You will provide culturally congruent care
  that fits reasonably with clients needs and
  realities

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COMING NEXT WEEK
THE BOOK CLUB FEATURING DR. M. LEININGERS
THEORY OF CULTURE CARE DIVERSITY AND UNIVERSALITY