Madeleine Leininger
“Culture Care Diversity and Universality Theory”
(Transcultural Nursing Theory)
“The purpose of transcultural nursing is to discover and establish a body of knowledge and
skills focused on transcultural care, health (or well-being), and illness in order to assist nurses
giving culturally competent, safe, and congruent care to people of diverse cultures
worldwide.”
Transcultural Nursing – learned subfield or branch of nursing which focuses upon the
comparative study and analysis of cultures with respect to nursing and health-illness caring
practices, beliefs, and values with the goal to provide meaningful and efficacious nursing care
services to people according to their cultural values and health-illness context.
Definition in Transcultural Nursing
Culture
o Broadly defined set of values, beliefs and traditions that are held by a specific
group of people handed down from generation to generation. Culture is also
beliefs, habits, likes, dislikes, customs and rituals learned from one’s family.
o Culture is the learned, shared and transmitted values, beliefs, norms and
practices of a particular group that guide thinking, decisions, and actions in
patterned ways.
Religion
o Is a set of beliefs in a divide or super human power to be obeyed and worshipped
as the Creator and Ruler of the universe. Ethical values and religion system of
beliefs and practices, differences within the culture, and across culture are found.
Ethnic
o Refers to the group of people who share a common and distinctive culture and
who are members of a specific group.
Ethnicity
o A consciousness of belonging to a group.
Cultural identity
o The sense of being a part of an ethnic group or culture.
Culture-universals
o Commonalities of values, norms of behavior, and life patterns that are similar
among different cultures.
Culture-specifics
o Values, beliefs and patterns of behavior that tend to be unique to a designate
culture.
Material culture
o Refers to objects (dress, arts, religious artifacts).
Non-material culture
o Refers to beliefs, customs, languages, social institutions.
Subculture
o Composed of people who have distinct identity but are related to a larger
cultural group.
Bicultural
o A person who crosses two cultures, lifestyles and sets of values.
Diversity
o Refers to the fact or state of being different. Diversity can occur between cultures
and within a cultural group.
Acculturation
o Individuals who have taken on usually observable features of another culture.
People of minority group tend to assume the attitudes, values, beliefs, and
practices of the dominant society resulting in a blended cultural pattern.
Cultural shock
o The state of being disoriented or unable to respond to a different cultural
environment because of its sudden strangeness, unfamiliarity and incompatibility
to the stranger’s culture and expectations that is differentiated from others by
symbolic markers (cultures, biology, territory, religion).
Ethnic groups
o Share a common social and cultural heritage that is passed on to successive
generations.
Ethnic identity
o Refers to a subjective perspective of the person’s heritage and to a sense of
belonging to a group that is distinguishable from other groups.
Race
o The classification of people according to shared biologic characteristics, genetic
markers, or features. Not all people of the same race have the same culture.
Culture care diversity
o Indicates the variabilities and/or differences in meanings, patterns, values,
lifeways or symbols of care within or between collectives that are related to
assistive, supportive, or enabling human care expressions.
Culture care universalities
o Indicates the common, similar or dominant uniform care meanings, patterns,
values, lifeways, or symbols that are manifest among many cultures and reflect
assistive, supportive, facilitative, enabling ways to help people.
Cultural imposition
o Refers to efforts of the outsider, both subtle and not so subtle, to impose his or
her own cultural values, beliefs, behaviors upon an individual, family, or group
from another culture.
Ethno-nursing – study of nursing care beliefs, values, and practices as cognitively perceived and
known by a designated culture through their direct experience, beliefs, and value system.
Culture Care – subjectively and objectively learned and transmitted values, beliefs, and
patterned lifeways that assist, support, facilitate, or enable another individual or group to
maintain their well-being, health, improve their human condition and lifeway, or to deal with
illness, handicaps or death.
Culturally Congruent Nursing Care – defined as those cognitively based assistive, supportive,
facilitative, or enabling acts or decisions that are tailor-made to fit with individual, group or
institutional cultural values, beliefs, and lifeways in order to provide or support meaningful,
beneficial, and satisfying health care, or well-being services.
THREE MODES OF NURSINF CARE DECISION AND ACTION MODELS TO ACHIEVE CULTURALLY
CONGRUENT CARE
1. Cultural preservation or maintenance
Assistive, supportive, facilitative, or enabling professional actions and decisions that help
people of a particular culture to retain and/or preserve relevant care values so that they
can maintain their well-being, recover from illness, or face handicaps and/or death.
2. Cultural care accommodation or negotiation
Assistive, supportive, facilitative, or enabling professional actions and decisions that help
people of a designated culture to adapt to or negotiate with others for a beneficial or
satisfying health outcome with professional care providers.
3. Culture care repatterning or reconstructing
Assistive, supportive, facilitative, or enabling professional actions and decisions that help
a client reorder, change, or greatly modify their lifeways for new, different, and beneficial
health care pattern while respecting the client’s cultural values and beliefs and still
proving a beneficial or healthier lifeway than before the changes were co-established
with the client.
Metaparadigm in Nursing
Person
Referred to a human being
Caring and capable of being concerned about others
Environment
Concepts of world view, social structure, and environmental context are discussed
Health
Viewed as a state of well-being
Reflects the ability of individuals to perform their daily roles
Is universal across all cultures yet defined differently by each to reflect its specific values
and beliefs.
Nursing
A learned humanistic and scientific profession and discipline which is focused on human
care phenomena and activities in order to assist, support, facilitate, or enable
individuals, or groups to maintain or regain their well-being (or health) in currently
meaningful and beneficial ways, or to help people face handicaps or death.