The Cultural Care Diversity and Universality Theory By Madeliene Leininger

Origin of Selected Theory Theory was initiated from clinical experiences recognizing that culture, a holistic concept, was the missing link in nursing knowledge and practice. Substantive theory-based research knowledge was greatly needed with global and comparative focus to care for people of diverse cultures. The philosophical roots of the theory derive from extensive and diverse nursing experiences, insightful anthropology, life experiences, values and creative thinking.

Cultural Care Diversity & Universality Theory This is a theory based on humanistic discipline, designed to serve individuals, organizations, communities, and societies. Nursing is a transcultural care, profession & discipline (Koloroutis, p. 34). Her theory validates the natural human attachment to one’s heritage, language, norms and customs. Leininger’s theory holds caring as an essential human need crossing every culture.

Research Completed with this Theory According to research derived from Wayne State University, this theory has assisted providers in offering cultural congruence and competent care across the globe. As early as the 1960’s, Leininger made her first trip to Australia. It was then that she discovered many immigrant and non-immigrant nurses were aware and practicing transcultural nursing concepts. Most recently, in the wake of 9/11, it was obvious that people do not need to be taught “accept patients for who they are”. According to author Rachel E. Spector, the objective is to become more sensitive to the crucial fact that multiple factors underlie patient behaviors. Each patient comes from a unique culture and a unique socialization process.

Application of Theory to Nursing To be culturally competent nurses, we must be open-minded to the diversity among the patients we serve. This in fact will provide a global focus of care to people of diverse cultures. On a daily basis nurses care for individuals from a wide variety of cultures. The Leininger theory engages us to respect and care for patients as individuals. As nurses utilizing this theory, there is a greater awareness of the complex issues that surround the delivery of health care from our patient’s viewpoint. The “Sunrise Model” provided on the next slide demonstrates culturally congruent care in nursing.

Nicole’s Experience During nursing school I saw the delivery of a baby from a Hispanic family. The patient’s husband was the only person present in the delivery room at the time of the birth. The husband sat in a chair a few feet from the bed, and did not interact with his wife during the different phases of labor and delivery. When the baby was delivered there was still no interaction between the couple. Initially, the child was placed on the mother’s chest. It wasn’t until the baby was placed on the isolette that the father walked over to see and hold the baby by himself. It was very interesting to observe the cultural differences in labor and delivery.

Katie’s Experience I had an experience with a man of Asian descent who was s/p surgery. Frequently I would ask him if he was in pain and he would continue to answer no, when clearly his face showed otherwise. Upon questioning this phenomenon, I realized that Asian people do not admit to pain because it is a sign of weakness. He would take the medication when given, but not because he had asked for it. I realized that due to his cultural beliefs, he was unable to express his emotions relating to his level of pain because it was culturally unacceptable.

Jenn’s Experience My biggest “wake-up” call in nursing was my move from New Jersey to New Mexico. It was there that I actually considered myself a minority, and it was stimulating. I not only had a large Hispanic population to tend to, but the unique Native American culture as well. What astonished me the most was how both cultures tended to their family members and how the organizations I worked for valued that notion. It was not uncommon for “curanderos” or “medicine men” to assist in the healing practice. Wow! Would I not give for that in a Pennsylvania based emergency department.

References Cross, Bazron, Dennis, & Isaacs. (1989). Toward a Culturally Competent System of Care (Volume 1). Washington DC, Georgetown University. McEwen & Wills. (2007). Theoretical Basis for Nursing (2nd ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Spector, Rachel. (2004). Cultural Diversity in Health and Illness (6th ed.). Upper Saddle River, NJ: Pearson Education, Inc.