Madeleine Leinenger

• Culture care diversity and universality theory

  Madeleine Leinenger
• Relieved to be caring and capable of being concerned about the desires, welfare, and continued existence of others

  Person
• • Being totality of an event, situation, or experience

  Environment
• • A particular group (society) and the patterning of actions, thoughts, and decisions that occurs as the result of the “learned, shared, and transmitted values, beliefs, norms, and lifeways”

  culture
• • A key concept in transcultural nursing
  • Is universal
  • Is diverse

  Health
• • To provide nursing care that best fits with the client’s culture so as to reduce culture stress and chance for conflict between client and caregiver 

  Nursing
• • 3 types of culturally-based nursing actions consistent with client needs and values 

  Cultural care preservation/maintenance

  Cultural care accommodation/negotiation

  Cultural care repatterning/restructuring
• • First presented in 1985
  • “Different cultures perceive, know, and practice care in different ways, yet there are some commonalities about care among all cultures of the world (Leinenger, 1985)
  • Universality = generalities
  • Diversity = differences

  transcultural theory
• • Differences or variations that can be found both between and among cultures 
  • Finding these variations, the nurse can avoid the problem of stereotyping and assuming that all people will react to the same nursing care

  cultural diversity
• • Commonalities and similarities existing among cultures

  cultural universality
• • Refers to the abstract and concrete phenomena related to assisting, supporting, or enabling experiences or behaviors toward or for others with evident or anticipated needs 

  care
• • Actions and activities directed toward
  • Assisting
  • Supporting
  • Enabling
  • Another individual or group with evident or anticipated needs to ameliorate or improve a human condition

  caring
• • Learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group that guides their thinking, decisions, and actions in patterned ways 

  culture
• • The 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 and health
  • To improve their human condition and lifeway
  • To deal with illness, handicaps or death

  cultural care
• • Refers to the variabilities and/or differences in meaning, patterns, values, lifeways, or symbols of care within or between collectivities that are related to assistive, supportive, or enabling human care expressions 

  cultural care diversity
• • Common, similar, or dominant uniform care meaning, patterns, values, lifeways, or symbols that are manifest among many cultures, and reflect assistive, supportive, facilitative or enabling ways to help people

  cultural care universality
• • Refers to a learned humanistic and scientific profession and discipline that is focused on human care phenomena and activities to assist, support, facilitate or enable individuals or other groups

  nursing
• • Refers to the way people tend to look out for the world or their universe to form a picture or a value stance about their life or world around them

  worldview
• • Dynamic patterns and features of interrelated structural and organizational factors of particular culture (subculture or society)
  • Religious
  • Kinship (social)
  • Political and legal
  • Economic
  • Educational
  • Technological
  • Cultural and ethnohistorical factors
  • How these factors may be interrelated and function to influence human behavior in different environmental context

  cultural and social structure dimensions
• • The totality of an event, situation, or particular experience that gives meaning to human expression, interpretations, and social interactions, particularly:
  • Physical 
  • Ecological 
  • Sociopolitical
  • Cultural settings

  environmental context
• • The past facts, events, instance, and experiences of individuals, groups, cultures, and institutions that are primarily people centered (ethno) and that describe, explain, and interpret human lifeways within particular cultural contexts and over short/long periods

  ethnohistory
• • The culturally learned and transmitted, indigenous (or traditional), folk (home based) knowledge and skills used to provide assisting, supporting, enabling, and facilitative act toward or for another individual, group, or institution with evident or anticipated needs 

  generic care system
• • Refers to formally taught, learned, and transmitted professional care, health, illness, wellness, and related knowledge and practice that prevail in professional institutions

  professional care system
• • A state of well being that is culturally defined, valued, and practiced and reflects the ability of individuals (or groups) to perform their daily role activities in culturally expressed, beneficial, and patterned lifeways

  Health
• • Those assisting, supporting, facilitative, or enabling professional actions and decisions that help retain and/or preserve care values

  cultural care preservation
• • To adapt to, or negotiate with others for a beneficial and satisfying health outcome with professional care providers

  cultural care accommodation
• • Help clients reorder, charge, or greatly modify their lifeways for new, different, and beneficial healthcare patterns while respecting the client’s cultural values and beliefs and still providing a beneficial or healthier lifeway than before the changes were co-established with client

  cultural care repatterning
• • Those cognitively based assisting, supporting, facilitative, enabling acts or decisions that are tailor made to fit with the client’s cultural beliefs, values, and lifeways to provide or support meaningful, beneficial and satisfying healthcare or well-being services

  cultural congruent care