DWETN Sunrise Model

• Madeleine Leininger, RPhD, LHD, DS, CTN, RN, FAAN, is the founder and leader of Transcultural Nursing and the leader of Human Care Research.
• Madeleine Leininger was an Anthropologist before focusing on Transcultural Nursing.
• Madeleine Leininger is a Professor Emeritus in the College of Nursing at Wayne State University in Detroit, Michigan.
• Madeleine Leininger is an Adjunct Faculty Member in the College of Nursing at the University of Nebraska Medical Center in Omaha, Nebraska.
• Madeleine Leininger is an internationally known transcultural nursing lecturer, educator, author, theorist, administrator, researcher, and consultant in nursing and anthropology.
• Madeleine Leininger initiated the Nurse Scientist and several transcultural nursing programs in the early 1970s and 1980s.
• Leininger’s Culture Care Theory attempts to provide ​culturally congruent nursing care through “cognitively ​based assistive, supportive, facilitative, or enabling act​s or decisions that are mostly tailor-made to fit with individual, group’s, or institution’s cultural values, ​beliefs, and lifeways
• The intent of the care is to fit with or have beneficial meaning and health outcomes for people of different or similar culture backgrounds
• "I believe that diverse cultures were created for a purpose, but

  our challenge as nurses is to discover, respect, understand,

  and help cultures as needed with a caring ethos and with other

  health professionals."
• Culturally Congruent Care

  ● All care modalities require co-participation of the nurse and clients (consumers) working together to identify, plan, implement, and evaluate each caring mode for culturally congruent nursing care.
• These modes can stimulate nurses to design nursing ​actions and decisions using new knowledge and ​culturally based ways to provide meaningful and ​satisfying wholistic care to individuals, groups or

  institutions.”
• “Together the nurse and the client creatively design a

  new or different care lifestyle for the health or ​well-being of the client.”
• Leininger’s model has developed into a movement in nursing

  care called transcultural nursing.
• Transcultural Nursing

  ● “A substantive area of study and practice focused On comparative cultural care (caring) values, beliefs, and ​practices of individuals or groups of similar or different cultures with the goal of providing culture-specific and ​universal nursing care practices in promoting health or well-being or to help people to face unfavorable

  human conditions, illness, or death in culturally ​meaningful ways.”
• The Leininger Sunrise Model represents the structure of culture care theory by describing the relationship between anthropological and nursing beliefs and principles. Nurses use this model when making cultural evaluations of patients.
• The sunrise model connects the concepts of the theory with ​actual clinical practices while offering a systemic approach to identifying values, beliefs, behaviors, and community customs.
• Encompasses numerous aspects of culture: religious, ​financial, social, technological, educational, legal, ​political, and philosophical dimensions.
• Sunrise Model as a Conceptual Enabler

  ● Developed as a conceptual holistic research ​guide or enabler

  ● Shows different factors or components that need ​to be systematically studied
• NOTE: The model is not the theory per se, but depicts factors

  that need to be studied in relation to the theory tenets and the

  specific domain of inquiry under study.
• Shows potential influencers (not causes) that might

  explain care phenomena related to historical,

  cultural, social structure, worldview, environmental,

  and other factors.
• HOLISTIC DIMENSIONS such as social structure

  factors, ethnohistory, genetics, religion, spirituality,

  ethics, language uses, environment, politics, family

  structures, arts, and other ideas reflected in the

  sunrise model… - all as influencers or potential

  influencers of human care
• With sunrise model, a truly HOLISTIC and

  COMPREHENSIVE picture can be discovered to

  reflect the TOTALITY OF KNOWING PEOPLE in

  their lifeworld or culture.
• Hidden, obvious, and unexpected factors influencing

  care meanings, patterns, symbols, and practices in

  different cultures. Nurses should open their minds.
• Greatly EXPANDS the world view and minds to look for OBVIOUS or COVERT embedded knowledge to

  obtain an accurate comprehensive picture of

  influencers on care health, illness, and dying or

  disabilities in cultures and goes beyond traditional

  mind-body-spirit holism views.
• Care

  ● As a noun is defined as those abstract and concrete

  phenomena related to assisting, supporting, or enabling experiences or behaviors toward or for others with evident or anticipated needs to ameliorate or improve a human condition or lifeway.
• ● Generic (folk or lay) care systems are culturally

  learned and transmitted, indigenous (or traditional),

  folk (home-based) knowledge and skills used to

  provide assistive, supportive, enabling, or facilitative

  acts toward or for another individual, group, or

  institution with evident or anticipated needs to

  ameliorate or improve a human life way, health

  condition (or well- being), or to deal with handicaps

  and death situations.
• Professional care systems are defined as formally

  taught, learned, and transmitted professional care,

  health, illness, wellness, and related knowledge and

  practice skills that prevail in professional institutions,

  usually with multidisciplinary personnel to serve

  consumers.
• Emic

  ● Knowledge gained from direct experience or directly

  from those who have experienced it. It is generic or

  folk knowledge.
• Etic

  ● Knowledge that describes the professional

  perspective. It is professional care knowledge.
• Ethnohistory includes those past facts, events,

  instances, experiences of individuals, groups,

  cultures, and instructions that are primarily

  people-centered (ethno) and describe, explain, and

  interpret human lifeways within particular cultural

  contexts over short or long periods of time.
• Culture shock may result when an outsider attempts

  to comprehend or adapt effectively to a different

  cultural group. The outsider is likely to experience

  feelings of discomfort and helplessness and some

  degree of disorientation because of the differences in

  cultural values, beliefs, and practices. Culture shock

  may lead to anger and can be reduced by seeking

  knowledge of the culture before encountering that

  culture.
• Cultural imposition refers to the outsider’s efforts, both

  subtle and not so subtle, to impose their own cultural

  values, beliefs, and behaviors upon an individual, family, or group from another culture. (Leininger, 1978)
• What are the Three Modes of Nursing Care Decision and Actions:

  1. Culture Care Preservation or Maintenance,

  2. Culture Care Accommodation and/or Negotiation,

  3. Culture Care Repatterning and/or Restructuring
• Culture Care Preservation or Maintenance ● refers to those assistive, supportive, facilitative, or enabling professional actions and decisions that help people of a particular culture to retain and/or maintain meaningful care values and lifeways for their well-being, to recover from illness, or to deal with handicaps or dying.
• Culture Care Accommodation and/or Negotiation ● refers to those assistive, supportive, facilitative, or enabling creative professional actions and decisions that help people of a designated culture (or subculture) to adapt to or to negotiate with others for meaningful, beneficial and healthy lifeways.
• Culture Care Repatterning and/or Restructuring ● refers to the assistive, supportive, facilitative, or enabling professional actions and decisions that help clients reorder, change, or modify their lifeways for new, different, and beneficial healthcare patterns while respecting the clients' cultural values and beliefs and still providing a beneficial or healthier lifeway before the changes were established with the clients
• 1. Decide whether you will be studying individuals, groups, families, communities, or institutions in relation to culture care and their domain of inquiry.
• 2. Remain focused on theory tenets and the domain of

  inquiry of the study which varies from each researcher.
• 3. Research can start either on the upper or lower part of the Sunrise Model depending on the researcher’s interests, knowledge, and competencies
• 4. ll dimensions or components in the Model should be

  explored especially with the particular domain to be

  studied.