Culture Care Diversity and Universality (Maedline Leininger)

• Culture Care Diversity and Universality Theory, introduced in 1960s to provide culturally congruent and competent care.
• The theory was developed to establish a substantive knowledge base to guide nurses in discovery and use of transcultural nursing practices.
• During the post–World War II period, Dr. Leininger realized nurses would need transcultural knowledge and practices to function with people of diverse cultures worldwide.
• The central purpose of Transcultural Nursing was to use research-based knowledge to help nurses discover care values and practices and use this knowledge in safe, responsible, and meaningful ways to care for people of different cultures.
• Human beings are believed to be caring and to be capable of being concerned about the needs, well-being, and survival of others.
• Nursing as a caring science should focus beyond traditional nurse-patient interactions and dyads to include families, groups, communities, total cultures, and institutions.
• Health is a state of well-being that is culturally defined, valued, and practiced, and which reflects the ability of individuals (or groups) to perform their daily role activities in culturally expressed, beneficial, and patterned lifeways.
• Nursing is defined as 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 culturally meaningful and beneficial ways, or to help people face handicaps or death.
• Environment is not defined by Leininger; she speaks instead of worldview, social structure, and environmental context.
• Worldview is the way in which people look at the world, or at the universe, and form a “picture or value stance” about the world and their lives.
• Environmental context is the totality of an event, situation, or particular experience that gives meaning to human expressions, interpretations, and social interactions in particular physical, ecological, sociopolitical and/or cultural settings.
• Therapeutic nursing care can occur only when culture care values, expressions, and/ or practices are known and used explicitly to provide human care.
• Every culture has generic (lay, folk, or naturalistic) care, and most also have professional care practices.
• Culture care is defined as 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, health, improve their human condition and lifeway, or to deal with illness, handicaps or death.
• The forms, expressions, patterns, and processes of human care vary among all cultures of the world.
• Care is essential for human growth, development, and survival and for facing death or dying.
• Leininger (1991) identified three nursing decision and action modes to achieve culturally congruent care: Cultural preservation or maintenance, Cultural care accommodation or negotiation, Cultural care repatterning or restructuring.
• Care is essential to curing and healing; there can be no curing without caring.
• To develop understanding, respect and appreciation for the individuality and diversity of patients beliefs, values, spirituality and culture regarding illness, its meaning, cause, treatment, and outcome.
• Nursing is essentially a transcultural care profession and discipline.
• The practice of nursing today demands that the nurse identify and meet the cultural needs of diverse groups, understand the social and cultural reality of the client, family, and community, develop expertise to implement culturally acceptable strategies to provide nursing care, and identify and use resources acceptable to the client.
• Culture care universality indicates the common, similar, or dominant uniform care meanings, pattern, values, lifeways or symbols that are manifest among many cultures and reflect assistive, supportive, facilitative, or enabling ways to help people.
• Culturally congruent, specific, or universal care modes are essential to the health or well-being of people of all cultures.
• Differences between caregiver and care receiver expectations need to be understood in order to provide beneficial, satisfying, and congruent care.
• Culture care diversity 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 values and beliefs are embedded in religious, kinship, social, political, cultural, economic, and historical dimensions of the social structure and in language and environmental contexts.
• Cultural congruent (nursing) care is 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.
• Transcultural nursing is defined as a 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.
• Ethnonursing is the 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 is the learned, shared and transmitted values, beliefs, norms, and lifeways of a particular group that guides their thinking, decisions, and actions in patterned ways.