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Cultural Care Diversity and Universality


Theoretical frameworks in nursing provide guidance to nurses in various settings and situations. Theories and models are developed on the basis of extensive experience and research. One of these paradigms is transcultural nursing. It has been acknowledged that the process of healing depends on numerous factors, and it is essential to take into account patients’ cultural peculiarities (Giger, 2016). The need to pay attention to the cultural domain is specifically pronounced in such ethnically diverse countries as the USA. This provides a brief evaluation of the theory of cultural care diversity and universality.

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The theory was developed at the end of the 20th century when healthcare professionals started advocating the need for patient-centered care. Shen (2015) states that the conceptual models developed within the scope of this theory, as well as the larger domain of transcultural nursing, have equipped nurses with tools applicable in their daily practice. For example, the cultural competence model is instrumental in identifying specific areas that should be properly addressed by nursing practitioners (Shen, 2015). The model enables nurses to create the most favorable atmosphere for the patient and contribute to their fast recovery. Bivins (2016) provides a review of studies aimed at examining the cultural factors affecting the development and treatment of diabetes. It is clear that the cultural component of treatment and prevention efforts can play a significant role.

The theory of cultural care diversity and universality implies the focus on the cultural peculiarities of patients. Nurses guided by this theoretical framework try to identify certain features of different cultural groups (McFarland & Wehbe-Alamah, 2014). It is stressed that cultural contexts shape people’s behaviors, which has a direct impact on their health. Thus, people pertaining to different ethnic groups often have specific dietary habits and attitudes to physical activity and medical treatment. It is believed that the provision of care should be shaped in accordance with certain cultural aspects. At the same time, the theory is often criticized for its generalizations. For instance, Darnell and Hickson (2015) emphasize that some healthcare professionals tend to generalize, which deteriorates the quality of the provided care. It is also stressed that people may live in several cultural contexts or have peculiarities that are not typical of other members of their ethnic group. Therefore, it is essential to balance cultural aspects and other factors to ensure the provision of patient-centered care.

As for empirical indications, the theory in question has proved to be effective in many settings. For instance, it has been acknowledged that Haitians are vulnerable to the development of diabetes due to their dietary habits and lifestyles (Bivins, 2016). Shen (2015) states that various models have been developed within the domain of the transcultural nursing paradigm. These models have been applied successfully. Phillips et al. (2014) develop a model aimed at improving gerontological care. Importantly, the researchers add socioeconomic factors to their cultural model as minority groups are often disadvantaged.

The brief analysis of the available data shows that the theory of cultural care diversity and universality is the theoretical framework that can improve nursing care in the USA. Nurses have applied the theory, developed, and used numerous models based on the paradigm. At that, it is also necessary to state that existing research lacks coherence. Researchers come up with models and check them in clinical settings, but such studies are often confined to particular facilities or communities. There is a need to assess the effectiveness of the existing models in different clinical settings. The theory also lacks precision as it does not include the guidance for the balance between cultural, biological, psychological, and other factors that have a substantial effect on the healing process.

Irrespective of some limitations and gaps in the theory of cultural care diversity and universality, nursing professionals have to employ it. The diversity of the patient population is significant, and nurses should be ready to provide truly patient-centered care. Cultural components may help nursing practitioners in this endeavor. The paradigm has been used in healthcare facilities for decades and has proved to be effective. However, it is still necessary to make practice and theory closer. The development of population-specific and community-specific models can do the job. It is also essential to include the discussion of the balance between cultural and other elements in the curriculum so that nursing students were ready to apply theories in the working environment.


In conclusion, it is necessary to note that the theory of cultural care diversity and universality has been applied to nursing practice successfully. Nurses pay attention to the cultural peculiarities of their patients, which has a positive effect on the provided healthcare services and patient satisfaction. However, nurses should be skillful in the provision of patient-centered care rather than concerned about their patients’ cultural backgrounds. The theory in question still has certain gaps, but it can guide and has guided many professionals. Therefore, the theory should be further developed through the creation of various models that can be applied to many groups and settings.

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Bivins, B. (2016). Integrative review on adherence in Haitians with diabetes. Nursing Forum, 52(3), 165-172.

Darnell, L., & Hickson, S. (2015). Cultural competent patient-centered nursing care. Nursing Clinics of North America, 50(1), 99-108.

Giger, J. (2016). Transcultural nursing: Assessment and intervention (7th ed.). Los Angeles, CA: Elsevier Health Sciences.

McFarland, M. R., & Wehbe-Alamah, H. B. (2014). The theory of culture care diversity and universality. In M. R. McFarland & H. B. Wehbe-Alamah (Eds.), Leininger’s culture care diversity and universality (pp. 1-35). Burlington, MA: Jones & Bartlett Publishers.

Phillips, L., Salem, B., Jeffers, K., Kim, H., Ruiz, M., Salem, N., & Woods, D. (2014). Developing and proposing the ethno-cultural gerontological nursing model. Journal of Transcultural Nursing, 26(2), 118-128.

Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing. Journal of Transcultural Nursing, 26(3), 308-321.

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