In their practice, nurses should focus on many theoretical models which explain the major aspects of nursing and demonstrate the relationships between such concepts as “health,” “nursing,” “environment,” and “patient.” In Theory of Culture Care: Diversity and Universality, Madeleine Leininger focused not only on the listed concepts but also on the idea of “culture” as important to be addressed while providing care (Alligood, 2014). The purpose of this paper is to discuss the meaning of Leininger’s theory, its origins, usefulness, and testability, as well as to present the overall evaluation.
While discussing the main ideas associated with Leininger’s theory and key assumptions related to this model, it is important to focus on the following aspects: patients’ culture is important to be addressed when care is provided; the effective nursing practice is associated with the principles of transcultural nursing; to provide culturally appropriate care, nurses should conduct the ethnonursing research. Therefore, the main concepts related to the theory include “culture,” “cultural diversity,” and “cultural universality” (McFarland & Wehbe-Alamah, 2014).
The main relationships between these concepts can be described the following way: culture can influence care significantly because patients differ in their beliefs, visions, and expectations. Thus, the concept of “cultural diversity” refers to patients’ differences. However, “cultural universality” as the reference to similarities in cultures can also influence care when patients are perceived as representatives of large communities (Alligood, 2013). According to Leininger, nurses are expected to provide care with the focus on patients’ culture, and this care can be culture-specific and culturally congruent to guarantee that patients’ beliefs and visions are addressed in the most efficient manner.
Origins of the Theory
As a nurse anthropologist, Leininger started to develop her theory in the 1950s, when she noticed the need for creating a specific model of nursing based on the principles of anthropology and cultural studies to address the issue of diversity in society with the focus on the development of the notion of multiculturalism. Thus, changes in the visions of culture and diversity observed in the 1950s motivated Leininger to develop her specific theory (Alligood, 2013). As the support and basis for the theory, Leininger selected the notions typical of anthropology and nursing. The theorist’s purpose was to create the combined concept to reflect both universality and diversity associated with nursing when care is provided to representatives of different cultures (Alligood, 2014). Thus, the idea of transcultural nursing was developed as a result of integrating the knowledge and principles typical of anthropology and nursing with the focus on the culturally congruent care proposed to diverse patients.
Leininger’s theory can be discussed as useful to be applied to nursing practice because it provides a framework for accentuating the role of a patient’s culture in the process of his or her recovery. Healing can be effective only when the culturally appropriate care is provided. Patients’ cultural visions, beliefs, and patterns, as well as their social environments, can influence their recovery, and care should address all these aspects to lead to positive results (Alligood, 2014). Applying the principles of transcultural nursing, nurses learn specific beliefs, worldviews, visions, and ideas typical of their patients, and they can predict outcomes of treatments while analyzing diverse patients’ responses. For instance, this theory can be used for working with representatives of Amish people or Native Americans whose culture and traditions differ significantly from Western patterns known in the American society (Alligood, 2013). As a result, to learn how to provide care for these people, nurses should apply the results of their ethnonursing research.
It is possible to state that this theory is characterized by a high level of testability as it was tested in different quantitative and qualitative studies on the principles of transcultural nursing. Researchers used this theory to guide their studies while working in different cultural contexts, studying interactions of cultures, and involving diverse populations. Therefore, many quantitative and qualitative studies were developed with reference to this theory, and they were related to not only nursing but also healthcare and social fields (McFarland & Wehbe-Alamah, 2014).
For instance, in 2012, Morris applied Leininger’s theory “to study urban adolescent gang members and identified ways for health care providers to maintain health and safety and promote wellness by using the positive attributes gangs can offer to an urban community” (Alligood, 2013, p. 358). As a result, it is important to state that testability of Leininger’s theory is significant, and this aspect influences the quality of propositions made in the context of the theory.
Leininger’s theory can be viewed as both specific and general. The reason is that, in spite of the fact that Theory of Culture Care: Diversity and Universality is directly related to the concepts of transcultural nursing and provision of culturally appropriate care, it can also be generally applied to any field of nursing and healthcare. Strengths of this theory are associated with its holistic character, high-level applicability, contributions to nursing practice, and accentuation of universal features and differences important to provide the culturally congruent care. Weaknesses are related to application of this theory to practice as nurses are often inclined to focus only on applying ethnonursing methodology or only principles of transcultural nursing (Alligood, 2013). Still, this theory is important to be used in advanced practice because of the importance of providing culturally relevant care for all patients.
Leininger’s theory is one of the most significant theoretical models in nursing. The review and evaluation of this theory indicates that it provides important concepts to focus on and important methods to apply while delivering the patient-centered care. Therefore, this theory is actively applied by nurses in environments which require focusing on patients’ cultures.
Alligood, M. R. (2013). Nursing theory: Utilization and application (5th ed.). St. Lois, MO: Elsevier Health Sciences.
Alligood, M. R. (2014). Nursing theorists and their work (8th ed.). St. Lois, MO: Elsevier Health Sciences.
McFarland, M., & Wehbe-Alamah, H. B. (2014). Leininger’s culture care diversity and universality: A worldwide nursing theory (3rd ed.). Burlington, MA: Jones & Bartlett Publishers.