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Theory of Culture Care Diversity and Universality

The nursing profession was historically viewed as a subordinate and lesser medical profession. Over time, it has gradually become a well-established and respected job that demands a high degree of skill. Today, the issue of developing a theoretical basis for nursing has also become urgent. Many researchers have developed their theories in order to address vital issues of nursing practice. There is also a philosophical value in theory, as it helps professionals develop a well-rounded view on a variety of issues and practices currently under debate. In addition, theory helps medical professionals to systematically asses the existing data and to develop new solutions and implications for practice. The theory of culture care was originally developed by Madeleine Leininger in 1995. Over the years, it has been reworked into a global and more well-rounded theory of nursing that addresses a wide variety of nursing issues, including treatment decisions, patient outcomes, culture-sensitive practices, and other practical and theoretical problems. Therefore, it is vital to critically assess it in terms of its relevance, strengths, and weaknesses, and to find implications for theory and practice in the modern healthcare setting.

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The Essence of Culture Care Diversity and Universality

According to McFarland (2015), Leininger made an enormous impact on nursing research and practice with respect to cultural awareness. She defined terms and notions relevant to the theory, restating the basics of nursing, introducing new terms, and reworking those that had previously been inadequate. The theory identifies cultural aspects that need to be considered when planning care interventions. Among those aspects are language, food, sexual orientation, occupation, age, cultural gender preferences, and other factors. There are three major ways to address culturally sensitive issues, including preservation, accommodation, and restructuring (Leininger & McFarland, 2006). Preservation presupposes minimal intrusion into the cultural practices and values of the patient by addressing his or her healthcare needs with maximal caution. The second approach utilizes negotiation tactics to help a person adapt to the cultural environment where the healthcare facility operates to ensure high quality health outcomes. The third refers to actions that aim to address potential culture-specific incompetencies in a patient’s behaviors that may impact his or her health in the future.

Leininger and McFarland (2006) identified two types of knowledge that are directly related to care and help build a strategy to addressing a patient’s needs. One is culture-based knowledge, which refers to practices and beliefs that result from a patient’s cultural background. The other focuses on medical traditions and standards that are used in a patient’s country of origin. In general, culture care theory employs all cultural knowledge and practices in combination with the latest medical techniques, and utilizes them to address the healthcare needs of a certain patient in a manner that is non-damaging to his or her cultural mindset and beneficial to his or her medical condition.


Personal Relevance

This approach is becoming increasingly relevant as many countries in the world become more and more globalized. It is a common notion nowadays that many nationalities and cultures live within the borders of a single country. When it comes to healthcare, hospitals admit patients with different social and cultural backgrounds and strive to provide high-quality care. However, the quality of service and certain treatments can be undermined, as common medical practices can sometimes contradict religious, moral, or social notions related to a specific culture. Therefore, in a diverse multicultural environment, culture care theory is highly relevant.

For instance, Florida is a state with a rich demographic composition. The state is home to many ethnicities, including Hispanic, Native American, Arab, Chinese, and many more. In such a diverse setting, patient-centered care becomes an issue, and there is an increasing need for culturally sensitive paradigms for providing care. Living in Miami, I appreciate the opportunity to encounter culturally diverse patient populations and test the culture care concept in real-life situations. I think that culture care had a special meaning for Madeleine Leininger also, as she was an anthropologist (Leininger & McFarland, 2006), and studying diversity (as well as applying knowledge about diversity to practice) was her personal interest.

Relevance to Health Care

Practical implications of the culture care theory include a wide range of intercultural communication strategies, culture-sensitive practices, intervention planning, and quality improvement issues. Communication is a key to healthy and mutually productive dialogue between a care provider and a patient, as much culturally sensitive knowledge can be obtain though direct verbal engagement. Methods of non-offensive information gathering can be a crucial part of the everyday schedule of nurses working in multicultural environments. In order to develop personalized and culture-sensitive interventions, a nurse needs to possess a well-established set of skills. The culture care paradigm provides an opportunity for professional development in the sphere of cultural management in a healthcare setting. Opportunities for growth also exist on the organizational level. In accordance with the theory, clinics need to reorganize their facilities to suit the needs of a diverse population and make sure their personnel are aware of sensitive methods for treating patients.

Application to Research

Culture care diversity and universality also push theoretical research in nursing further by broadening the horizons of healthcare professionals. As working environments change, with hospitals being frequently exposed to culture-related issues, a need emerges for various theoretical frameworks that address the problems that healthcare providers encounter. An approach grounded in theory usually analyzes various aspects of the issue, supports the findings and implications with substantial amounts of data, and generates knowledge accessible to practitioners that helps make sense of the problem and elaborate workplace-specific improvements and changes. In this regard, culture care theory goes beyond these steps and defines healthy practices, differentiating them from unhealthy ones. In has also broadened the vision of care itself by placing it in a new cultural setting and enriching it with notions of tolerance, patience, and respect. Thus it provides a well-developed code that helps nurses establish positive relationships with their patients from various cultural environments.

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Strengths and Limitations

Among the strengths of the theory, there are the evident improvements that it brings to the healthcare system as a whole, enabling it to redefine and enrich the notion of care and updating standards, norms, and practices in order to fit into a modern globalized world. It provides a holistic view of the role of culture in a modern healthcare setting (Jeffreys, 2015). As it was developed as a global theory, it raises nurses’ awareness of methods and practices that ensure that the best quality of care is delivered to patients with different cultural backgrounds. It covers a variety of culture-related issues, placing them directly in the healthcare environment and developing new significance for them.

The theory also reinforces the author’s prior work by supporting it with new evidence and making its claims even stronger. This allows nurses to form a comprehensive and multifaceted perspective on cultural problems in healthcare. From the standpoint of everyday practice, hospital nurses may conduct their interactions with diverse populations more effectively. They may utilize updated communication strategies, planning, and interventions in accordance with the new understanding of the interrelation of culture and care, helping them to provide high-quality services to their patients.

Possible limitations may include the high cost of changes that a national healthcare system may face if it chooses to follow this theoretical framework (Alligood, 2014). Addressing the cultural needs of every possible ethnicity may be extremely costly. In addition, a major reeducation of healthcare providers is also necessary, which imposes further costs on the system. Gathering cultural information in every particular case can be hindered by a variety of factors, such as the inability of patients to communicate their wishes and the absence of relatives who could clarify matters. Personal factors can also pose an issue, potentially disrupting the process of cultural communication. For instance, a patient and their relatives could express different views of cultural issues regarding treatment procedures, placing a care provider into a mediator position. Many cultures also utilize non-verbal communication patterns that may obstruct the process of cultural exchange between a nurse and a patient. A constant need to pay attention to possible indicators of patients’ expressing their wishes may place an additional burden on caregivers, whose working conditions tend to be extremely stressful.


All things considered, cultural care diversity and universality made an enormous impact on the theory and practice of nursing. This theory provides an opportunity to reassess the very concept of care, adding new meaning to it. It is extremely relevant to the present-day global healthcare environment due to the fact that it addresses one of the main problems of a globalized world, namely, cultural diversity. It enables nurses to develop professionally to be able to work with patients of various cultural backgrounds and provide them high-quality care. Despite the barriers to its implementation, it possesses the capacity to change care delivery around the world for the better, provided it receives a substantial amount of support. Therefore, it is pivotal to conduct further research in the sphere of culture care and seek more refined methods for its implementation.


Alligood, M. R. (2014). Nursing theorists and their work. Berlin, Germany: Elsevier Health Sciences.

Jeffreys, M. R. (2015). Teaching cultural competence in nursing and health care: Inquiry, action, and innovation. New York, NY: Springer Publishing Company.

Leininger, M., M., & McFarland, M., R. (2006). Culture care diversity and universality: A worldwide nursing theory (2nd ed.). Sudbury, MA: Jones & Bartlett.

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McFarland, M., R. (2015). Culture care diversity and universality. Burlington, MA: Jones & Bartlett Learning.

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