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Madeleine Leiniger's Culture Care Theory of Diversity and Universality

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Madeleine Leiniger's Culture Care Theory of Diversity and Universality

Ball State University

Spring 2013

Madeleine Leininger first entered the world of nursing in 1948 upon graduating from the diploma program at St. Anthony's School of Nursing in Denver, Colorado (George, 2011). Even at a young age, Leininger understood the importance of a solid educational background and, thus, continued with her studies to eventually obtain a bachelors degree in biological science, a masters degree is psychiatric-mental health nursing, and a PhD degree in cultural and social anthropology. Additionally, Leininger submersed herself in the indigenous culture of the Gadsup people of New Guinea for two years in order to fully study and understand this subculture (MacFarland, 2010). From this unique collection of educational degrees and expierences, Leininger obtained a well rounded understanding of human and social sciences, which served her well in creating her Theory of Culture Care of Diversity.

Leininger soon noticed a severe deficiency in nursing education for caring for different patients from varying background. Therefore, Leininger set to creating a theory for caring for these patients in a culturally congruent way, which led to her becoming known as the founder of transcultural nursing (George, 2011). Since beginning her work, Leininger has spoken at thousands of international nursing and anthropology conferences, published hundreds of books and journal compositions, and served at many prestigous universities as an associate professor. Because of Leininger's work, several masters and doctoral programs worldwide have been established and teach her works and Theory of Culture Care of Diversity. Additionally, Leininger established the Journal of Transcultural Nursing and served as its editor for many years (McFarland, 2010). Leininger contiunes to this day be very active in both the fields of nursing and anthropolgy and serves as a consultant for many committess focused on providing culturally competent care.

Internal Evaluation


Major assumptions of Leininger's theory include (McFarland, 2010):

1. The single, unifying focus of nursing is caring.

2. Care based on culture is necessary for health, wellness, basic survival and the dying process.

3. The most comprehensive option on which to base nursing care and nursing decisions is culturally based care.

4. The central purpose of transcultural nursing is to serve individuals and groups. It is a holistic and science-based discipline.

5. Culturally based care is important in both curing and caring.

6. Transculturally, Culture Care concepts vary with differences and similarities in meanings, patterns, and processes.

7. Every culture has lay/folk care and knowledge. Most cultures also have professional care knowledge. Both vary from culture to culture and amongst individuals.

8. There are many influences on Culture Care values, beliefs, and practices. These influences include the following: philosophy, religion (spirituality), politics, kinship, context, environment, language, and worldview.

9. Within their environment, culturally based care that is healthy and beneficial influences the health and well-being of the individual, the family, and the community.

10. Only when care values are known and used appropriately can culturally congruent care occur.

11. Universally, within cultures, Culture Care differences and similarities exist between professional and lay care.

12. Lack of Culture Care that is safe and culturally congruent leads to cultural conflicts, impositions, and stresses.

13. Ethnonursing is a priceless means of obtaining and interpreting emic and etic Cultural Care data that is diverse and complex.

Four concepts of the metaparadigm:

Leininger did not rely on the four concepts of the nursing metaparadigm. She found them to be too restrictive and not consistent across cultures. However, one can find or extrapolate the folowing definitions (Leininger & McFarland, 2008; McFarland, 2010):

a. Nursing: Nursing is both a scientific profession and a discipline. Nursing focuses on care tasks and occurrences. The goal of nursing is to help human beings to get well or maintain wellness in ways that are supportive of and familiar to their own culture. Leininger also includes dealing with handicaps and impending death in the scope of nursing practice. Leininger believed that the nursing profession has a social obligation to serve people in a culturally competent way.

b. Health: Health and well-being have distinct definitions in each culture. Each culture has its own idea of health maintenance. In many cultures, the definition of health is deeply influenced by the emic practices of that culture. Differences and similarities will exist between cultures, as well as within cultures between lay folk and professionals.

c. Environment: In Leininger's model, the environment is comprised of the geography, ecology, economy, norms, and shared beliefs of a culture. A culture learns and shares beliefs, norms, and ways of life in a common setting. Environment plays a distinct role in every culture.

d. Person: Leininger did not accept the concept of the person as universally applicable to all cultures. The definition or idea of personhood varies greatly from culture to culture. Many cultures are not person-based. Instead, Leininger felt that the metaparadigm should embrace the concept of the human being. Human beings are capable of caring and surviving in cultures all over the world.

Leininger strongly believed that the concept of care should be added to the metaparadigm. Care is a major piece of the theory. Care is made up of both etic and emic experiences that support, enable, and assist human beings toward recovery or well-being. Care includes actions, experiences, practices, and attitudes. Care can be abstract or concrete and exists in each and every culture.


Because the Culture Care Theory was one of the earliest nursing theories and it is the only theory focused on transcultural nursing, it involves many unique terms and concepts. Leininger coined many terms as she built and adapted her theory. These terms help explain how the concepts are interrelated. The following



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