Madeleine Leininger (Transcultural Theory) PDF

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Theoretical Foundations in Nursing - Interpersonal Relationship Theories and Theorists...

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INTERPERSONAL RELATIONSHIPS TRANSCULTURAL NURSING Madeleine Leininger

BIOGRAPHY Madeleine Leininger, an educator, author, researcher, public speaker, theorist, and founder of "Transcultural Nursing". She was named as a living legend by the American Academy of Nursing for a certain reason. Leininger was born on July 13, 1925, in Sutton, Nebraska. She grew up on the farm with her four brothers and sisters. After graduating from Sutton High School, Leininger pursued a basic nursing program in the U.S Army Nursing Corps. It was her aunt who suffered from congenital heart disease that led her to pursue nursing. She received a nursing diploma from St. Anthony's Hospital School of Nursing in 1948, followed by an undergraduate degree at Benedictine College and a Master's degree in Psychiatric Nursing from the Catholic University of America in 1954. She started her doctoral studies in 1960 and earned a Ph.D. in Cultural and Social Anthropology from the University of Washington in 1966.

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Leininger's Theory was greatly influenced by world war II. During this period immigrants were moving to the United States. With her interaction with various people of different ethnicities and health conditions, she became conscious that healing from disease was influenced by how medicinal services were given to a person. The Transcultural Nursing Theory or Culture Care Theory of Madeleine Leininger focuses on understanding the different cultures concerning nursing and health-illness caring practices. It is said that different cultures have different ways of caring and different health and illness beliefs, however, there are still some commonalities about care among all cultures in the world. Leininger defined Transcultural Nursing as "a substantive area of study and practice focused on comparative cultural care (caring) values, beliefs, and practices of individuals or groups of similar or different cultures to provide culture-specific and universal nursing care practices in promoting health or well-being or to help people to face unfavourable human conditions, illness, or death in culturally meaningful ways.” The Transcultural Nursing Theory is a theory that involves knowing and understanding different cultures for nursing care and health care practices. It is a theory that understands the similarities and differences of different cultures or human groups (Leininger, 1991). The goal of this theory was to provide meaningful nursing care services to people from different cultural backgrounds. CONCEPTS, RELATIONSHIPS, MODEL AND NURSING PARADIGM The Concepts in Transcultural Nursing of Madeleine Leininger Transcultural Nursing is a comparative study and analysis of cultures to understand similarities and differences across human groups. The cultures help to understand the differences in terms of health care, behaviour, beliefs, and practices. Culture is the set of values, beliefs, and traditions that are held by a specific group of people and handed down from generation to generation. Culture is learned by each generation through formal and informal life experiences. Practices often arise because of the group's social and physical environment. It is adapted over time but they mainly remain constant as long as they satisfy needs. Ethnonursing is the study of nursing care beliefs, values, and practices are cognitively perceived and known by a designated culture through their direct experience, beliefs, and value system (Leininger, 1979). Nursing is defined as a learned humanistic and scientific profession and discipline which focuses on human care development and activities to assist individuals or groups to maintain their wellbeing in culturally meaningful ways. The Professional Nursing Care or Caring is the formal and cognitively learned professional care knowledge and practice skills obtained in education institutions. it is used to provide, assist, support, and enable acts to improve the health of an individual or a group. Health is the state of well-being of a person in terms of values and practice. It also reflects the ability of a person to perform daily activities in various ways. Human Beings are believed to be caring and concerned about others. Leininger states that nursing as a caring science should focus beyond traditional nurse-patient interactions to include families, communities, cultures, and institutions.

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Society and Environment are categorized into Worldviews in which how people perceive the world or universe. Culture and Social Structures include factors related to religion, social structure, legal concerns, cultural values that influence the cultural responses of human beings. An Environmental Context is an event, situation, or experience that gives meaning to human expressions, particularly, in the setting of physical, socio-political, ecological, or cultural. Culture Care is the subjectively and objectively learned and transmitted values, beliefs, and ways that help, support, and facilitate an individual to maintain their well-being, health, and improve their conditions. It also helps to deal with illness, handicaps, or even death. The Culture Care Diversity indicates the variabilities and differences in meanings, values, patterns, or symbols of care within collectives that are related to assistive, supportive, or enabling human care expressions. The Culture Care Universality indicates the common, similar, or dominant uniform care meanings, patterns, values, lifeways, or symbols that are manifest among many cultures and reflect assistive, supportive, facilitative, or enabling ways to help people. (Leininger, 1991) The Sub-Concepts of the Transcultural Nursing Theory of Madeleine Leininger Generic Care Systems are indigenous (traditional) and folk (home-based) knowledge and skills used to provide assistance, support, and facilitate acts towards other people. Emic is the knowledge gained from direct experience. It is folk knowledge. The Professional Care System is formally taught, learned, and transmitted care, health, illness, and wellness that is related to the knowledge and practice skills obtained in institutions. Etic is the knowledge that describes the professional perspective. It is professional care knowledge. Ethnohistory includes those past events and experiences of an individual or group that are primarily people-centered (ethno) it describes human lifeways within the particular event. Care as a noun is related to support and enables experiences or behavior toward others. care as a verb, is the actions and activities directed toward assisting and supporting others. Culture Shock is when an individual attempts to adopt a different cultural group effectively. The individual may experience discomfort because of the differences in some factors such as practices and beliefs. Cultural Composition refers to the efforts of the outsider, both subtle and not so subtle, to impose his or her own cultural values, beliefs, behaviours upon an individual, family, or group from another culture. (Leininger, 1978).

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The Sunrise Model of Madeleine Leininger's Transcultural Nursing

The sunrise model is relevant because it enables nurses to develop critical and complex thinking towards the practice of nursing. It is used and valued to expand nurses' views and discoveries. It depicts multiple factors predicted to influence culture care expressions and their meanings. The upper half of the circle depicts components of the social structure and world view factors that influence care and health through language and environment. These factors influence the folk, professional, and nursing system, which are in the lower half of the model. The two halves together form a full sun, which represents the universe that nurses must consider to appreciate human care and health. The nursing subsystem can act as a bridge between the folk and personal health systems through the three types of nursing actions; cultural care preservation, cultural care accommodation, and cultural patterning. The Three Modes of Nursing Care Decisions and Actions 1. The Cultural Care Preservation or Maintenance focuses on nursing care activities that will help people of different cultures to preserve and use their cultural care values related to healthcare concerns or conditions. 2. The Cultural Care Accommodation or Negotiation focuses on the creative nursing actions that will help people of different cultures to adapt or negotiate with others in the community with an effort to achieve the shared goal of optimal health outcomes for people in their culture. 3. The Cultural Patterning focuses on the therapeutic actions taken by nurses or family. These actions help people to modify personal health behaviors towards an outcome.

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These three modes can be seen on a daily basis in nursing care. Nurses learn not just to focus on the illness but also on how the patient perceives the illness. THE METAPARADIGM MADELEINE LEININGER’S THEORY Person Human beings are caring and capable of being concerned about others. Health Culturally defined, valued, and practiced; Ability of an individual to perform their daily roles. Environment Totality of an event, situation, or experience; Related to the concept of culture. Nursing A humanistic art and science that focuses on personalized behaviours, functions, processes to promote and maintain health or recovery from illness.

Health Practices in Different Cultures 1. Use of Protective Objects: It can be worn, carried, or hung in the home. Charms are worn on different parts of the body and it serves as a protection from the evil spirits. 2. Use of Substances: certain food substances can be ingested to prevent illness. Raw garlic or onion are used to prevent illness. 3. Religious Practices: Burning of candles, rituals of redemption to protect an individual from the evil spirits. 4. Traditional Remedies: The use of traditional medicine is seen among people from different cultural ethnic backgrounds. 5. Healers: Specific persons are known to have the power that heals a sick person. 6. Immigration: People from different cultures have their own beliefs and attitudes regarding the area. 7. Gender Roles: The dominant role that practices health care depends on the culture whether it is female or male. In some cultures, women are discriminated from doing health care practices.

APPLICATION OF THE THEORY Field of Practice The theory of Leininger is very useful in the field of nursing. It guides the nurses to have knowledge and understanding in practice when it comes to different cultural backgrounds. This is not only beneficial to the nurses but to the people that need medical and personal needs. Different Communities are becoming more multicultural. With that, health care workers are expected to respond to client’s cultural needs.

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Field of Research A lot of nurses today are using the theory of Madeleine Leininger worldwide. This theory is the only one that focuses on the culture and care. Ethnonursing is use to examine this theory. The Ethnonursing is the method used to describe, document, and explain nursing care phenomena through studying the beliefs, values, and practices of different culture with concern to nursing care. Field of Academe In 1966, the culture and relative care nursing began in the University of Colorado. Since 1980, different nursing curriculum emphasizes transcultural nursing of human care. Nowadays, there is a demand for transcultural people who are trained to protect the quality of care and to prevent improper care. Culture care theory is widely accessible as it is the major and most significant contributor to transcultural nursing. (Ayonrinde, 2003). it will continue to play a significant role in the practice of nursing, research, and education. From the world we face right now, the role of nurses is very significant in numerous factors. Today's world is multicultural, the culture care theory is well established, and " it has been the most significant breakthrough in nursing and the health fields in the 20th century and will be in greater demand in the 21st century.” (Leininger, 2002). Because of the Transcultural Theory of Madeleine Leininger, she established a strong foundation in the field of nursing. With her guidance, nurses are ready to meet the future demands for culturally competent nursing care.

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