MADELEINE LEININGER

 Developed the Transcultural Nursing Model.

 Advocated that nursing is a humanistic and scientific mode of helping a client through
specific cultural caring process to improve or maintain a health condition.
 Leininger is the founder of the transcultural nursing movement in education research and
practice.

THEORY: Transcultural Nursing

 The Transcultural Nursing Theory or Culture Care Theory by Madeleine Leininger

involves knowing and understanding different cultures with respect to nursing and health-
illness caring practices, beliefs and values with the goal to provide meaningful and
efficacious nursing care services to people according to their cultural values and health-
illness context.

 It focuses on the fact that different cultures have different caring behaviors and different
health and illness values, beliefs, and patterns of behaviors.

 The cultural care worldview flows into knowledge about individuals, families, groups,
communities, and institutions in diverse health care systems. This knowledge provides
culturally specific meanings and expressions in relation to care and health. The next focus
is on the generic or folk system, professional care system(s), and nursing care.
Information about these systems includes the characteristics and the specific care features
of each. This information allows for the identification of similarities and differences or
cultural care universality and cultural care diversity.

 Next are nursing care decisions and actions which involve cultural care
preservation/maintenance, cultural care accommodation/negotiation and cultural care re-
patterning or restructuring. It is here that nursing care is delivered.

Major Concepts of Transcultural Nursing Theory:

The following are the major concepts and their definitions in Madeleine Leininger’s
Transcultural Nursing Theory.

1. Transcultural Nursing

Transcultural nursing is defined as a learned subfield or branch of nursing which focuses upon
the comparative study and analysis of cultures with respect to nursing and health-illness caring
practices, beliefs, and values with the goal to provide meaningful and efficacious nursing care
services to people according to their cultural values and health-illness context.

2. Ethnonursing
This is the study of nursing care beliefs, values, and practices as cognitively perceived and
known by a designated culture through their direct experience, beliefs, and value system
(Leininger, 1979).

3. Nursing

Nursing is defined as a learned humanistic and scientific profession and discipline which is
focused on human care phenomena and activities in order to assist, support, facilitate, or enable
individuals or groups to maintain or regain their well-being (or health) in culturally meaningful
and beneficial ways, or to help people face handicaps or death.

4. Professional Nursing Care (Caring)

Professional nursing care (caring) is defined as formal and cognitively learned professional care
knowledge and practice skills obtained through educational institutions that are used to provide
assistive, supportive, enabling, or facilitative acts to or for another individual or group in order to
improve a human health condition (or well-being), disability, lifeway, or to work with dying
clients.

5. Cultural Congruent (Nursing) Care

Cultural congruent (nursing) care is defined as those cognitively based assistive, supportive,
facilitative, or enabling acts or decisions that are tailor-made to fit with individual, group, or
institutional cultural values, beliefs, and lifeways in order to provide or support meaningful,
beneficial, and satisfying health care, or well-being services.

6. Health

It is a state of well-being that is culturally defined, valued, and practiced, and which reflects the
ability of individuals (or groups) to perform their daily role activities in culturally expressed,
beneficial, and patterned lifeways.

7. Human Beings

Such are believed to be caring and to be capable of being concerned about the needs, well-being,
and survival of others. Leininger also indicates that nursing as a caring science should focus
beyond traditional nurse-patient interactions and dyads to include families, groups, communities,
total cultures, and institutions.

8. Society and Environment

These terms are not defined by Leininger; she speaks instead of worldview, social structure, and
environmental context.

9. Cultural and Social Structure Dimensions

Cultural and social structure dimensions are defined as involving the dynamic patterns and
features of interrelated structural and organizational factors of a particular culture (subculture or
society) which includes religious, kinship (social), political (and legal), economic, educational,
technological and cultural values, ethnohistorical factors, and how these factors may be
interrelated and function to influence human behavior in different environmental contexts.

10. Environmental Context

Environmental context is the totality of an event, situation, or particular experience that gives
meaning to human expressions, interpretations, and social interactions in particular physical,
ecological, sociopolitical and/or cultural settings.

11. Culture

Culture is the learned, shared and transmitted values, beliefs, norms, and lifeways of a particular
group that guides their thinking, decisions, and actions in patterned ways.

12. Culture Care

Culture care is defined as the subjectively and objectively learned and transmitted values, beliefs,
and patterned lifeways that assist, support, facilitate, or enable another individual or group to
maintain their well-being, health, improve their human condition and lifeway, or to deal with
illness, handicaps or death.

13. Culture Care Diversity

Culture care diversity indicates the variabilities and/or differences in meanings, patterns, values,
lifeways, or symbols of care within or between collectives that are related to assistive,
supportive, or enabling human care expressions.

14. Culture Care Universality

Culture care universality indicates the common, similar, or dominant uniform care meanings,
pattern, values, lifeways or symbols that are manifest among many cultures and reflect assistive,
supportive, facilitative, or enabling ways to help people. (Leininger, 1991)

Sunrise Model of Madeleine Leininger’s Theory:

  The cultural care worldview flows into knowledge about individuals, families, groups,
communities, and institutions in diverse health care systems. This knowledge provides
culturally specific meanings and expressions in relation to care and health. The next focus
is on the generic or folk system, professional care systems, and nursing care. Information
about these systems includes the characteristics and the specific care features of each.
This information allows for the identification of similarities and differences or cultural
care universality and cultural care diversity.

 Next are nursing care decisions and actions which involve cultural care preservation or
maintenance, cultural care accommodation or negotiation and cultural care repatterning
or restructuring. It is here that nursing care is delivered.

Three modes of nursing care decisions and actions:

1. Cultural care preservation or Maintenance

Cultural care preservation is also known as maintenance and includes those assistive, supporting,
facilitative, or enabling professional actions and decisions that help people of a particular culture
to retain and/or preserve relevant care values so that they can maintain their well-being, recover
from illness, or face handicaps and/or death.
2. Cultural care accommodation or Negotiation

Cultural care accommodation also known as negotiation, includes those assistive, supportive,
facilitative, or enabling creative professional actions and decisions that help people of a
designated culture to adapt to or negotiate with others for a beneficial or satisfying health
outcome with professional care providers.

3. Culture care repatterning or Restructuring

Culture care repatterning or restructuring includes those assistive, supporting, facilitative, or

enabling professional actions and decisions that help a clients reorder, change, or greatly modify
their lifeways for new, different, and beneficial health care pattern while respecting the clients
cultural values and beliefs and still providing a beneficial or healthier lifeway than before the
changes were coestablished with the clients. (Leininger, 1991)