Madeleine Leininger's

"Culture Care Diversity

and Universality
Theory"
 Madeleine Leininger
• Born in Sutton, Nebraska
• Graduated from St. Anthony's School of Nursing
in 1948
• Started nursing career in the U.S. Army Nurse
Corps
• Earned a bachelor's degree in biological science
in 1950
• Obtained MSN from Catholic University in 1953
• Introduced the first transcultural nursing course
in 1966 at the University of Colorado 2
• Published Culture Care Diversity and
Universality theory in 1985
• Further explained the theory in 1988 and
published a comprehensive book in 1991
• Appointed as the dean of the University of
Washington School of Nursing in 1969
• Inspired by a trip to Papua New Guinea in the
1960s to emphasize cultural understanding in
patient care
• Founded transcultural nursing and
established a program in 1974
3
• Transcultural Nursing Society, founded by
Leininger, celebrated its 35th anniversary in
2009
• Mission of TCNS is to enhance culturally
congruent, competent, and equitable care
globally
• TCNS aims to provide healthcare
professionals with cultural competence in
practice, education, research, and
administration.
4
DEFINITIONS IN TRANSCULTURAL NURSING:
• Culture
Set of values, beliefs, and traditions handed down through
generations.
• Religion
Beliefs in a divine power; ethical values and practices within cultures.
• Ethnic Group
People sharing a common culture.
• Cultural Identity
Feeling part of an ethnic group or culture.
• Culture Universals 5
5
Shared values and norms among different cultures.
• Culture-Specifics
Unique values and behaviors within a culture.
• Material Culture
Objects like dress and religious artifacts.
• Non-material Culture
Beliefs, customs, language, and social institutions.
• Subculture
Distinct identity within a larger cultural group.
• Bicultural
Person crossing two cultures, lifestyles, and values.
• Diversity
Being different, occurring between cultures or within a group.
• Acculturation 9
Adopting features of another culture.
• Cultural Shock
Disorientation in a different cultural environment.

• Ethnic Identity
Personal perspective on heritage and belonging to a group.
• Race
Classification based on biological characteristics; not always tied to
culture.
• Culture Care Diversity
Variances in meanings, values, and lifeways in human care expressions.
• Culture Care Universality
Common care meanings and values across many cultures. 4
 TRADITIONAL CONCEPTS OF HEALTH AND
DISEASE
° Health Concepts
- Cultural groups may prefer non-Western treatments due to
differing views on illness origins.
- Eastern cultures often see disease causality externally,
while Western cultures focus internally.
- Traditional individuals seeking Western treatment may
7
struggle to articulate symptoms accurately.
° Treatment Follow-Through
- Individuals from diverse cultures may resist health
recommendations due to negative perceptions.
- Acknowledge explanatory models, shaped by cultural, social,
and personal beliefs, influencing health views.

° Biomedical vs. Lay Models

- Disparities between biomedical and lay explanatory models

may lead to resistance in health programs. 4
° Flexibility in Design
- Design programs, policies, and services flexibly to address
the needs of culturally diverse populations.

✓ CAREEssential for survival, varies culturally.

√ CULTURAL CARE
Diverse values, vital for nursing, requires understanding cultural diversity.
√ WORLD VIEW
Outlook shaped by social structure and environmental context.
√ FOLK HEALTH
Cultural care practices, supplementing professional health systems. 3
√ ILLNESS CASUALITY
Folk illnesses have multiple causes, may need folk healers alongside Western
interventions.

√ CONCEPT OF CULTURE
Learned through experiences, transmitted via language, adapts but remains
constant.

√ CULTURAL AWARENESS
Examining biases and assumptions about others, understanding one's background.

4
2
THEORETICAL ASSERTIONS
Tenets are the positions one holds or the givens that the theorist uses with a
theory. In developing the Culture Care Theory, four major tenets were
conceptualized and formulated (Leininger, 2002, 2006)

1. Culture Care expressions, meanings, patterns, and practices are diverse,

and yet there are shared commonalities and some universal attributes.

2. The worldview consists of multiple social structure factors (eg, religion,

economics, cultural values, ethnohistory, environmental context, language,
and generic and professional care), which are critical influencers of cultural
care patterns to predict health, well-being, illness, healing, and ways
people face disabilities and death.
3. Generic emic (folk) and professional etic care in different environmental
contexts can greatly influence health and illness outcomes

4. From an analysis of the previously listed influencers, three major actions

and decision guides were predicted to provide ways to give culturally
congruent, safe, and meaningful health care to cultures. The three culturally
based action and decision modes were the following: (1) Culture Care
preservation or maintenance, (2) Culture
Care accommodation or negotiation, and (3) Culture Care repatterning or
restructuring. Decision and action modes based on culture care were
predicted as key factors to arrive at congruent, safe, and meaningful care
(1) Culture Care preservation or maintenance
- Nursing care activity that help people of particular cultures to retain and use core
cultural care values related to health care concerns or conditions.

(2) Culture Care accommodation or negotiation

- creative nursing actions that help people of a particular culture adapt to or negotiate
with others in the health care community

(3) Culture Care repatterning or restructuring

-therapeutic action taken by culturally competent nurse(s) or family. These actions
enable or assist a client to modify personal
health behavior towards beneficial outcomes while respecting the client's cultural
2
value.
 Thank you
for listening!