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Madeleine Leininger

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Yvonne Yang

on 21 November 2013

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Transcript of Madeleine Leininger

Written Work:
Culture Care Diversity and Universality (1991)
Transcultural Nursing (1995)
Transcultural Nursing (2002)

Founder of Two International Organizations:
Transcultural Nursing Society
International Association of Human Caring

1945 Nursing Diploma

St. Anthony's School of Nursing
1950 Bachelor of Science Degree in Biological Science
Minor in Psychiatric Mental Health Nursing and Psychology

Benedictine College
1954 Master of Science in Nursing Degree

Catholic University of America
1966 Doctorate in Anthropology

University of Washington

1969 - 1974 Dean & Professor of Nursing
Adjunct Professor of Anthropology
Director of Transcultural Nursing
To discover human care diversities and similarities in order to generate new knowledge to guide nursing care practices
A parsimonious theory, simple but accounts for a broad range of empiric experiences
Highly generalizable
Applies to individuals, families, communities, and societies
Not just specific to nursing but for any and all care providers
Best applied to the present and future because of growing cultural diversity

Madeleine Leininger
Transcultural Nursing Theory
History of Madeleine Leininger
July 6,1925 - August 10, 2012
Born in Sutton, Nebraska

Nursing Theory:
Transcultural Nursing

Clarity of the Theory
“a similar empiric image comes to mind when the word for the concept is used” (Chinn & Kramer, 2011, p. 198)

Major concepts clearly defined; empiric indicators can be easily identified

Uses concept map to enhance clarity

Several terms were created "lifeways" and "worldview" but are defined

Clarity of the Theory
According to Chinn and Kramer (2011), structural clarity refers to how “identifiable and apparent the connections and reasoning within theory are” (p. 200).

Conceptual network can be easily and readily identified

Concepts are interconnected

Theory is organized as a whole

Simplicity of the Theory
Generalizability of the Theory
Transcultural Nursing
Recognized a lack in cultural knowledge to support nursing care.
Theory derived from disciplines of anthropology and nursing.
Goal of Theory:
To improve and provide culturally congruent care to people in order to improve health of client, family, or culture group
Purpose of Theory:
“the concepts of the theory are used in ways that are consistent with their definition” (Chinn & Kramer, 2011, p. 199)

Purpose of theory, definitions of concepts and relationships are consistent

The same concepts are used in latest publications

Semantic Clarity
Semantic Consistency
Structural consistency refers to the consistent use of structural form within a theory (Chinn & Kramer, 2011, p. 201).

Directed towards individuals, families, groups, communities or institutions in diverse health care settings

Broad scope theory that is useful in nursing practice

Structural Clarity
Structural Consistency
Includes many different holistic factors universally found in cultures.
Can be used in Western and Non-Western cultures.
Sunrise Model
Theory is unique in focusing on discovering holistic and comprehensive culture care.
Designed to illustrate theoretical framework.
Helps to conceptualize components of theory.
Overview of Major Concepts & Definitions
Accessibility of the Theory
Accessibility = the extent to which empiric indicators for the concepts can be identified and to what extent the purposes of the theory can be attained

Empiric Indicators = perceptually accessible experiences that can be used in practice to assess the phenomena that the theory describes and that can be used to determine whether the purposes of the theory are realized in a way that the theory suggests
Based on Chinn & Kramer's (2011) theoretical critique model, Madeleine Leninger's Transcultural Nursing Theory (TCN) is an appropriate and applicable nursing theory. Overall, TCN theory is important to nursing practice because cultures will continue to be passed down from generation to generation indefinitely (as history has shown), and cultures will always differ from one another; therefore, this theory will forever be relevant to the nursing profession.
According to Leininger (1995), "the...theoretical assumptive statements are purposefully broad in order to guide researchers in discovering largely unknown phenomena..." (p. 104).
Purposeful Broad Concept Definitions
Specific Concept Definitions
The definitions within this theory are very
specific, allowing for a similar or same understanding regardless of who reads them.
Pertinent Definitions
Empiric Indicators
The care we provide differs from client to client, as each person comes to us with varying degrees of experiences, beliefs, and values.

It is important to remember that we must treat each client, whether that is an individual person, a family, a child and family, or a community, with appropriate care that is tailored to their individual needs.
Clinical Relevance
19.1% visible minority (2011) in Canada
45.2% visible minority (2011) in Vancouver
4.3% Aboriginal (2011) in Canada
Eastern and Western European immigrants
not included in these statistics
Importance of the Theory
1. Human Care and Caring
2. Culture
3. Culture Care
4. Culture Care Diversity
5. Culture Care Universality
6. Worldview
7. Culture and Social Structure Dimensions
8. Environmental Context
9. Ethnohistory
10. Emic
11. Etic
12. Health
13. Transcultural Nursing
14. Culture Care Preservation or Maintenance
15. Culture Care Accommodation or Negotiation
16. Culture Care repatterning or Restructuring
17. Culturally Competent Nursing Care

Influences interpersonal nursing care practices by considering cultural differences, resulting in cultural sensitivity, cultural awareness, and cultural competence

Starting in term one, Langara Nursing taught us the concepts of cultural awareness, cultural sensitivity, and cultural competence.

The TCN Theory has been incorporated into nursing education in order to improve quality of care for culturally diverse populations.
Educational Influences
Nursing Practice Implications
This theory specifically guides nursing research to further broaden the knowledge and understanding of different cultures.
Nursing Research Implications
The purpose of the theory are specific because it centers around providing culturally congruent care and it predicts the phenomena of healing by focusing on holistic health.
Implications on Health and Healing
The theory is consistent with the nursing philosophy and shapes it by guiding nursing actions to revolve around culturally congruent care.

However, the scientific component of nursing is missing from the theory because it focuses heavily on the aesthetic ways of knowing/aesthetic components of nursing.
Application on Nursing Practice
The stated purpose of the theory is to provide culturally congruent care which is the essence of nursing care practices. By using this theory when providing care, nurses are equipped with the knowledge and guiding framework of cultural sensitivity, cultural awareness, and cultural competency.
Sunrise Model
Essence of Nursing Care
This theory has shaped the way nursing education has been taught, how nurses operate, and will continue to guide nurse’s care because our society is becoming more culturally diverse.

We as health care professionals need to be knowledgeable and confident caring for these diverse individuals.

Further research done based on this theory would provide for more data of different cultures and allow for greater understanding of their unique needs and care practices.
Future Implications
It is pivotal to nursing practice because nurses provide care to anyone in need.

People in need come from culturally diverse backgrounds.

We have to achieve culturally congruent nursing care that is meaningful, beneficial, and satisfying to clients.
Practical Relevance
Group Evaluation of Theory
This allows us to provide medical care in a culturally safe manner in order to facilitate physical, emotional, spiritual, and psychological healing.
Resolution of Nursing Issues
The TCN theory allows for people of diverse cultures to feel respected, empowered, and safe.

This allows clients to feel that they feel that their voices their concerns are being addressed.
Clarity of the Theory
Presented by
Annita, April, Christina, Jessica, & Yvonne
NURS 3225
Theoretical Critique

Group Activity
Major Concepts & Definitions
Leininger, M. (2001). The Theory of Culture Care Diversity and Universality.In M. M. Leininger (Ed.), Culture care diversity and universality: A theroy of nursing (pp. 5-68). Mississauga, ON: Jones and Bartlett Publishers.

Leininger, M. (1995). Overview of Leininger's culture care theory. Transcultural nursing: Concepts, theories, research & practices (2nd ed., pp. 93-114). New York, NY: Mcgraw-Hill.

McFarland, M. (2006). Madeleine Leininger. In A. M. Tomey, & M. R. Alligood (Eds.), Nursing theorists and their work (6th ed., pp. 472-496). St. Louis: Mosby Elsevier.

Case Study
Class Discussion
In general, Chinese people are taught self-restraint. The needs of the group are more important than those of the individual. Another factor that may be involved in some Chinese people's refusal of pain medication is courtesy. They generally consider it impolite to accept something the first time it is offered. The safest approach for the nurse is to anticipate the needs of a Chinese patient for pain medication without waiting for requests. Nurses should be aware of Chinese rules of etiquette when offering pain medication, food or other services. But if the patient continues to refuse medication, their wishes should be respected.
A middle-aged Chinese patient refused pain medication following cataract surgery. When asked, he replied his discomfort was bearable and he could survive without any medication.

How would you respond in this situation?

Later the nurse found him restless and uncomfortable. Again the nurse offered pain medication. Again he refused, explaining that her responsibilities at the hospital were far more important than his comfort and he did not want to impose.

What nursing actions would you incorporate in your nursing care plan?

After this class discussion, how will this case study affect your future nursing care practice and the way you will approach patients of diverse cultural backgrounds?
Coming to Know
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