Introduction
The world is increasingly becoming complex and multicultural that makes the element of cultural competency an essential aspect of healthcare. Culture can bring people together. Thus, a study of the concepts of culture can result in an effective and exceptional healthcare provision since it will establish a strong bond between a nursing professional and the patient. Nurses are usually mandated to provide personalized care to patients thus plays an imperative role healthcare provision. Several scholars have looked into the issue of transcultural nursing, Madeleine Leininger being one of the main pioneers. She developed the culture care universality and diversity theory. It is in this regard that this essay seeks to look into the theory. It will provide an overview of the theory, stating the theory’s purpose, definitions, and concepts, relationships and structure as well as the assumptions made while developing the theory. Moreover, it will also discuss the application of the theory by describing a potential problem and how the theory will be useful to nurses.
Description of the theory
Purpose
Madeleine’s cultural theory focused on providing culturally congruent health care by providing a cognitively based assistive, facilitative, supportive and enabling decisions that are custom made to meet and exceed the needs and wants of specific individuals, institutions, groups, life ways, beliefs or cultural values. Its primary aim is to provide care that will benefit or improve the health outcome for people of similar or diverse cultures. The theory emphasizes on the changing dynamics and patterns on healthcare that will encourage or intrigue efforts on enhancing a strong patient-nurse relationship (Leininger, 2002). To attain a harmonious healthcare provision, the model presents health as both diverse and universal thus it is important for nurses to have the requisite knowledge about the particular culture in which they are practicing nursing. She argues that despite health being considered as universal across cultures, it is, however, distinct from one culture to another due to different practices, beliefs, and values. The health concept is similar across cultures but is diverse when it comes to the manners that particular cultures approach healthcare provision. In the theory, she focused on patient care from the cultural viewpoint. According to (Leininger & McFarland, (2006) nursing is a scientific and humanistic discipline that looks into human care and important cultural ways that can help patients regain their health.
Concepts of the Theory
It is prudent to understand the concepts of the theory to have a better insight into the theory. Some of the basic concepts she developed included the concept of care which she termed as the act of assisting patients with their needs to improve their health condition. The caring concept which entailed the activity aimed at providing health care. The culture concept, which she referred to as shared, learned and transmitted beliefs, norms, life ways, and values of a group or individual that dictates their thinking, actions, decisions and patterned ways of living. The cultural care concept involves cultural aspects that influence a person or a group to deal with death, improve their condition or even death (Leininger & McFarland, 2006). The concept of cultural diversity refers to the differences in values, beliefs, and acceptable mode of care between various groups of people. Similarly, cultural care universality is the common care that is evident across many cultures.
Definitions
Some of the terms used in the model and their definitions include (Leininger, 2006):
Nursing: it refers to a learning profession aimed at providing care to patients.
Transcultural: refers to the study and practice that aims on comparative cultural values, care, practices and beliefs of persons or groups of different or similar cultures with a primary motive of offering a culture focused and universal nursing practices in enhancing the well-being or health or even helping people to face the tough and unfavorable conditions in meaningful ways.
Ethonursing: it is a nursing discipline that focuses on studying nursing values, beliefs and values as cognitively viewed and known by specific cultures through their direct experience, value system, and beliefs.
Relationship and structure
Leininger developed her model or structure by relating to different aspects of nursing that she had experienced in a person as a nurse. She has worked as a nurse for more than thirty years. Thus, the model was primarily built out of her observations and how different patients from various cultures perceived their nursing experience and care differently based on their health practices and beliefs. Therefore, she relates transcultural care to the care nurses provide is shaped and derived from their cultural contexts (Reynolds & Leininger, 2003).
Assumptions of the theory
Leininger's Theory is based on numerous assumptions some of the assumptions include (Leininger, 2008);
She assumed that care is the main role of nursing.
Caring is important for a person’s well-being, growth, and health and healing.
Nursing is humanistic, transcultural and a scientific care profession with an aim of providing care to humanity across the world.
Concepts of cultural care, expressions, meanings, patterns, structures, and processes are the same across all cultures in the world
Reflections on the theory
Critique
The theory put forth by Madeleine is relatively clear as it gives an extensive insight of the theory, she has strong arguments to support her arguments and puts it in a simple and clear way that is easily understood and comprehended. Thus, it is simple and clear. However, she has made a lot of generalization in developing her model. Her conclusion that nursing provision is the same across cultures is not very true since different cultures have different perceptions of care (Reynolds & Leininger, 2003). What may be considered as a good care by one community could be deemed bad in another culture. Consequently, the theory is readily accessible for journals and online sources and also in books. It provides relevant knowledge for scholars and academicians to conduct future researches. Thus, the theory is of great importance.
The strength and limitation of the theory
The theory of the culture care universality and diversity of nursing development has some strengths and weaknesses. However, these weaknesses can be controlled. Leininger in her theory recognizes the fact that individuals from the different culture may have different cultures and theories concerning health practices and beliefs. Her theory, therefore, is of much importance to transcultural nursing because all the needs of the nurses will be taken into consideration. Her theory aims at providing universal nursing care as well as culture-specific practices that will enhance the welfare of the people to face unfavorable conditions, death or illness through means that are meaningful to a particular culture. For these reasons, transcultural nursing is very essential for the development of nursing career.
One of the main strength of the theory that was developed by Madeleine is that the theory equips nurses with skills that make them provide medical care that is holistic. This holistic approach will enable the nurses to have a broader knowledge of the psychological, physical and emotional needs of the patients. For full efficiency of the nurses, they must consider all these needs so that they can offer quality services to their patients. Quality service to patients is the ultimate goal of each and every nurse. Therefore to offer a holistic care to the patients, the nurses must put into consideration the cultural differences and any other kind of personal differences between their patients. A better understanding of their culture as stipulated in the theory of Madeleine will help the nurses to provide holistic care to the nurses. This is because the basis for providing holistic care is founded on a deeper understanding of the patient need and culture.
Despite the strength of the theory in nursing development, the nurses also experience some challenges. The challenge that most nurses face in this theory is that the theory demands understanding the culture and needs of the patients. Some of the needs and the cultures of these patients contradict the required standards of the health profession (Leininger, 2002). The patients may be so conservative and may not want to adapt to the new ways in the health profession. It thus becomes an uphill task to the nurses convincing the patients on the importance of modern day health care. However, this method may be of much ease when the patients and the nurses are willing to agree on one term despite the cultural and personal differences in eliminating the health problem. This theory best works for those who are educated. The literate is not so much conservative.
Problem experienced in the application of the theory
During application of this theory, nurses are normally faced with the problem of impoverished African American teens that have problems complying with the medical health needs. The teen African Americans who mostly normally come from low-class families have got cultural and personal beliefs that make them hard to comply easily with the medical health needs. Lifestyle preferences, geographical distribution, family influence and the family structure, environmental risks as well as communication patterns among the Africa America teens and the rest of Africa America highly impact on their health beliefs and culture (Leininger, 2001). There is this common perception that is rooted in the minds of many African Americans that they are unequal to their white counterparts. For that reason, they feel inferior to undergo the health care system that the whites normally undergo. They believe that the kind of discrimination that the white has always mated on them will be the same case if they attend the same medical care as the whites. To avoid the predicament that they normally foresee, they normally avoid receiving the same treatment and medication and quality of health care as whites. This perception among the black American teens is impacting negatively in their lives. The culture that existed, the culture of discrimination has made them have that belief.
Conclusion
It is evitable that the theory of Leininger in nursing development is very essential as it stipulates the procedure on how to deal with nurses. It acknowledges the fact that patients come from various backgrounds and, therefore, to give them holistic treatment, the nurses must deeply understand their culture. However, the theory faces some challenges despite its bid to boost the culture of the nurses.
Reference
Leininger, M. (2002). Culture care theory: a major contribution to advance transcultural nursing knowledge and practices. Journal of transcultural nursing, 13(3), 189-192.
Leininger, M. (2006). Culture care diversity and universality theory and evolution of the ethnonursing method. Culture care diversity and universality: A worldwide nursing theory, 2, 1-41.
Leininger, M. M. (2008). Leininger's theory of nursing: Cultural care diversity and universality. Nursing Science Quarterly, 1(4), 152-160.
Leininger, M. M., & McFarland, M. R. (2006). Culture care diversity & universality: A worldwide nursing theory. Jones & Bartlett Learning.
Reynolds, C. L., & Leininger, M. M. (2003). Madeleine Leininger cultural care diversity and universality theory.
