Madeleine Leininger’s

Culture Care Theory

Dileep Kumar
MSc. N Student
College of Nursing, JPMC, Karachi
 Objectives
Today’s my presentation objectives are to;
• Introduce the Theorist Madeleine Leininger
• Define culture care theory and Sun Rise model
• List the purpose and goals of the culture care
theory
• Define major assumptions of culture care theory
• Describe the Metaparadigm of theory
• Discuss about the nursing implications of theory
 Credentials & Background of Theorist
• Madeleine Leininger is a Founder of Transcultural Nursing
and Human Care Theory
• First professional Nurse with graduate preparation in nursing
to hold a PhD
• Was born in Sutton, Nebraska in 1920
• 1948 Diploma in Nursing, Was in US army Nurse corps, while
pursuing the basic nursing program
• 1950 BS in Biological Sciences
• 1954 obtained master degree in psychiatric nursing
• Initiated and directed the 1st Graduated Nursing Program in
Psychiatric Nursing at University of Cincinnati
Credentials & Background of Theorist
• 1966 offered 1st course in Transcultural Nursing in
University of Colorado
• 1969 appointed as Dean and Professor of Nursing and
Lecturer in Anthropology
• Studied 14 major cultures in depth and has had experience
with many different additional cultures.
• Authored or edited more than 27 books
• Published more than 200 articles and 45 chapters plus
numerous research projects focused on transcultural
nursing, human care and health phenomena.
• 1974, initiated National Transcultural Nursing Society org:
• 1989, initiated Journal of Transcultural Nursing
 Her other Areas of Interest
Besides transcultural nursing with care as a
central focus her other areas of interest are;
• Comparative education and administration
• Nursing theories
• Politics
• Ethical dilemmas of nursing and health care
• Qualitative research methods
• Future of nursing and health care
• Nursing leadership
 Theoretical sources
• Derived from disciplines of anthropology and nursing but
is reformulated to be transcultural nursing with human care
perspective
• She has defined the transcultural nursing as a major area of
nursing that focuses on a comparative study and analysis of
different cultures and subcultures in the world with respect
to their caring values, expressions, and health-illness
beliefs and pattern of behavior with the goal to develop a
scientific and humanistic knowledge to provide culture
specific and/or culture universal nursing care practice.
 Development of the theory
• Developed in the mid-1950s and early 1960s.
• Developed particularly to discover the meanings and ways
to give care to people who have different values and life
ways.
• Designed to guide nurses to provide nursing care that fits
with those that are being cared for.
• Culture Care theory not only focuses on nurse-client
interaction but the focus also includes care for families,
groups, communities, cultures and institutions.
 The Theory
Culture Care: Diversity and Universality
• Focuses on describing, explaining and predicting
nursing similarities and differences focused primarily
on human care and caring in human cultures.
• The Culture Care Diversity & Universality theory
does not focus on medical symptoms, disease entities
or treatments.
• It is instead focused on those methods of approach to
care that means something to the people to whom the
care is given.
 Central Purpose of the Theory

• To discover and explain

diverse and universal
culturally based care factors
influencing the health, well
being , illness or death of
individuals or groups
 Goals
• To give culturally congruent care
• To discover the meanings and ways to give care to
people with different values
• To promote well-being, growth & development,
healthy lifestyles and recovery from illness
• To work & function effectively with people having
different values, beliefs, and ideas about nursing,
health, caring, wellness, illness, death & disability
 Major Assumptions
1.Care is the essence of nursing and a distinct, dominant,
central and unifying focus.
2.Care (caring) is essential for well-being, health, growth,
survival and to face handicaps or death.
3.Culturally based care is the broadest holistic means to
know, explain, interpret and predict nursing care
phenomena and to guide nursing decisions and actions
4. Nursing is a transcultural humanistic and scientific care
discipline and profession with the central purpose of
serving individuals, groups, communities or
institutions worldwide.
 Major Assumptions
5. Care (caring) is essential to curing and healing,
for there can be no curing without caring
6. Culture care concepts, meanings, expressions,
patterns, processes, and structural forms of care
vary transculturally with diversities and some
universalities
7. Every human culture has generic (lay, folk or
indigenous) care knowledge and practices which
vary transculturally
 Major Assumptions
8. Culture care values, beliefs, and practices are influenced by
and tend to be imbedded in the worldview, language,
philosophy, religion (and spirituality), kinship, social,
political, legal, educational, economic, technological, ethno
historical, and environmental context of cultures
9. Beneficial, healthy and satisfying culturally-based care
influences the health and well-being of individuals, families,
groups, and communities within their environmental context
10. Culturally congruent or beneficial nursing care can only
occur when individual, group, family, community, or
institutional care values, expressions, or patterns are known
and used explicitly in appropriate and meaningful ways
 Major Assumptions
11. Culture care differences and similarities between
professionals and client participants exists in all human
cultures worldwide
12 Culture conflicts, imposition practices, cultural stresses
and pain reflect the lack of professional care
knowledge to provide culturally congruent, responsible,
and sensitive care
13. The ethnonursing qualitative research method
provides an important means to discover and accurately
interpret emic and etic embedded, complex and diverse
culture care factors
 The Sunrise Model (developed in1970)
• Serves as a conceptual guide or cognitive map to guide
nurses in the systematic study of all dimensions of theory.
• Symbolize “rising of the sun(care)”
• Upper half of the circle depicts component of the social
structure and world view factors that influence care and
health through language, ethnohistory and environmental
context.
• These factors also influence the folk, professional and
nursing system(s), which are in the middle part of the
model.
 Sun Rise Model
• Nursing act as a bridge between the folk generic
and the professional system
• Three kinds of nursing care & decisions and
actions are predicted in theory
1. Cultural care preservation and maintenance
2. Cultural care accommodation and/or negotiation
3. Cultural care repatterning and/or restructuring
 Scope
• She includes care/caring beyond the interpersonal level to
include families, groups & cultures.
• She is searching for worldwide human meanings
• Theory has multiple levels of scope dealing with human
cultures and nursing worldwide
– Broad macro level (etic analysis)
– Middle range (emic analysis)
– Concrete empirical level
• Sunrise model pictorially depicts the multiple theoretical
levels
• 90 cultures in Western and non-Western worlds have been
studied with the theory and 185 care constructs have been
identified
Metaparadigm concepts defined
• Nursing: care has the greatest meaning which
explains nursing
• Person: should refer to families, groups, and
communities
• Health: not distinct to nursing as many disciplines
use this term
• Environment: included events with meanings and
interpretations given to them in particular physical,
ecological, sociopolitical or cultural setting.
 Nursing Implications
• Nurse can asses, understand and plan care for
patient in tradition way
• Nurse documents the description of an individual’s,
family’s or community’s cultural social structure
that influence health patterns and concern
• Leininger’s theory does not focus on medical
symptoms, disease, or treatment, it focuses on the
nurse’s approach to care (this is truly a holistic
nursing idea!)
 Nursing Implications
– Nurse invites an individual, family or
community to describe their own experience
about health and caring

– Modify your nursing care to your patients with

the goal of improving their comfort and
response to care

– Utilize this theory for holistic assessments of

the patient
 Conclusion
We live in a city that is rich in diversity. How,
then, should we treat one another? We
should value diversity. We have the capacity
to perform a cultural self-assessment. We
should be conscious of the dynamics
inherent when cultures interact and we
should exercise cultural awareness. Being
culturally competent is essential to being an
efficient nurse.
 References
• Basvanthappa, B.T.(2007). “Nursing Theories” 1st Edition,
Jaypee Brothers, New Delhi
• Leininger, M. (2002) “Culture Care Theory: A Major
Contribution to Advance Transcultural Nursing Knowledge
and Practices”, Journal of Transcultural Nursing, Vol. 13 No.
3, 189-192. retrieved on 25-12-2009 from
http://tcn.sagepub.com/cgi/reprint/13/3/189.pdf
• Tommy, A. M., & Alligood, M. R. (1998). “Nursing theorists
and their works” 4th edition, A Harcourt Health Sciences
Company. Mosby
 Thanks
For your Attention

Any ????