Nola J.

Pender

Middle range theories that have been tested in research provide evidence for evidence based
practice, thus facilitating translation of research into practice.

1. Prior related behavior

Refers to the frequency of the same or similar behavior in the past. This has direct and indirect

effects on the likelihood of engaging in health promotion behavior.

2. Personal Factors

Are categorized as biological ,psychological, and sociocultural. These factors are predictive of a
given behavior and are shaped by the nature of the target behavior being considered.

3. Personal Biological Factors

Include in personal biological factors are variables such as age, gender, body mass index,
pubertal status, menopausal status, aerobic capacity, strength, agility, and balance.

4. Personal Psychological Factors

Include variables such as self-esteem , self-motivation, personal competence, perceived health

status, and definition of health.

5. Personal Sociocultural

Factors such as race, ethnicity, acculturation, education, and socioeconomic status are included
in sociocultural factors.

6. Behavioral-Specific Cognitions and Affects

The following are behavioral-specific cognitions and affects that are considered of major
motivational significance; these variables are modifiable through nursing action (Pender, 1996).

7. Perceived Benefits of Action

Are anticipated positive outcomes that will result from health behavior.

8. Perceived Barriers to Action

Are anticipated, imagined, or real blocks and personal costs of undertaking a given behavior.
9. Commitment to a Plan of Action

Describes the concept of intention and identification of a planned strategy that leads to
implementation of health behavior.

10. Immediate Competing Demands and Preferences

Are alternative behaviors over which individuals have low control, because there are
environmental contingencies such as work or family care responsibilities. Competing
preferences are alternative behaviors over which individuals exert relatively high control, such
as the choice of ice cream or an apple for a snack.

11. Health-Promoting Behavior

Is an end point or action outcome that is directed toward attaining positive health outcomes
such as optimal well-being, personal fulfillment, and productive living. Examples of health-
promoting behavior are eating a healthy diet, exercising regularly, managing stress, gaining
adequate rest and spiritual growth, and building positive relationship.

Care is the essence of nursing and a distinct, dominant, central and unifying focus.

MAJOR CONCEPTS AND DEFINITIONS

Leininger develop constructs relevant to her culture care theory. The major constructs are listed
here. The reader is referred to her definitive works to study the full theory

1. Care and Caring Care

Refers to abstract and manifest phenomena with expression of assistive, supportive,

enabling, and facilitating ways toward or about self or others. Caring refers to action,
attitudes, or practices to assist others toward healing and well-being . Care….includes
generic/folk care and professional care which are major parts of the theory that have been
predicted to influence and explain the health and well-being of diverse cultures.
2. Generic Care

Refers to the learned and transmitted lay, indigenous, traditional or local folk knowledge
and practices to provide assistance, supportive, enabling, and facilitative acts for or toward
others with evident or anticipated health needs in order to improved well-being or to help
with dying or other human conditions.

3. Professional Care

Refers to formal and explicit cognitively learned professional care knowledge and practices
obtained generally through educational institutions are taught to nurses and others to
provide assistive, supportive, enabling, or facilitative acts for or to another individual or
group in order to improve their health, prevent illnesses or to help with dying or other
human conditions.

4. Culture

Refers to learned, shared, and transmitted values, beliefs, norms , and lifeways of a
particular culture that guide thinking, decision, and actions in patterned ways. Culture is
equally as important of care ; is not an adverb or adjective to care. Leininger conceptualized
culture care as synthesized and closely linked phenomen a with interrelated ideas.

5. Culture Care

Refers to the synthesis of the two major constructs that guide the researcher to discover,
explain, and account for health, well-being, care expression, and other human conditions.
6. Culturally Congruent Care

Is culturally based care knowledge, acts, and decision use in sensitive , creative and meaning
full ways to appropriately fit the cultural values , beliefs , and lifeways of client for their
health and well-being , or to prevent of face illness, disabilities, or death.

7. Culture Care Diversity

Refers to variabilities or differences in culture care beliefs, meaning, patterns, values,

symbols, life ways, symbols and other features among human beings related to providing
beneficial care for clients from a designated culture.
8. Culture Care Universality

Refers to commonly shared or similar cultural care phenomena features of human being or
groups with recurrent meanings, patterns, symbols or lifeways that serve as a guide to care
givers to provide assistive , supportive facilitative, or enabling people care for healthy
outcomes.

9. Worldview

Refers to the way people look out on their world or universe to form a picture or value
stance about life or the world around them. Worldwide provide a broad perspective about
once orientation to life, people, or groups that influence care or caring responses and
guides ones decision or action , especially related to matters of well-being.

10. Cultural and Social Structure Dimensions

Refers to the dynamic, holistic, and interrelated pattern structured features of a culture
that include but are not limited to technology factors ; religious and philosophical factors ;
kinship and social factors ; cultural values , beliefs and lifeways educational factors as well
as environmental context , language and ethnohistory.

11. Environmental Context

Refers to the totality of an event , situation, or particular experience that gives meaning to
peoples expression , interpretation ,and social interaction within particular geophysical ,
ecological , spiritual, sociopolitical, and technological factors.

12. Ethnohistory

Refers to the sequence of past facts, events, instances, or experiences of human beings ,
groups , cultures, or institutions over time in particular context that help explain past and
current lifeways about culture care influencer.

13. Emic

Refers to local ,indigenous, or the insider cultural knowledge and views about specific
phenomena.

14. Etic
 Refers to the outsider or stranger views or institutional or system knowledge edge and
interpreted values about cultural phenomena.

15. Health

Refers to a state of well-being that is culturally defined, valued, and practice that reflect
the ability of individuals or groups to perform their daily role activities in culturally
expressed , beneficial, and patterned lifeways.

16. Culture Care Preservation

Refers to assistive , supportive, facilitative or enabling professional actions and decision

that help people of a particular culture to retain, preserved, or maintain meaningful care
beliefs and values for their well-being.

17. Culture Care Accommodation or Negotiation

Refers to those assistive , accommodating, facilitative, or enabling creative professional care

action and decision that help people of a designated culture.

18. Culture Care Repatterning or Restructuring

Refers to the assistive , supportive, facilitative, or enabling professional actions and

decision that help clients reorder, change, or modify their lifeways for beneficial health
care patterns , practices, or out come.