NURSING THEORIS GUIDE

MADELEINE LEININGER
TRANSCULTURAL NURSING
 Theoretical Foundations in Nursing
Description

In 1995, Madeleine Leininger defined transcultural nursing as  “a

substantive area of study and practice focused on comparative
cultural care (caring) values, beliefs, and practices of individuals or
groups of similar or different cultures with the goal of providing
culture-specific and universal nursing care practices in promoting
health or well-being or to help people to face unfavorable human
conditions, illness, or death in culturally meaningful ways.”

Name of the Theorist:

Madeleine M. Leininger, RN: PhD, CTN,FRCAN;

Birthday: July 13, 1925

Birthplace: Sutton, Nebraska United States

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Family Background: She lived on a farm with four brothers and
sisters, and graduated from Sutton High School. She also credits
an aunt who suffered from congenital heart disease with
encouraging her to enter the field of nursing. In 1945, the post-
depression period, Madeleine and her sister entered the Cadet
Nurse Corps and a diploma program at St. Anthony’s School of
Nursing in Denver, CO

Reason for the Creation of the Theory:

Transcultural Nursing Theory

 Through her observations while working as a nurse,
Madeleine Leininger identified a lack of cultural and care
knowledge as the missing component to a nurse’s
understanding of the many variations required in patient
care to support compliance, healing, and wellness which led
her to develop the theory of Transcultural Nursing also
known as Culture Care Theory.

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Background of the Theory:
 The Transcultural Nursing Theory or Culture Care
Theory  by Madeleine Leininger involves knowing and
understanding different cultures with respect to nursing and
health-illness caring practices, beliefs and values with the
goal to provide meaningful and efficacious nursing care
services to people according to their cultural values and
health-illness context. It focuses on the fact that different
cultures have different caring behaviors and different health
and illness values, beliefs, and patterns of behaviors. The
Culture Care Diversity and Universality theory focuses on
describing, explaining and predicting nursing similarities and
differences focused primarily on human care and caring in
human cultures. However, this 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.

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Sunrise Model of Madeleine Leininger’s Theory

 The Sunrise Model is relevant because it enables nurses to
develop critical and complex thoughts towards nursing
practice. These thoughts should consider, and integrate,
 cultural and social structure dimensions in each specific
context, besides the biological and psychological aspects
involved in nursing care.

Concept of Person
 Humans are believed to be caring and to be capable of
being concerned about the needs, well-being, and survival
of others. Leininger also indicates that nursing as a caring
science should focus beyond traditional nurse-patient
interactions and dyads to include families, groups,
communities, total cultures, and institutions.

Person: The focus of nursing care

Example: Watson’s Theory of Human Caring views the patient
holistically, while Johnson’s Behavioral System model views the
person through a lens of seven different subsystems.
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Concept of Health
 It is a state of well-being that is culturally defined, valued,
and practiced, and which reflects the ability of individuals (or
groups) to perform their daily role activities in culturally
expressed, beneficial, and patterned life-ways.
Health: Depending on the theorist, health and illness can be
perceived as two separate constructs (or concepts) or health and
illness is viewed as a continuum (changes slowly over time).
Example: King’s Theory of Goal Attainment views health a
functional state throughout a person’s life (a continuum), while
Neuman’s Systems model views health and illness as two separate
constructs.

Concept of Nursing
 Nursing is defined as a learned humanistic and scientific
profession and discipline which is focused on human care
phenomena and activities in order to assist, support,
facilitate, or enable individuals or groups to maintain or
regain their well-being (or health) in culturally meaningful
and beneficial

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 Ways, or to help people face handicaps or death.

Nursing: A process whereby nurses provide care. The process

changes based on the theorist.
Example: Watson’s Theory of Human Caring views nursing as
provision of care using the 10 creative factors whereas Orem’s
Self-Care Deficit theory where nurses’ focus of care is assisting
patients to meet their self-care needs
Concept of Environment
 These terms are not defined by Feininger; she speaks
instead of worldview, social structure, and environmental
context.

Worldview
 Worldview is the way in which people look at the world, or at
the universe, and form a “picture or value stance” about the
world and their lives.

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Cultural and Social Structure Dimensions

 Cultural and social structure dimensions are defined as
involving the dynamic patterns and features of interrelated
structural and organizational factors of a particular culture
(subculture or society) which includes religious, kinship
(social), political (and legal), economic, educational,
technological and cultural values, ethnohistorical factors,
and how these factors may be interrelated and function to
 influence human behavior in different environmental
contexts.

Environmental Context
 Environmental context is the totality of an event, situation,
or particular experience that gives meaning to human
expressions, interpretations, and social interactions in
particular physical, ecological, sociopolitical and/or cultural
settings.

Environment: the person’s environment within a global context

(Mintz-Binder, 2019).

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Theory Critiques:

Introduction
 The analysis is based on Feininger’s publications about her
theory starting in the mid-1950‘s with her major part
stemming from her 2nd book, Transcultural Nursing:
Concepts, Theories, Research, and Practice in 1978. The
theoretical account used to analyze this theory is the Chinn
and Kramer theoretical account. This theoretical account
was developed by Peggy Chinn and Maenoa Kramer in
 1983. The theoretical account utilizes a two-step procedure
to measure theories called theory description and critical
contemplation.
Aim
 Transcultural Nursing Theory discovers and explains the
culturally based attention factors that influence wellness,
wellbeing, unwellness, and decease of each person or
community. The intent and end of the transcultural nursing
theory is to supply culturally congruous, safe, and
meaningful attention to clients of diverse or similar
civilizations. (Leininger, 2002, p. 190) Leininger has
established a theory that surveies cultures to understand
their differences and similarities.
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 Cultural competency is of import within the nursing

profession due to the differences in each person‘s
perceptual experience of unwellness and health.
Congruency between civilization and wellness attention is
indispensable to the wellbeing of each person and
community. An person‘s wellness beliefs and patterns are
linked by his/her civilization. The civilization attention theory
focuses on cultural beliefs and patterns when finding a
program of attention

Concepts & Definitions

  Transcultural theory uses the concepts of culture, race, and
ethnicity to understand human behavior. When providing
culturally competent care nurses should understand the
meaning of these terms. Leininger also focuses on a few
other concepts such as cultural competence, cultural
awareness, and acculturation. Leininger’s theory focuses on
numerous concepts, but these were selected based on the
importance of nurses integrating the most basic concepts of
transcultural nursing into their well-established knowledge
base.

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Relationships & Structure

 The relationship and structure between the concepts in the
culture care theory is presented in Leininger’s sunrise
model. (Figure 1) This model is viewed as a rising sun and
should be utilized as an available tool for nurses when
conducting cultural assessments. This model interconnects
Leininger’s concepts and forms a structure that is usable in
practice. The model provides a systematic way to identify
the beliefs, values, meanings, and behaviors of people. The
dimensions of the model include technological, religious,
philosophic, kinship, social, values and lifeway, political,
legal, economic, and educational factors. These factors
influence the environment and language, which affects the
 overall health of the individual. Individuals who may not feel
understood may refuse or delay care or may withhold vital
information. The factors within the sunrise model,
environment and language, affects the overall health
system. The overall health system is comprised of the folk
and professional health system.

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 The folk health system consists of the traditional beliefs,

while the professional health system consists of our learned
knowledge such as organized school and evidenced-based
practice.

Premises
 The first is “Care is the kernel of nursing and a
distinguishable, dominant, cardinal, and consolidative focal
point.” ( Leininger, 2002, p. 192 ) Nurses provide attention
with sensitiveness and compassion. Cultural attention
theory requires nurses to supply that same attention, but
based on the cultural singularity of each person. The 2nd is
“Culturally based attention (caring) is indispensable for well-
being wellness, growing, endurance, and in confronting
disabilities or decease.” ( Leininger, 2002, p. 192 ) Non-
culturally competent attention may increase the cost of
wellness attention and diminish the chance for positive
 wellness results. The 3rd is “Culturally based attention is the
most comprehensive, holistic, and particularistic agencies to
cognize, explicate, construe, and predict good congruent
attention patterns. 

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Critical Reflection
 Culture Care Theory has played an important function in
nursing pattern. The theory is high spots legion constructs
in which Leininger clearly defines and systematically utilizes
in legion publications. The constructs in Leininger‘s theory
are the gilded criterion for transcultural nursing and are
mentioned in the bulk of literature sing culturally based
attention. The theory is complex with a figure of constructs
and interrelatedness. The complexness is of import as it
develops a meaningful and comprehensive position of
cultural and holistic based attention. Leininger‘s theory has
a high degree of generalization due to its ability wide to be
applied to all civilizations, ethnicities, and races. The key to
Leininger‘s theory is communicating, and even crosses
linguistic communications and establishes how to extinguish
linguistic communication barriers, through the usage of
translators. The theory systematically approaches culturally
based attention by necessitating the nurse to utilize cultural
 cognition every bit good as specific accomplishments when
makeup one’s minding nursing intercessions and patterns.
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Importance of the Theory:

The importance of Leininger’s, theory of culture care

diversity and university is it provides culturally congruent
nursing care through “cognitively based assistive,
supportive, facilitative, or enabling acts or decisions that
are mostly tailor-made to fit with individual, group’s, or
institution’s cultural values, beliefs, and life-ways.” The
intent of the care is to fit with or have beneficial meaning
and health outcomes for people of different or similar
culture backgrounds. And it also, helps the nurse to
understand, communicate, and interact with people
effectively. More specifically, it centers around:
Understanding the relationship between nurses and
patients. Acquiring knowledge of various cultural practices
and views of the world.
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Theory Application/ Case Sample:

A concrete example is of an old Filipino faith healer who never
consulted any clinician to diagnose the pain sensation he feels
during urination. He believed that, it was spiritual opposition who
inflicted the pain. Taking herbal medicine, going to a faith healer,
massage therapy, and black magic could be an example for the
application of this theory.

References and Sources

· Transcultural Nursing Society. (n.d.). Transcultural Nursing
Society. Retrieved from August 1, 2014, from https://www.tcns.org/
· Tributes to Dr. Madeleine Leininger. (n.d.). Tributes to Dr.
Madeleine Leininger. Retrieved from August 1, 2014, from
https://www.madeleine-leininger.com/
· Retrieved from Leininger, M. (1978). Transcultural nursing:
Concepts, theories, and practices. In George, J. (Ed.). Nursing
theories: the base for professional nursing practice.  Norwalk,
Connecticut: Appleton & Lange.
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Retrieved from https://nursinganswers.net/essays/critique-of-madeleine-

leiningers-culture-care-theory-nursing-essay.php
· Retrieved from https://prezi.com/lnessxo2usfn/madeleine-
leiningers-culture-care-theory/?
frame=ff13934d2924804d9ef1a1de665444d16ffb28b5
· Retrieved from https://www.thechicagoschool.edu/insight/health-
care/the-importance-of-cultural-competence-in-nursing/
· Retrieved from https://www.wikitree.com/wiki/Leininger-166

Submitted by: EROWVILAH MORDEN BANTIGUE

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