Erickson, H.C., Tomlin, E.M., & Swain, M.A.P. (1983). Modeling and role modeling: A theory and paradigm for nursing.


A grand theory focusing on the discovery of human care diversities and universalities and ways to provide culturally congruent care to people. The concepts of the theory are:


Care —abstract and concrete phenomena related to assisting, supporting, or enabling experiences or behaviors toward or for others with evident or anticipated needs to ameliorate or improve a human condition or lifeway.


Caring —the actions and activities directed toward assisting, supporting, or enabling another individual or group with evident or anticipated needs to ameliorate or improve a human condition or lifeway or to face death.


Culture —the learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group that guide thinking, decisions, and actions in patterned ways; encompasses several cultural and social structure dimensions: technological factors, religious and philosophical factors, kinship and social factors, political and legal factors, economic factors, educational factors, and cultural values and lifeways.


Language —word usages, symbols, and meanings about care.


Ethnohistory —past facts, events, instances, experiences of individuals, groups, cultures, and institutions that are primarily people centered (ethno) and that describe, explain, and interpret human lifeways within particular cultural contexts and over short or long periods of time.


Environmental context —the totality of an event, situation, or particular experiences that give meaning to human expressions, interpretations, and social interactions in particular physical, ecological, sociopolitical, and/or cultural settings.


Health —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 lifeways.

or enabling human care expressions. and patterned lifeways that assist. Cultural care universality—the common. 10. or symbols of care within or between collectivities that are related to assistive. The two types of care systems are: Generic (emic) lay care system—traditional or local indigenous health care or cure practices that have special meanings and uses to heal or assist people. lifeways. or death. preserve. or death. or conditions. Care systems —the values. patterns. or enable another individual or group to maintain well-being and health. facilitative. concerns. patterns. Worldview —the way people tend to look out on the world or their universe to form a picture of or a value stance about their life or the world around them. lifeways. supportive. 9. Professional (etic) health care system—professional care or cure services offered by diverse health personnel who have been prepared through formal professional programs of study in special educational institutions. beliefs. similar. acts. . and structural features of an organization designed for serving people's health needs. or enabling ways to help people. The two dimensions are: Cultural care diversity—the variabilities and/or differences in meanings. to improve his or her human condition and lifeway. values. or symbols that are manifest among many cultures and reflect assistive. or dominant uniform care meanings. and decisions used in sensitive and knowledgeable ways to appropriately and meaningfully fit the cultural values. or to prevent illness. or maintain beneficial care beliefs and values or to face handicaps and death. and lifeways of clients for their health and well being. to deal with illness. Cultural care —the subjectively and objectively transmitted values. norms. or enabling professional acts or decisions that help cultures to retain. beliefs. values. disabilities.8. 11. supportive. handicaps. which are generally offered in familiar home or community environmental contexts with their local practitioners. support. The three modes of culturally congruent care are: Culture care preservation and/or maintenance refers to assistive. facilitative. Culturally congruent care —culturally based care knowledge. supportive.

and cultural beliefs and values. communities. actions and mutual change. including gender and class differences in religion or spirituality. groups. values. and lifeways. families. or to deal with illness or dying. Nursing practice is directed toward improving and providing culturally congruent care to people. The nurse shares professional knowledge only if the client asks about such knowledge. family.Culture care accommodation and/or negotiation refers to assistive. . well being. A practice methodology for the Theory of Culture Care Diversity and Universality is as follows: Goals of Nursing Practice are: to improve and to provide culturally congruent care to people that is beneficial. special language terms. learner. kinship or social ties. communication modes. The nurse asks open-ended questions and maintains the role of an active listener. or (or beneficial) health 12. politics. modify. safe. philosophy of life. or enabling creative provider care actions or decisions that help cultures to adapt to or negotiate with others for culturally congruent. The nurse is aware that the client may belong to a subculture or special group that maintains its own values and beliefs that differ from the values and beliefs of the dominant culture. or enabling professional decisions that would help people to reorder. and be useful to the client. economics. or outcomes. and institutions. he nurse begins the assessment with such questions as: What would you like to share with me today about your experiences or beliefs. will fit with. facilitative. The nurse shows a genuine interest in the client and learns from and maintains respect for the client. Culturalogical Assessment The nurse maintains a holistic or total view of the client's world by using the Sunrise Model and Enablers to guide assessment of cultural beliefs. and reflector. education. facilitative. accommodating. technology. and use of space and foods. refers to assistive. legal issues. restructure their life ways and institutions for better care patterns. Cultural and social structure factors —Factors that influence expressions and meanings of care. practices. or culture group healthy lifeways. subcultures. Culture care repatterning and/or restructuring supportive. to help you keep well? Are there some special ideas or ways you would like nurses to care for you? The nurse gives attention to clients' gender differences. Clients include individuals. interpersonal relationships. and effective care for their health. to provide culturally congruent nursing care in order to improve or offer a different kind of nursing care service to people of diverse or similar cultures.

Culture care diversity and universality: A worldwide nursing theory (2nd ed. Leininger. and evaluate the appropriate mode(s) of culturally congruent care. . or maintain care beliefs Culture Care Accommodation and/or Negotiation—used when professional decisions and actions are needed to help clients of a designated culture adapt to or negotiate with others for care. or consultants. Professional nursing care. preserve.. plan. modify. learned in formal educational programs. have in-depth understanding of a few cultures and can function as field practitioners. researchers. Transcultural nurse generalists are prepared at the baccalaureate level for the general use of transcultural nursing concepts. The research findings are used to develop protocols for cultural-congruent care that blends with the particular cultural values. change.Nursing Judgments.R. Nurse and client select one or more mode of culturally congruent care. principles.M. Culture Care Repatterning and/or Restructuring—used when professional decisions and actions are needed to help clients of a designated culture to reorder. Clinical Protocols Specific nursing practices or clinical protocols are derived from the findings of research guided by the Theory of Culture Care Diversity and Universality. who are prepared at the doctoral level. The curriculum emphasizes transcultural nursing knowledge. facilitating. beliefs. Boston: Jones and Bartlett. satisfying. supporting. implement. and is assessed to be beneficial. and practices. Culture Care Preservation and/or Maintenance—used when professional decisions and actions are needed to help clients of a designated culture to retain. or restructure their life ways and institutions. as well as culture-universal and culture-specific health care needs of people and nursing care practices. and Actions Nursing practice requires the coparticipation of nurses and clients working together to identify. Decisions. M. (2006). accommodating. M. and enabling.). and meaningful to the client. and lifeways of the client. & McFarland. Nursing decisions and actions encompass assisting. Transcultural nurse specialists. Certification is awarded by the Transcultural Nursing Society to nurses who have educational preparation in transcultural nursing or the equivalent and who demonstrate basic clinical competence in transcultural nursing. with formal study about different cultures in the world. builds upon the generic care given by naturalistic lay and folk care givers. teachers.