CULTURE CARE THEORY

BY: JENNAH ERCY S. DE LEON, RN

INTRODUCTION
• Madeleine Leininger is considered as the
founder of the Theory of Transcultural Nursing.

• Transcultural Nursing Theory is also known as

Culture Care Theory.

• Theoretical framework is depicted in her model

called the Sunrise Model (1997).
ABOUT THE THEORIST
MADELEINE M. LEININGER
• Born: July 13, 1925
• Sutton, Nebraska U.S
• Died: 10 August 2012 (aged 87)
• Occupation: Nurse, former CEO of the American
Nurses Association
• One of the first nursing theorist and transcultural
global nursing consultant.
• MSN - Catholic University in Washington DC.
• PhD in anthropology - University of Washington.
• She developed the concept of transcultural
nursing and the ethnonursing research model.
 TRANSCULTURAL NURSING THEORY
• The Transcultural Nursing Theory or Culture Care
Theory 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.
DEFINITIONS

• ETHNONURSING - is the study of nursing care beliefs, values,

and practices as cognitively perceived and known by a
designated culture through their direct experience, beliefs,
and value system.

• ACCULTURATION - People of a minority group tend to assume

the attitudes, values, beliefs, find practices of the dominant
society resulting in a blended cultural pattern
• CULTURE - Set of values, beliefs and traditions, that are held by
a specific group of people and handed down from
generation to generation.
- Culture is the learned, shared and transmitted
values, beliefs, norms and life way practices of a particular
group that guide thinking, decisions, and actions in patterned
ways.
• CULTURE CARE - is defined as the subjectively and objectively
learned and transmitted values, beliefs, and patterned lifeways
that assist, support, facilitate, or enable another individual or group
to maintain their well-being, health, improve their human condition
and lifeway, or to deal with illness, handicaps or death.
• CULTURE CARE DIVERSITY - indicates the variabilities and/or
differences in meanings, patterns, values, lifeways, or symbols of
care within or between collectives that are related to assistive,
supportive, or enabling human care expressions.
• CULTURE CARE UNIVERSALITY - indicates the common, similar, or
dominant uniform care meanings, pattern, values, lifeways or
symbols that are manifest among many cultures and reflect
assistive, supportive, facilitative, or enabling ways to help people.
• CULTURAL AWARENESS - It is an in-depth self-examination of one's
own background, recognizing biases and prejudices and
assumptions about other people.

• CULTURALLY CONGRUENT CARE - Care that fits the people's

valued life patterns and set of meanings -which is generated from
the people themselves, rather than based on predetermined
criteria.

• CULTURALLY COMPETENT CARE - is the ability of the practitioner to

bridge cultural gaps in caring, work with cultural differences and
enable clients and families to achieve meaningful and supportive
caring.
• 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 lifeways.

• HUMAN BEINGS - Such 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.

• SOCIETY AND ENVIRONMENT - These terms are not defined by

Leininger; she speaks instead of worldview, social structure, and
environmental context.
• 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.

• 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 - 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.
LEININGER’S
SUNRISE
MODEL
 LEININGER SUNRISE MODEL
• Represents the structure of culture care theory by describing
the relationship between anthropological and nursing beliefs
and principles.
• Nurses use this model when making cultural evaluations in
patients.
• This model encompasses numerous aspects of culture:
religious, financial, social, technological, educational, legal,
political, philosophical dimensions, language and social
environment.
• Helps healthcare professionals to avoid stereotyping of
patients.
• The CULTURAL CARE WORLDVIEW flows into knowledge about
individuals, families, groups, communities, and institutions in
diverse health care systems.

• The next focus is on the GENERIC OR FOLK SYSTEM,

PROFESSIONAL CARE SYSTEMS, AND NURSING CARE.
Information about these systems includes the characteristics
and the specific care features of each. This information allows
for the identification of similarities and differences or cultural
care universality and cultural care diversity.
 THREE MODES OF NURSING CARE DECISIONS
AND ACTIONS
• 1. CULTURAL CARE PRESERVATION OR MAINTENANCE - refers to nurses'
provision of support for cultural practices, such as employing acupressure
or acupuncture for anxiety and pain relief prior to medical interventions
• 2. CULTURAL CARE ACCOMMODATION OR NEGOTIATION refers to the
support provided to the patients and their family members in carrying out
cultural activities that do not pose threats to the health of the patients or
any other individual in the healthcare setting.
• 3. CULTURE CARE REPATTERNING OR RESTRUCTURING - refers to nurses' efforts
to deliver patient-centered care by helping patients modify or change
their cultural activities. Cultural restructuring is suggested only when certain
cultural practices may cause harm to the patient or those in the
surrounding environment.
CONCLUSION
• According to transcultural nursing, the goal of nursing care is to provide
care congruent with cultural values, beliefs, and practices.
• Cultural knowledge plays a very important role for nurses on how to deal
with the patients. To start off, it helps nurses to be aware on ways in which
the patient’s culture and faith system provide resources for their
experiences with illness, suffering, and even death.
• Cultural knowledge to treat a patient also helps a nurse to be open
minded to treatments that can be considered non-traditional, such as
spiritually based therapies like meditation and anointing.
• Awareness of the differences allows the nurse to design culture-specific
nursing interventions.
• Through the help of Leininger’s Theory, nurses
can actually observe on how a patient’s cultural
background is related to his or her health, and
use that knowledge to create a nursing plan that
will help the patient get healthy quickly while
still being sensitive to his or her cultural
background.