Introduction
In all fields, nursing, in particular, one can identify theory for every activity. Theory can be described as the basic reason with the intent of accounting for something (Cohen, 2000). Whereas theory may be present in several fields the significance of theory may only be particularly obvious in a select few. In nursing, theories are utilized in the everyday situation as nurse practitioners relate with patients (Andrews, 2008). The manner in which a nurse practitioner practices can significantly have an effect on the result of the patient (Leininger, 1978). In this regard, nursing practices focused on rationales and perceptions should be studied. The process to use rationales, studies and ideas to form premises generally starts with an idea or principle and is recurring in nature, since each constituent may result in the other. In the nursing field, a number of model-based premises direct both practice and research.
The aim of this paper is that of selecting and analyze one of the numerous nursing premises that exist. The rationale of the premise and its development will be discussed. Also, the motivational aspect behind the creation of the premise and the theorist’s theoretical principles and ideas will, in addition, be explored. Then, ideas of the identified premise will be linked to the activities of a family nurse practitioner. The nursing premise that will be explored in this assignment is the Interpersonal Relationship premise, developed by Madeleine Leininger. Before I continue delving into how significant Leininger’s premise evidently is to my day-to-day application of medical care, let me foremost explain who Leininger was and what her premise is all about.
Background
Madeleine Leininger is broadly appreciated as the original author of social premise in nursing (Cohen, 2000). Leininger started writing in the 1970s and her premise of Social Care Variety and Generality also referred to as intercultural nursing, has turned out to be an influential theory in the sector and has been broadly utilized in research. As Andrews (2008) proposes, “Intercultural nursing has taken action and is changing nursing and family care in a number of countries globally” (p. 13). Leininger’s premise has not only advanced her own theory but has supported the creation of many later frameworks that have led to its continued utilization today (Stout & Downey, 2006).
In the 1970s, nurse practitioners in the United States of America started to generate and utilize organized nursing premises. Such premises provided nurse practitioners with an innovative approach to awareness of family care and offered a way of methodically ordering, analyzing and interpreting data and, by doing so, turned out to be an apparatus via which family nurse practitioners might examine their philosophy and reflect on their practice in nursing (Pearson, 2007). A nursing premise like that of Leininger’s plays many roles. It is utilized in explaining, guiding and structuring concepts and it facilitates the support of a specific action with an aim of enriching the practice of nurse practitioners. Family Care Variety and Generality was documented in the style of a mid-range nursing premise of the time and the theorist used the notions of individual, surroundings, nursing and healthcare common with theorists (Leininger, 1978). Among the premises from the United States of America, Leininger’s premise of healthcare is one that has gotten considerable attention during research and regular efforts have been made with an intention of establishing its utilization outside its place of origin. Therefore, in identifying and distinguishing the contribution that Leininger’s nursing premise might have had for family nurse practitioners, it is imperative to look at the premise.
Theory description
The theorist was the first nursing practitioner to officially examine the relation between patients and patients’ diverse cultural backgrounds. Leininger realized that a patient’s background had the capability of impacting on health and sickness. She suggested that nurse practitioners might be more helpful in their action if they created an awareness of the relation between culture and health. The theorist portrays herself as a nurse and a psychologist. She holds a doctor of philosophy in Cultural Psychology and developed her premise while researching in that sector. In 1969 she developed the initial concept in cultural nursing and in 1977 started the first postgraduate and doctor of philosophy courses especially in that sector (Leininger, 1978).
Leininger’s premise was established in a particular socio-cultural environment – that of the United States of America. Assessment and documentation happens in a specific socio-cultural context that represents the culture and setting of the theorist and this setting will have an effect on the nature of concepts establishment. When Leininger started her nursing career in the 1960’s, the United States civil society association was just starting to take hold. The United States of America has an up to date history of settlement by foreigners from United Kingdom. As a result, socio-cultural traditions, principles and standards basically came to support the USA cultural organization and control its social institutions such as healthcare. Social isolation of the African-American people had just ended in 1950’s. The black societies of past African slaves (entered America 200 years before) became gradually eloquent regarding civil rights and were no longer pleased to assume a passive socio-economic position. Such a black society started to claim an influence as citizens born in the United States of America and at liberty to all the human rights and gains this entailed. In addition, during the 1970’s and 1980’s, foreigners from less cultural origin communities like the Hispanic and Asiatic groups were settling in the United States of America in large numbers. The initial principle of the “melting pot” tradition, where immigrants to the United States of America were anticipated to relinquish current norms and cultures and integrate into the American culture, was coming under attack (Pearson, 2007). Such minority groups gradually obtained considerable significance in promoting the cultural the USA, so joining them were the Native American Individuals, initially culturally dislodged and disempowered during those periods of immigration and migration, and who in addition desired to be represented in the modern civil rights group and claim equal rights with conventional Americans (Daly & Jackson, 2003). The cultural era in which Leininger was initially documenting was one where cultural adjustment was quickly happening and there was a sharp and increasing knowledge of civil rights. This has aspect of an equivalent with the quick cultural adjustment on an international level that the nurse practitioners are facing today.
Leininger initially worked as a children’s nurse in a psychiatric context and realized that among “the young people who came from different social origins like Afro-American … their obvious characters undoubtedly varied” (Leininger, 1978, p. 21). Such findings lead Leininger to have a desire in psychology. Leininger’s goal was that of investigating her belief that patients’ ethnicity greatly influenced their knowledge of sickness and healthy living, which in turn defined the kind of healthcare needed by people. Leininger (1978) argued that “nurse practitioners were likely to depend on social expert norms which are greatly described from our dominant American healthcare traditions and thus not suited for utilization in the nursing of individuals from other ethnic backgrounds” (p. 11).
The theorist came to understand that belief structures from other ethnic backgrounds required to be evaluated and recognized in order for the mainly Anglo-American nurse practitioners of United States of America to make forecasts regarding the health principles, and so predict the healthcare needs, of people from traditions other than their culture. From Leininger’s research in psychology, her premise of cultural healthcare was published in 1960’s and over a 50 year period it has been further advanced and improved. Consequently, the premise of Social Healthcare Variety and Generality surfaced. As Daly and Jackson (2003) argue: “the premise was to identify what is general and what is variety as far as healthcare norms, ethics and concepts are concerned” (p. xii). This resulted in what is referred to as the intercultural nursing guideline, which Leininger regards as “ethno-nursing” and the type of a study method known as “ethno-science” was created to gather social information. Ethno-science offered a way “of obtaining local or native individuals’ views, perspectives and norms regarding nursing or the styles of healthcare attitudes and procedures of the selected ethnic group” for utilization to provide healthcare to that specific group (Leininger, 1978, p. 15).
In her previous work, Leininger (1970) utilized a comprehensive description of ethnicity, in the culture of psychology, which included “the whole composite of material things, instruments, concepts, institutions, and non-material factors associated with people’s survival” (p. 11). Leininger (1993) advanced this previous description of ethnicity to become more inclusive of norms and ethics and she in addition started to consider “the taught, common and transmitted norms, ethics and traditions of a specific grouping that direct their tradition, choices and activities in modeled manner” (p. 9).
Evaluation
The background to this theory was developed in a fundamental manner from, and is based on, psychology and the idea of healthcare is based on nursing. Leininger (1970) appreciated the influence of psychology on her theory when she argued that nursing and psychology are united in a single particular and unitary whole. The theorist felt that psychology’s most significant contribution to healthcare was to offer an underpinning for the argument that health and sick conditions are mainly defined by the ethnic background of a person (Leininger, 1978). Leininger’s premise is in line with the psychological frameworks that dominated in the 1970’s when the theorist initially started research in America, a research which she still continues to acknowledge some 5 decades later. Particularly, intercultural nursing premise refers to the unified multicultural nursing models and assumptions which consider individual and shared nursing actions, norms and traditions determined by their social needs, with an intention of providing efficient and fulfilling healthcare to patients; and if such caring strategies fail to identify cultural elements of human needs, there will be certain symptom of less efficacious healthcare strategies and certain undesirable repercussions to those being served. The theorist has long argued that the particular ethnic norms or what she considered being the general nursing care norms, traditions and strategies utilized by diverse cultural groupings have to be understood and utilized as a link by the nurse practitioner with an intention of providing culturally suitable healthcare (Leininger, 1978, p. 33).
In developing the body of knowledge in multicultural care, the ethno-science method was utilized. Leininger (1978) argued that the knowledge of cultural strategies is best identified by obtaining and “researching the native (insider) opinions” (p. 35). In multicultural nursing, diverse social institutions are researched in an extremely particular manner so that the researchers then becomes very well-informed or a leader on diverse social groupings’ values and ethics. Nurse practitioners can then utilize this data to make forecasts regarding a specific cultural grouping’s views and perspectives as far as health is concerned. This in turn assists the provision of suitable and “ethnically particular” healthcare (Leininger, 1978).
Leininger (1970) argues that the aim to use the ethno-science method is that of reducing chaos so that the theory precisely shows the native individuals’ viewpoints and offers a high level of reliability and legality regarding these individuals. The following section delves into how significant Leininger’s premise evidently is to my day to day application as a family nurse practitioner.
Conclusion
The goal of multicultural nursing is that of providing ethnically harmonious, responsive and competent nursing care. Utilizing the information from the theory, I will be able to understand the viewpoint of the native and foreign culture and utilize that in modifying or varying family nursing care, modifying it and making it more suitable. The family nurse practitioner’s work is advanced by the utilization of the multicultural evaluation, in which the practitioner is involved to identify and appraise the trends, behaviors and smallest elements of social behavior as a framework for nursing care strategies and intervention methods. Culturally matching healthcare happens when there is an important and fulfilling link between the nursing norms, ethics and beliefs of the individual and the behavior of the family nurse practitioner. As a family nurse practitioner, based on the concepts presented by the theory, I have to preserve, maintain or amend family healthcare behaviors with the aim to satisfy the needs of patients.
References
Andrews, M. (2008). Global leadership in transcultural practice, education and research. Contemporary Nurse, 28(2), 13-16.
Cohen, A. (2000). Signifying Identities: Anthropological perspectives on boundaries and contested values. London: Routledge.
Daly, J. & Jackson, D. (2003). Transcultural health care: Issues and Challenges for nursing. Contemporary Nurse, 15(3), xiii-xiv.
Leininger, M. (1970). Nursing and Anthropology: Two worlds to blend. New York: John Wiley and Sons.
Leininger, M. (1978). Transcultural nursing: Concepts, theories, research and practices. Columbus, Ohio: McGraw Hill.
Leininger, M. (1993). Some transcultural nursing definitions of concepts/constructs. Journal of transcultural Nursing, 6(2), 10-26.
Pearson, A. (2007). Editorial: exploiting the potential of international collaboration in nursing. International Journal of Nursing Practice, 13(2), 69-73.
Stout, M. & Downey, B. (2006). Nursing, indigenous people and cultural safety: So what? Now what? Contemporary Nurse, 22(2), 327-332.