Introduction
Numerous nursing theories applied in the healthcare sector are the achievements of individual professionals who have dedicated their careers to nursing development. One of such concepts that is still relevant today is Madeleine Leininger’s culture care diversity and universality theory. Being not only an American nurse but also an anthropologist, she promoted the idea of ​​transcultural care. In a broad sense, the concept involves patients themselves, who can guide nurses on the most appropriate care based on specific cultural backgrounds. The application of this concept is often accompanied by the Sunrise Model which defines people as inseparable from their cultural heritage and social structure. This work is aimed at describing the main provisions of Leininger’s theory, highlighting its key themes and ideas, and assessing how this concept may be applied to modern nursing.
Overview of Madeleine Leininger’s Theory
The theory formulated by Madeleine Leininger is based on the application of anthropology to nursing care. According to Sagar and Sagar (2018), intercultural care was defined by the author herself as the main area of ​​nursing work. The idea focused on the comparative study and analysis of distinctive cultures and subcultures of the world in terms of values ​​of care, beliefs, as well as behavioral patterns. Leininger’s intention in developing her theory was to adapt nursing care to patients’ cultural and social characteristics. In doing this, she tried to improve treatment or provide suitable care for those who were close to death. Thus, transcultural nursing surpassed in its approaches the fact of applying formal nursing knowledge. Professionals had to possess certain knowledge of anthropology and apply it to their daily tasks. As Sagar and Sagar (2018) note, for Leininger, a transcultural nurse should receive regulated discipline training. In addition, she needs to be able to apply the concepts of transcultural to patient care. These factors are integral components of the theory under consideration.
The key factor that prompted Leininger to create her theory was her work in different countries. Sagar and Sagar (2018) remark that during her world practice, Madeleine Leininger began to notice that patients’ cultural peculiarities influenced their behavior and the effectiveness of treatment. Medical personnel, in turn, did not take these nuances into account. As a result, she raised the question of the need to change the approach by taking into account these cultural features. The substantiation of the problem from an anthropological perspective allowed her to develop the theory that later became a widely used nursing model. Thus, the comprehensive coverage of patients’ problems helped Leininger come to an awareness of patients’ individual needs from the perspective of their cultural distinctions.
Major Concepts of Madeleine Leininger’s Theory
One of the main concepts of Leininger’s theory implied engaging patients themselves as informants in care regimes. McFarland and Wehbe-Alamah (2019) argue that, in her work on theory, the author divided care into two large groups. The first was formed by the followers of transcultural care itself when specialists received special training in interacting with patients from different cultures. The second group, on the other hand, related to intercultural care without this training and the use of medical or applied anthropological knowledge. As a result, through practical analysis, Leininger concluded that appropriate training was a valuable factor in improving the quality of nursing care and in enhancing provider-patient interaction through productive communication. This concept of separation has proven the value of anthropological evidence and expanded the range of involvement of healthcare professionals in working with target patients.
Leininger insisted that people from different cultures could help nurses by offering the most appropriate care for their beliefs and customs. McFarland and Wehbe-Alamah (2019) state that the crucial concepts of the theory were the involvement of medical professionals in the knowledge of patients’ world and attention to individual opinions by maintaining adequate ethics. Leininger wanted the care offered to be consistent with patients’ cultural beliefs that, in turn, correlated with the quality of care positively and allowed people to respond better to the treatment they received.
Another concept of Leininger’s broad theory is the Sunrise Model. In this concept, she tried to present some of the essential elements of her theory. McFarland and Wehbe-Alamah (2019) describe this model and give its structural components as parts of a circle symbolizing the sun. In the two halves, one can find the elements of social structure and cultural beliefs. They inevitably influence a person’s concept of the world, thereby affecting beliefs about care and health. Nurses are in the central part of the model and, by connecting the two halves, represent a coherent system of effective interaction and acceptance.
Finally, one should also mention the concept of active modes. According to McFarland and Wehbe-Alamah (2019), the theory suggests that nurses can follow three types of patient care: “culture care preservation and/or maintenance,” “culture care accommodation and/or negotiation,” and “culture care repatterning and/or restructuring” (p. 545). All these modes differ in individual manifestations, but each of them is part of Leininger’s theory and corresponds to the tasks set by the author.
Application of Madeleine Leininger’s Theory to Modern Nursing
In modern nursing, Leininger’s theory has not lost its relevance. Person-centered care promoted today is largely based on the assessment of patients’ individual characteristics, including their cultural background. Nurses who provide culturally competent care have the ability to give patients the attention they need. As Wehbe-Alamah and McFarland (2020) note, in today’s reality, issues of medical bias arise, and affected participants in the care process are forced to face the other party’s unethical behavior. However, Leininger’s theory encourages the involvement of nursing staff in active interaction with target patients with an emphasis on individual cultural characteristics, and this type of communication minimizes the risks of inequality and bias. Modern principles of nursing education include a wide range of concepts that cover different areas of healthcare depending on a specific profile. Nevertheless, the theory under consideration is universal and can be applied to different conditions and environments, which makes it a widespread and valuable nursing concept.
Conclusion
Madeleine Leininger is the author of an outstanding nursing theory that considers care from an anthropological perspective and stimulates paying attention to patients’ cultural differences. The main idea is the target patients themselves are informants and help medical specialists choose the best ways of interaction. Among the concepts of the theory, one can highlight specific action modes, the Sunrise Model as a framework explaining the role of nurses, and the basic factors to take into account, particularly beliefs and cultural traditions. In modern nursing, Leininger’s theory is a widely applicable and convenient methodology to follow the idea of ​​patient-centered care and avoid bias or inequality.
References
McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s theory of culture care diversity and universality: An overview with a historical retrospective and a view toward the future. Journal of Transcultural Nursing, 30(6), 540-557.
Sagar, P. L., & Sagar, D. Y. (2018). Current state of transcultural nursing theories, models, and approaches.Annual Review of Nursing Research, 37(1), 25-41.
Wehbe-Alamah, H., & McFarland, M. (2020). Leininger’s ethnonursing research method: Historical retrospective and overview. Journal of Transcultural Nursing, 31(4), 337-349.