Madeleine Leininger, PhD, LHD, DS, CTN, RN, FAAN, FRCNA

(Culture Care: Diversity and Universality Theory)

Brief History:
• Dr. Leininger is the founder of transcultural nursing.
• Initiated this field of nursing in the mid-1950s.
• Born in Sutton, Nebraska, lived on a farm with two brothers and sisters.
• Attended Sutton High School, Scholastica College, the Catholic University of America in DC, and the University
of Washington, Seattle
• Her Culture Care Diversity & Universality theory was one of the earliest nursing theories and it remains the only
theory focused specifically on transcultural nursing with a culture care focus. Her theory is used worldwide.
• Dr. Leininger established the first Caring Research Conference in 1978. She developed the theory of Culture Care
with the ethnonursing method.
The Theory
• The Culture Care Diversity and Universality theory, according to Dr. Leininger, focuses on describing, explaining
and predicting nursing similarities and differences focused primarily on human care and caring in human cultures.
• The Culture Care Diversity & Universality 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.
Development of the theory
• Developed in the mid-1950s and early 1960s.
• Developed particularly to discover the meanings and ways to give care to people who have different values and
lifeways. Designed to guide nurses to provide nursing cares that fits with those that are being cared for.
• Culture Care theory not only focuses on nurse-client interaction but the focus also includes care for families,
groups, communities, cultures and institutions.
The Sunrise Enabler
• The theory includes an enabler (Dr.Leininger prefers it not be called a model), serves as a conceptual guide or
cognitive map to guide nurses in the systematic study of all dimensions of the theory. This map or guide is called
the Sunrise Enabler.
Application of the theory
• Key elements of a method of application in Practice Methodology have been identified by Dr. Leininger and they
are (1) goals of nursing which address practices,clients (2) cultural assessment ( using the Sunrise Enabler) and
(3) nursing judgments, decisions and actions.
• Research findings are used to develop protocols for cultural-congruent care that blends with the particular cultural
values, beliefs and life ways of the client.
Terminologies:
• Culture = the learned, shared and transmitted values, beliefs, norms, and lifeways of a particular group that
guides their thinking, decisions, and actions in patterned ways
• Culture Care = the subjectively and objectively learned and transmitted values, beliefs, and patterned lifeways
that assist, support, facilitate or enable an individual or group to maintain well-being and health, to improve the
human condition and lifeway or to deal with illness, handicaps, or death.
• Culture Care Diversity = the variables and/or differences in the ways that cultures perceive, know, and practice
health and nursing care.
• Culture Care Universality = the commodities in the ways that cultures share the perceptions, knowledge and
practices related to health and nursing care
• Ethnohistory = past facts, events, instances and experiences of individuals, groups, cultures and institutions that
are primarily people-centered and that describe, explain and interpret human lifeways with in a particular culture
over periods of time.
• Cultural and Social Structure Dimensions = refers to the dynamic patterns and features of interrelated
structural and organizational factors of a particular culture, which includes religions, kinship, political, economic,
educational, technological, cultural values, and ethnohistorical factors and how these factors may be interrelated
and function to influence human behavior in different environmental context.
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