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Madeleine Leininger: Transcultural Nursing
Theory
UPDATED ON JULY 2, 2023
BY ANGELO GONZALO, BSN, RN I-download Ngayon I-download
Madeleine Leininger is a nursing theorist who developed the Transcultural Nursing Theory
or Culture Care Nursing Theory. Get to know Madeleine Leininger’s biography, theory
application, and major concepts in this nursing theory study guide.
Table of Contents
Biography of Madeleine Leininger
Early Life
Education
Career and Appointments of Madeleine Leininger
Transcultural Nursing Theory
Works
Awards and Honors
Death
Leininger’s Transcultural Nursing Theory
Description
Major Concepts of the Transcultural Nursing Theory
Transcultural Nursing
Ethnonursing
Nursing
Professional Nursing Care (Caring)
Cultural Congruent (Nursing) Care
Health
Human Beings
Society and Environment
Worldview
Cultural and Social Structure Dimensions
Environmental Context
Culture
Culture Care
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1/23/24, 1:53 AM Madeleine Leininger: Transcultural Nursing Theory - Nurseslabs 1/23/24, 1:53 AM Madeleine Leininger: Transcultural Nursing Theory - Nurseslabs
Culture Care Diversity Madeleine Leininger was born on July 13, 1925, in Sutton, Nebraska. She lived on a farm
Culture Care Universality with her four brothers and sisters and graduated from Sutton High School. After
Subconcepts graduation from Sutton High, she was in the U.S. Army Nursing Corps while pursuing a
Generic (Folk or Lay) Care Systems basic nursing program. Her aunt, who had congenital heart disease, led her to pursue a
Emic career in nursing.
Professional Care Systems
Etic Education
Ethnohistory
Care In 1945, Madeleine Leininger, together with her sister, entered the Cadet Nurse Corps, a
Care federally-funded program to increase the number of nurses trained to meet anticipated
Culture Shock needs during World War II.
Cultural Imposition
Sunrise Model of Madeleine Leininger’s Theory She earned a nursing diploma from St. Anthony’s Hospital School of Nursing, followed by
Three modes of nursing care decisions and actions undergraduate degrees at Mount St. Scholastica College and Creighton University.
Cultural care preservation or Maintenance
Cultural care accommodation or Negotiation Leininger opened a psychiatric nursing service and educational program at Creighton
Culture care repatterning or Restructuring University in Omaha, Nebraska. She earned the equivalent of a BSN through her studies in
Assumptions biological sciences, nursing administration, teaching, and curriculum during 1951-1954.
Analysis
Strengths
Weakness
Conclusion
Recommended Resources
See Also
References and Sources
External Links
Further Reading
Biography of Madeleine Leininger She received a Master of Science in Nursing from the Catholic University of America in
1954.
Madeleine Leininger (July 13, 1925 – August 10, 2012) was an internationally known
educator, author, theorist, administrator, researcher, consultant, public speaker, and the
And in 1965, Leininger embarked upon a doctoral program in Cultural and Social
developer of the concept of transcultural nursing that has a great impact on how to deal
Anthropology at the University of Washington in Seattle and became the first professional
with patients of different culture and cultural background.
nurse to earn a Ph.D. in anthropology.
She is a Certified Transcultural Nurse, a Fellow of the Royal College of Nursing in Australia,
and a Fellow of the American Academy of Nursing. Her theory is now a nursing discipline
Career and Appointments of Madeleine Leininger
that is an integral part of how nurses practice in the healthcare field today. While working in a child guidance home during the 1950s, Madeleine Leininger
experienced what she described as a cultural shock when she realized that children’s
Early Life recurrent behavioral patterns appeared to have a cultural basis. She identified a lack of
cultural and care knowledge as the missing link to nursing.

In 1954, she moved on to serve as Associate Professor of Nursing and Director of the Leininger visited and studied more than a dozen
cultures worldwide.
Graduate Program in Psychiatric Nursing at the University of Cincinnati. She also studied in
this university, pursuing further graduate studies in curriculum, social sciences, and nursing. From 1974 to 1980, Leininger served as Dean, Professor of Nursing, Adjunct Professor of
Anthropology, and Director of the Center for Nursing Research and the Doctoral and
Transcultural Nursing Programs at the University of Utah College Nursing.
She was the first full-time President of the American Association of Colleges of Nursing and
one of the first members of the American Academy of Nursing in 1975.
Leininger’s professional career is recognized as an educator and academic administrator

from 1956 to 1995, a writer from 1961 to 1995, a lecturer from 1965 to 1995, a consultant
from 1971 to 1992, and a leader in the field of transcultural nursing from 1966 to 1995.
Leininger, together with a group of Gadsup children on She was Professor Emeritus of Nursing at Wayne State University and an adjunct faculty
a return trip to Papua New Guinea probably in 1990. member at the University of Nebraska Medical Center in Omaha and retired as the former
in 1995.
She was the first in the 1960s to coin the concept of “culturally congruent care,” which was
the goal of the Theory of Culture Care, and today the concept is being used globally.
Her official certifications read LL (Living Legend), Ph.D. (Doctor of Philosophy), LHD (Doctor
Leininger was appointed Professor of Nursing and Anthropology at the University of of Human Sciences), DS (Doctor of Science), CTN (Doctor of Science), RN (Registered
Colorado — the first joint appointment of a nursing professor and a second discipline in Nurse), FAAN (Fellow American Academy of Nursing), and FRCNA (Fellow of the Royal
the United States. College of Nursing in Australia).
As for being a pioneer nurse anthropologist, Leininger was appointed Dean of the Transcultural Nursing Theory
University of Washington, School of Nursing in 1969 and remained in that position until
Through her observations, while working as a nurse, Madeleine
1974. In 1973, under her leadership, the University of Washington was recognized as the
Leininger identified a lack of cultural and care knowledge as the
outstanding public institutional school of nursing in the United States.
missing component to a nurse’s understanding of the many
variations required inpatient care to support compliance, healing,
Her appointment followed a trip to New Guinea in the 1960s that opened her eyes to the
and wellness, which led her to develop the theory of Transcultural
need for nurses to understand their patients’ culture and background to provide care. She
Nursing also known as Culture Care Theory.
is considered by some to be the “Margaret Mead of nursing” and is recognized worldwide
as the founder of transcultural nursing, a program that she created at the School in 1974.
This theory attempts to provide culturally congruent nursing care
through “cognitively based assistive, supportive, facilitative, or
enabling acts or decisions that are mostly tailor-made to fit with the Culture Care Diversity and
individual, group’s, or institution’s cultural values, beliefs, and Universality: A Worldwide
lifeways.” Nursing Theory
Leininger’s theory’s main focus is for nursing care to fit with or have beneficial meaning
and health outcomes for people of different or similar cultural backgrounds. With these,
she has developed the Sunrise Model in a logical order to demonstrate the
interrelationships of the concepts in her theory of Culture Care Diversity and Universality.

Transcultural Nursing Theory is discussed further below.

Discover related topics
Works
Nursing Theory
Leininger wrote and edited 27 books and founded the Journal of
Transcultural Nursing to support the Transcultural Nursing Society’s
Leininger's Theory
research, which she started in 1974. She published over 200 articles
and book chapters, produced numerous audio and video recordings,
and developed a software program. She has also given over 850 Transcultural Nursing Theory Concepts
keynote and public lectures in the US and around the world.
Transcultural Nursing Theory
She also established the Journal of Transcultural Nursing and served
Culture Care Diversity &
as editor from 1989 to 1995. She also initiated and promoted
Universality: A Theory of Transcultural Model
transcultural nurses’ worldwide certification (CTN) for client safety Nursing
and knowledgeable care for people of diverse cultures. While at Wayne State, Leininger won numerous awards, including the prestigious
President’s Award for Excellence in Teaching, the Board of Governors Distinguished Faculty
Her web pages now reside on a discussion board. Leininger has Award, and the Gershenson Research Fellowship Award.
provided downloads and answers to many common questions.
Board users are encouraged to post questions to her discussion In 1998, she was honored as a Living Legend by the American
board about transcultural nursing, her theory, and her research. Academy of Nursing and Distinguished Fellow, Royal College of
During her time, Leininger enjoys helping students, and she Nursing in Australia.
responds to questions as her time permits.
The Leininger Transcultural Nursing Award was established in 1983
Awards and Honors to recognize outstanding and creative leaders in transcultural
Transcultural Nursing:
nursing. This prestigious award will continue as the Leininger
In 1960, Leininger was awarded a National League of Nursing Concepts, Theories,
Research and Practice Transcultural Nursing Award under the Transcultural Nursing
Fellowship for fieldwork in the Eastern Highlands of New Guinea. She
Society’s auspices in Madeleine Leininger’s honor.
studied the convergence and divergence of human behavior in two Qualitative Research
Gadsup villages. Methods in Nursing
Death
On August 10th, 2012, Leininger passed away at her home in Omaha, Nebraska. She was
buried in Sutton’s Calvary Cemetery.
Leininger’s Transcultural Nursing Theory

The Transcultural Nursing Theory or Culture Care Theory by Madeleine Leininger
involves knowing and understanding different cultures concerning nursing and health-
illness caring practices, beliefs, and values to provide meaningful and efficacious nursing
care services to people’s cultural values 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.

The cultural care worldview flows into knowledge about individuals, families, groups, Nursing
communities, and institutions in diverse health care systems. This knowledge provides
Nursing is defined as a learned humanistic and scientific profession and discipline which is
culturally specific meanings and expressions about care and health. The next focus is on the
focused on human care phenomena and activities to assist, support, facilitate, or enable
generic or folk system, professional care system(s), and nursing care. Information about
individuals or groups to maintain or regain their well-being (or health) in culturally
these systems includes the characteristics and the specific care features of each. This
meaningful and beneficial ways, or to help people face handicaps or death.
information allows for the identification of similarities and differences or cultural care
universality and cultural care diversity.
Professional Nursing Care (Caring)
Next are nursing care decisions and actions which involve cultural care Professional nursing care (caring) is defined as formal and cognitively learned professional
preservation/maintenance, cultural care accommodation/negotiation, and cultural care re- care knowledge and practice skills obtained through educational institutions that are used
patterning or restructuring. It is here that nursing care is delivered. to provide assistive, supportive, enabling, or facilitative acts to or for another individual or
group to improve a human health condition (or well-being), disability, lifeway, or to work
Description with dying clients.
In 1995, Madeleine Leininger defined transcultural nursing as “a substantive area of study

Cultural Congruent (Nursing) Care
and practiced focused on comparative cultural care (caring) values, beliefs, and practices of
individuals or groups of similar or different cultures to provide culture-specific and universal Cultural congruent (nursing) care is defined as those cognitively based assistive, supportive,
nursing care practices in promoting health or well-being or to help people to face facilitative, or enabling acts or decisions that are tailor-made to fit with the individual,
unfavorable human conditions, illness, or death in culturally meaningful ways.” group, or institutional, cultural values, beliefs, and lifeways to provide or support
meaningful, beneficial, and satisfying health care, or well-being services.
The Transcultural Nursing Theory first appeared in Leininger’s Culture Care Diversity
and Universality, published in 1991, but it was developed in the 1950s. The theory was Health
further developed in her book Transcultural Nursing, which was published in 1995. In the
It is a state of well-being that is culturally defined, valued, and practiced. It reflects
third edition of Transcultural Nursing, published in 2002, the theory-based research and the
Transcultural theory application are explained. individuals’ (or groups) ‘ ability to perform their daily role activities in culturally expressed,
beneficial, and patterned lifeways.
Major Concepts of the Transcultural Nursing Theory

Human Beings
The following are the major concepts and their definitions in Madeleine Leininger’s
Such are believed to be caring and capable of being concerned about others’ needs, well-
Transcultural Nursing Theory.
being, and survival. Leininger also indicates that nursing as a caring science should focus
beyond traditional nurse-patient interactions and dyads to include families, groups,
Transcultural Nursing
communities, total cultures, and institutions.
Transcultural nursing is defined as a learned subfield or branch of nursing that focuses
upon the comparative study and analysis of cultures concerning nursing and health-illness Society and Environment
caring practices, beliefs, and values to provide meaningful and efficacious nursing care
Leininger did not define these terms; she speaks instead of worldview, social structure, and
services to their cultural values and health-illness context.
environmental context.
Ethnonursing
Worldview
This is the study of nursing care beliefs, values, and practices as cognitively perceived and
Worldview is how people look at the world, or the universe, and form a “picture or value
known by a designated culture through their direct experience, beliefs, and value system
stance” about the world and their lives.
(Leininger, 1979).
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Cultural and Social Structure Dimensions Generic (folk or lay) care systems are culturally learned and transmitted, indigenous (or
traditional), folk (home-based) knowledge and skills used to provide assistive, supportive,
Cultural and social structure dimensions are defined as involving the dynamic patterns and
enabling, or facilitative acts toward or for another individual, group, or institution with
features of interrelated structural and organizational factors of a particular culture
evident or anticipated needs to ameliorate or improve a human life way, health condition
(subculture or society) which includes religious, kinship (social), political (and legal),
(or well-being), or to deal with handicaps and death situations.
economic, educational, technological, and cultural values, ethnohistorical factors, and how
these factors may be interrelated and function to influence human behavior in different
Emic
environmental contexts.
Knowledge gained from direct experience or directly from those who have experienced it. It
Environmental Context is generic or folk knowledge.
Environmental context is the totality of an event, situation, or particular experience that

Professional Care Systems
gives meaning to human expressions, interpretations, and social interactions in particular
physical, ecological, sociopolitical, and/or cultural settings. Professional care systems are defined as formally taught, learned, and transmitted
professional care, health, illness, wellness, and related knowledge and practice skills that
Culture prevail in professional institutions, usually with multidisciplinary personnel to serve
consumers.
Culture is learned, shared, and transmitted values, beliefs, norms, and lifeways of a
particular group that guides their thinking, decisions, and actions in patterned ways.
Etic
Culture Care The knowledge that describes the professional perspective. It is professional care
knowledge.
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
Ethnohistory
group to maintain their well-being, health, improve their human condition lifeway, or deal
with illness, handicaps or death. Ethnohistory includes those past facts, events, instances, experiences of individuals, groups,
cultures, and instructions that are primarily people-centered (ethno) and describe, explain,
Culture Care Diversity and interpret human lifeways within particular cultural contexts over short or long periods
of time.
Culture care diversity indicates the variabilities and/or differences in meanings, patterns,
values, lifeways, or symbols of care within or between collectives related to assistive,
Care
supportive, or enabling human care expressions.
Care as a noun is defined as those abstract and concrete phenomena related to assisting,
Culture Care Universality supporting, or enabling experiences or behaviors toward or for others with evident or
anticipated needs to ameliorate or improve a human condition or lifeway.
Culture care universality indicates the common, similar, or dominant uniform care
meanings, patterns, values, lifeways, or symbols manifest among many cultures and reflect
Care
assistive, supportive, facilitative, or enabling ways to help people. (Leininger, 1991)
Care as a verb is defined as actions and activities directed toward assisting, supporting, or
Subconcepts enabling another individual or group with evident or anticipated needs to ameliorate or
improve a human condition or lifeway or face death.
The following are the subconcepts of the Transcultural Nursing Theory of Madeleine
Leininger and their definitions: Culture Shock
Generic (Folk or Lay) Care Systems

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Culture shock may result when an outsider attempts to comprehend or adapt effectively to
a different cultural group. The outsider is likely to experience feelings of discomfort and
helplessness and some degree of disorientation because of the differences in cultural
values, beliefs, and practices. Culture shock may lead to anger and can be reduced by
seeking knowledge of the culture before encountering that culture.
Cultural Imposition
Cultural imposition refers to the outsider’s efforts, both subtle and not so subtle, to impose
their own cultural values, beliefs, behaviors upon an individual, family, or group from
another culture. (Leininger, 1978)
Sunrise Model of Madeleine Leininger’s Theory

The Sunrise Model is relevant because it enables nurses to develop critical and complex
thoughts about nursing practice. These thoughts should consider and integrate cultural
and social structure dimensions in each specific context, besides nursing care’s biological
and psychological aspects.

Different cultures perceive, know, and practice care differently, yet there are some
Madeleine Leininger’s Sunrise Model. Click to enlarge. commonalities about care among all world cultures.
Values, beliefs, and practices for culturally related care are shaped by, and often
The cultural care worldview flows into knowledge about individuals, families, groups,
embedded in, “the worldview, language, religious (or spiritual), kinship (social),
communities, and institutions in diverse health care systems. This knowledge provides
political (or legal), educational, economic, technological, ethnohistorical, and
culturally specific meanings and expressions concerning care and health. The next focus is
environmental context of the culture.
on the generic or folk system, professional care systems, and nursing care. Information
While human care is universal across cultures, caring may be demonstrated through
about these systems includes the characteristics and the specific care features of each. This
diverse expressions, actions, patterns, lifestyles, and meanings.
information allows for the identification of similarities and differences or cultural care
Cultural care is the broadest holistic means to know, explain, interpret, and predict
universality and cultural care diversity.
nursing care phenomena to guide nursing care practices.
All cultures have generic or folk health care practices, that professional practices
Next are nursing care decisions and actions which involve cultural care preservation or
vary across cultures, and that there will be cultural similarities and differences
maintenance, cultural care accommodation or negotiation, and cultural care repatterning
between the care-receivers (generic) and the professional caregivers in any culture.
or restructuring. It is here that nursing care is delivered.
Care is the distinct, dominant, unifying, and central focus of nursing, and while
curing and healing cannot occur effectively without care, care may occur without a
Three modes of nursing care decisions and actions cure.
Cultural care preservation or Maintenance Care and caring are essential for humans’ survival and their growth, health, well-
being, healing, and ability to deal with handicaps and death.
Cultural care preservation is also known as maintenance. It includes those assistive, Nursing, as a transcultural care discipline and profession, has a central purpose of
supporting, facilitative, or enabling professional actions and decisions that help people of a serving human beings in all areas of the world; that when culturally based nursing
particular culture to retain and/or preserve relevant care values so that they can maintain care is beneficial and healthy, it contributes to the well-being of the client(s) –
their well-being, recover from illness, or face handicaps and/or death. whether individuals, groups, families, communities, or institutions – as they function
within the context of their environments.
Cultural care accommodation or Negotiation Nursing care will be culturally congruent or beneficial only when the nurse knows
the clients. The clients’ patterns, expressions, and cultural values are used in
Cultural care accommodation, also known as negotiation, includes those assistive,
appropriate and meaningful ways by the nurse with the clients.
supportive, facilitative, or enabling creative professional actions and decisions that help
If clients receive nursing care that is not at least reasonably culturally congruent
people of a designated culture to adapt to or negotiate with others for a beneficial or
(that is, compatible with and respectful of the clients’ lifeways, beliefs, and values),
satisfying health outcome with professional care providers.
the client will demonstrate signs of stress, noncompliance, cultural conflicts, and/or
Culture care repatterning or Restructuring ethical or moral concerns.
Culture care repatterning or restructuring includes those assistive, supporting, facilitative, Analysis
or enabling professional actions and decisions that help clients reorder, change, or greatly
modify their lifeways for new, different, and beneficial health care pattern while respecting In Leininger’s nursing theory, it was stated that the nurse would help the client move
the clients’ cultural values and beliefs and still providing a beneficial or healthier lifeway towards amelioration or improvement of their health practice or condition. This statement
than before the changes were established with the clients. (Leininger, 1991) would be of great difficulty for the nurse because instilling new ideas in a different culture
might present an intrusive intent for the “insiders.” Culture is a strong set of practices
developed over generations that would make it difficult to penetrate.
Assumptions
The following are the assumptions of Madeleine Leininger’s theory: The whole activity of immersing yourself within a different culture is time-consuming to
understand their beliefs and practices fully. Another is that it would be costly on the part of
the nurse.

Because of its financial constraints and unclear ways of being financially compensated, it Nowadays, nurses must be sensitive to their patients’ cultural backgrounds when creating a
can be the reason why nurses do not engage much with this kind of nursing approach. nursing plan. This is especially important since so many people’s culture is so integral in
who they are as individuals, and it is that culture that can greatly affect their health and
Because of the intrusive nature, resistance from the “insiders” might impose a risk to the their reactions to treatments and care. With these, awareness of the differences allows the
nurse’s safety, especially for cultures with highly taboo practices. nurse to design culture-specific nursing interventions.
It is highly commendable that Leininger formulated a theory that is specified to a Through Leininger’s theory, nurses can observe how a patient’s cultural background is
multicultural aspect of care. On the other side, too much was given to the culture concept related to their health and use that knowledge to create a nursing plan that will help the
per se that Leininger failed to discuss the functions or roles of nurses comprehensively. It patient get healthy quickly while still being sensitive to his or her cultural background.
was not stated how to assist, support or enable the client to attuning them to an improved
lifeway.
Recommended Resources
Strengths Recommended books and resources to learn more about nursing theory:
Leininger has developed the Sunrise Model in a logical order to demonstrate the
interrelationships of the concepts in her theory of Culture Care Diversity and Disclosure: Included below are affiliate links from Amazon at no additional cost
Universality. from you. We may earn a small commission from your purchase. For more
Leininger’s theory is essentially parsimonious in that the necessary concepts are information, check out our privacy policy.
incorporated in such a manner that the theory and its model can be applied in many
different settings.
It is highly generalizable. The concepts and relationships presented are at a level of Nursing Theorists and Their Work (10th Edition) by Alligood
abstraction, which allows them to be applied in many different situations. Nursing Theorists and Their Work, 10th Edition provides a clear, in-depth look at
Though not simple in terms, it can be easily understood upon the first contact. nursing theories of historical and international significance. Each chapter presents a
key nursing theory or philosophy, showing how systematic theoretical evidence can
Weakness enhance decision making, professionalism, and quality of care.
Knowledge Development in Nursing: Theory and Process (11th Edition)
The theory and model are not simple in terms. Use the five patterns of knowing to help you develop sound clinical judgment. This
edition reflects the latest thinking in nursing knowledge development and adds
Conclusion emphasis to real-world application. The content in this edition aligns with the new
2021 AACN Essentials for Nursing Education.
According to transcultural nursing, nursing care aims to provide care congruent with
Nursing Knowledge and Theory Innovation, Second Edition: Advancing the
cultural values, beliefs, and practices.
Science of Practice (2nd Edition)
This text for graduate-level nursing students focuses on the science and philosophy
Cultural knowledge plays a vital role for nurses on how to deal with the patients. To start, it
of nursing knowledge development. It is distinguished by its focus on practical
helps nurses to be aware of how the patient’s culture and faith system provide resources
applications of theory for scholarly, evidence-based approaches. The second edition
for their experiences with illness, suffering, and even death. It helps nurses understand and
features important updates and a reorganization of information to better highlight
respect the diversity that is often present in a nurse’s patient load. It also helps strengthen
the roles of theory and major philosophical perspectives.
a nurse’s commitment to nursing based on nurse-patient relationships and emphasizing
Nursing Theories and Nursing Practice (5th Edition)
the whole person rather than viewing the patient as simply a set of symptoms or illness.
The only nursing research and theory book with primary works by the original
Finally, using cultural knowledge to treat a patient also helps a nurse be open-minded to
theorists. Explore the historical and contemporary theories that are the foundation
treatments that can be considered non-traditional, such as spiritually based therapies like
of nursing practice today. The 5th Edition, continues to meet the needs of today’s
meditation and anointing.
students with an expanded focus on the middle range theories and practice models.

1/23/24, 1:53 AM Madeleine Leininger: Transcultural Nursing Theory - Nurseslabs
Strategies for Theory Construction in Nursing (6th Edition)

The clearest, most useful introduction to theory development methods. Reflecting
vast changes in nursing practice, it covers advances both in theory development and
in strategies for concept, statement, and theory development. It also builds further
connections between nursing theory and evidence-based practice.
Middle Range Theory for Nursing (4th Edition)
This nursing book’s ability to break down complex ideas is part of what made this
book a three-time recipient of the AJN Book of the Year award. This edition includes
five completely new chapters of content essential for nursing books. New exemplars
linking middle range theory to advanced nursing practice make it even more useful
and expand the content to make it better.
Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice
This book offers balanced coverage of both qualitative and quantitative research
methodologies. This edition features new content on trending topics, including the
Next-Generation NCLEX® Exam (NGN).
Nursing Research (11th Edition)
AJN award-winning authors Denise Polit and Cheryl Beck detail the latest
methodologic innovations in nursing, medicine, and the social sciences. The updated
11th Edition adds two new chapters designed to help students ensure the accuracy
and effectiveness of research methods. Extensively revised content throughout
strengthens students’ ability to locate and rank clinical evidence.
See Also
Recommended site resources related to nursing theory:
Nursing Theories and Theorists: The Definitive Guide for Nurses MUST READ!
In this guide for nursing theories, we aim to help you understand what comprises a
nursing theory and its importance, purpose, history, types or classifications, and give
you an overview through summaries of selected nursing theories.
Other resources related to nursing theory:
Betty Neuman: Neuman Systems Model

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Dorothy Johnson: Behavioral System Model
Faye Abdellah: 21 Nursing Problems Theory
Florence Nightingale: Environmental Theory
Hildegard Peplau: Interpersonal Relations Theory
Ida Jean Orlando: Deliberative Nursing Process Theory
Imogene King: Theory of Goal Attainment
Jean Watson: Theory of Human Caring
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CULTURE CARE THEORY

Culturally congruent care is possible when the following occurs in the nurse-patient relationship: “Together the nurse and the
client creatively design a new or different care lifestyle for the health or well-being of the client. This mode requires the use of both
Early in her career, Madeleine Leininger (../nursing-theorists/Madeleine-Leininger.php) recognized the importance of the element
generic and professional knowledge and ways to fit such diverse ideas into nursing care actions and goals. Care knowledge and
of caring in the profession of nursing. Through her observations while working as a nurse, she identified a lack of cultural and care
skill are often repatterned for the best interest of the clients. Thus all care modalities require coparticipation of the nurse and
knowledge as the missing component to a nurse’s understanding of the many variations required in patient care to support
clients (consumers) working together to identify, plan, implement, and evaluate each caring mode for culturally congruent nursing
compliance, healing, and wellness.
care. These modes can stimulate nurses to design nursing actions and decisions using new knowledge and culturally based ways
to provide meaningful and satisfying wholistic care to individuals, groups or institutions.”
Leininger’s Culture Care Theory attempts to provide culturally congruent nursing care through “cognitively based assistive,
supportive, facilitative, or enabling acts or decisions that are mostly tailor-made to fit with individual, group’s, or institution’s
cultural values, beliefs, and lifeways.” The intent of the care is to fit with or have beneficial meaning and health outcomes for
people of different or similar culture backgrounds.
Leininger’s model has developed into a movement in nursing care called transcultural nursing. In 1995, Leininger defined
transcultural nursing as “a substantive area of study and practice focused on comparative cultural care (caring) values, beliefs,
and practices of individuals or groups of similar or different cultures with the goal of providing culture-specific and universal
https://nursing-theory.org/theories-and-models/leininger-culture-care-theory.php?fbclid=IwAR1XFEs1z0tbE_SJcYzxdvxBDN89nziMsRGLDb2WKRAe… 1/6 https://nursing-theory.org/theories-and-models/leininger-culture-care-theory.php?fbclid=IwAR1XFEs1z0tbE_SJcYzxdvxBDN89nziMsRGLDb2WKRAe… 2/6

nursing care practices in promoting health or well-being or to help people to face unfavorable human conditions, illness, or death The theory’s culturalogical assessment provides a holistic, comprehensive overview of the client’s background. The assessment
in culturally meaningful ways.” addresses the following:
Leininger developed new terms for the basic concepts of her theory. The concepts addressed in the model are: communication and language
gender considerations
Care, which assists others with real or anticipated needs in an effort to improve a human condition of concern, or to face
death. sexual orientation
Caring is an action or activity directed towards providing care. ability and disability
Culture refers to learned, shared, and transmitted values, beliefs, norms, and lifeways to a specific individual or group that occupation
guide their thinking, decisions, actions, and patterned ways of living.
age
Culture Care is the multiple aspects of culture that influence and help a person or group to improve their human condition or
deal with illness or death. socioeconomic status
Culture Care Diversity refers to the differences in meanings, values, or acceptable forms of care in or between groups of interpersonal relationships
people.
appearance
Culture Care Universality refers to common care or similar meanings that are evident among many cultures.
dress
Nursing is a learned profession with a disciplined focus on care phenomena.

use of space
Worldview is the way people tend to look at the world or universe in creating a personal view of what life is about.
foods and meal preparation and related lifeways
Cultural and Social Structure Dimensions include factors related to spirituality, social structure, political concerns, economics,
educational patterns, technology, cultural values, and ethnohistory that influence cultural responses of people within a cultural
context.
Health refers to a state of well-being that is culturally defined and valued by a designated culture.
Cultural Care Preservation or Maintenance refers to nursing care activities that help people from particular cultures to retain
and use core cultural care values related to healthcare concerns or conditions.
Cultural Care Accommodation or Negotiation refers to creative nursing actions that help people of a particular culture adapt or
negotiate with others in the healthcare community in an effort to attain the shared goal of an optimal health outcome for
patients of a designated culture.
Leininger proposes that there are three modes for guiding nurses judgments, decisions, or actions in order to provide appropriate,
Cultural Care Re-Patterning or Restructuring refers to therapeutic actions taken by culturally competent nurses. These actions
beneficial, and meaningful care: preservation and/or maintenance; accommodation and/or negotiation; and re-patterning and/or
help a patient to modify personal health behaviors towards beneficial outcomes while respecting the patient’s cultural values.
restructuring. The modes have greatly influenced the nurse’s ability to provide culturally congruent nursing care, as well as
fostering culturally-competent nurses.
Leininger’s model makes the following assumptions:
1. Care is the essence of nursing and a distinct, dominant, and unifying focus.
2. Caring is essential for well-being, health, healing, growth, and to face death.
3. Culture care is the broadest holistic means by which a nurse can know, explain, interpret, and predict nursing care
phenomena to guide nursing care practices.

4. Nursing is a transcultural, humanistic, and scientific care discipline and profession with the central purpose to serve human
beings worldwide.
5. Caring is essential to curing and healing. There can be no curing without caring.
6. Culture care concepts, meanings, expressions, patterns, processes, and structural forms of care are different and similar
among all cultures of the world.
7. Every human culture has lay care knowledge and practices and usually some professional care knowledge and practices
which vary transculturally.
8. Culture care values, beliefs, and practices are influenced in the context of a particular culture. They tend to be embedded in
such things as worldview, language, spirituality, kinship, politics and economics, education, technology, and environment.
9. Beneficial, healthy, and satisfying culturally-based nursing care contributes to the well-being of individuals, families, and
communities within their environmental context.
10. Culturally congruent nursing care can only happen when the patient, family, or community values, expressions, or patterns
are known and used appropriately, and in meaningful ways by the nurse with the people.
11. Culture care differences and similarities between the nurse and patient exist in any human culture worldwide.
12. Clients who experience nursing care that fails to be reasonably congruent with their beliefs, values, and caring lifeways will
show signs of cultural conflicts, noncompliance, stresses and ethical or moral concerns.
13. The qualitative paradigm provides new ways of knowing and different ways to discover the epistemic and ontological
dimensions of human care.
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The Culture Care Theory defines nursing as a learned scientific and humanistic profession that focuses on human care
phenomena and caring activities in order to help, support, facilitate, or enable patients to maintain or regain health in culturally
meaningful ways, or to help them face handicaps or death.
The Sunshine Model is Leininger’s visual aid to the Culture Care Theory.

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1/23/24, 1:53 AM Madeleine Leininger: Transcultural Nursing Theory - Nurseslabs 1/23/24, 1:53 AM Madeleine Leininger: Transcultural Nursing Theory

, 1:53 AM Madeleine Leininger: Transcultural Nursing Theory - Nurseslabs

https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU3… 1/31 https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU3… 2/31

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Leininger’s professional career is recognized as an educator and academic administrator

https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU3… 5/31 https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU3… 6/31

Transcultural Nursing Theory is discussed further below.

Leininger’s Transcultural Nursing Theory

https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU3… 7/31 https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU3… 8/31

In 1995, Madeleine Leininger defined transcultural nursing as “a substantive area of study

Major Concepts of the Transcultural Nursing Theory

https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU3… 9/31 https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU… 10/31

Environmental context is the totality of an event, situation, or particular experience that

Generic (Folk or Lay) Care Systems

Sunrise Model of Madeleine Leininger’s Theory

https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU… 13/31 https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/?fbclid=IwAR21ZXOmWKSzYKt1e0YURZruVNUGhvprK2VZcTtlfgyoU… 14/31

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Strategies for Theory Construction in Nursing (6th Edition)

Other resources related to nursing theory:

Betty Neuman: Neuman Systems Model

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Theories & Models (https://nursing-theory.org/theories-and-models/)

Nursing Theorists (https://nursing-theory.org/nursing-theorists/)

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CULTURE CARE THEORY

https://nursing-theory.org/theories-and-models/leininger-culture-care-theory.php?fbclid=IwAR1XFEs1z0tbE_SJcYzxdvxBDN89nziMsRGLDb2WKRAe… 1/6 https://nursing-theory.org/theories-and-models/leininger-culture-care-theory.php?fbclid=IwAR1XFEs1z0tbE_SJcYzxdvxBDN89nziMsRGLDb2WKRAe… 2/6

Nursing is a learned profession with a disciplined focus on care phenomena.

Leininger’s model makes the following assumptions:

https://nursing-theory.org/theories-and-models/leininger-culture-care-theory.php?fbclid=IwAR1XFEs1z0tbE_SJcYzxdvxBDN89nziMsRGLDb2WKRAe… 3/6 https://nursing-theory.org/theories-and-models/leininger-culture-care-theory.php?fbclid=IwAR1XFEs1z0tbE_SJcYzxdvxBDN89nziMsRGLDb2WKRAe… 4/6

© Copyright 2023 Alice Petiprin, Nursing-Theory.org. All Rights Reserved

A RAPTIVE PARTNER SITE

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