Healthcare settings are made of social entities with culturally diverse people. As a consequence, there has emerged a need to provide health care that not only meets that needs of patients but also treats each patient according to their cultural background. Madeleine Leininger identified this gap in the 1950s (Leininger, 1988). Leininger developed the culture care theory to guide nurses in providing congruent service based on unique cultural needs of patients. The approach is based on practical and efficient care through cognitive assistance that tailored to the needs of the patient. The attention must align with the institution's beliefs, culture, and goals. The care aims to provide quality care that fits a specific context as well as provide better outcomes for individuals with varying cultural backgrounds. According to this theory, nurses can give congruent care when the culture, patterns, and practices of the patient are known.
Cultural care theory provides a framework for specific practice using three useful action plans. According to Sagar, nurses who want to move from the approach to the method of sensitive cultural care should maintain desirable values and beliefs. For example, the caretaker must encourage the patient to feed and bath and ask family members to actively take part in assisting the client (Sagar 2011). The second hand-on-hand situation involves patterning and restructuring. This refers to working with the client to make mutual decisions, which the nurse can then modify to realize better outcomes. In practice, this would entail dealing with a client who believes the sicknesses he/she suffers is a punishment from God does not think an intervention will help. The caregiver is supposed to respect the client understands and values, while at the same time educate him/her that his decision will be followed when he can no longer speak (Seaton, 2010). Each of these modes in the model can be experienced every day in healthcare settings. The theoretical model will become more useful and applicable when nurses get more experience with different cultural contexts that exist across the world.
Leininger used several perspectives that formed the philosophical basis for social care theory. First, the caregivers should tend to the needs of people suffering from health complications (Betancourt & Daniel, 2015). Concepts of culture are influenced by different contexts and culture of the world. Care values and practices are not universal but vary across the world due to different customs, language, and religion, political, economic and educational differences (McFarland and Webhe (2012). Nurses who fail to integrate social care intervention will have patients experience stress, moral concerns, and cultural conflict. Cultural care can only be achieved when the values, patterns, and expressions of the healthcare are well defined and known by the caregiver.
Leininger provides insights on how to identify and perform cultural based care to users who do not need to travel across the world to understand the concern in different cultures. The nurse should start by listening attentively to patients, assess their values and make decisions that deviate from offensive practices (Leininger 2006). Communication should be prioritized since some patients may require tailored care. In a real-life application, Leininger notes that individual cultures can be grouped especially when handling East Asian patients (Leininger 2006). These people love to be treated according to their unique needs and standards of care and do not like to be generalized. By doing so, the caregiver may discourage them from seeing assistance. Another hand-on-hand application of culturally based care is a technique called palpation. This is a method of touch that is common in western countries. However, some cultures do not tolerate touch, and it has not been well accepted in non-western nations. Throughout the interaction, nurses must maintain a high degree of professionalism by taking initial steps to communicate with patients.
One of the core requirements of advanced professional nursing is to integrate theory and research into practice. Nurses continuously look for latest and widely acted knowledge through study and practice. Culturally based care theory offers a lot of insights to guide nurses who want to get more information about cultural influences in the nursing. Ethnic-Nursing research can be used to explore faculty in nursing care expression, patterns and practices (McFarland and Webhe (2012). The methods used should be open and naturalistic and look for information from the subject point of view. It should also be inductive such that it is easy to document, describe and interpret people's beliefs and attitudes. Additionally, culturally based research should aim to discover people way of living.
Leininger theoretical model provides a framework for predicting interventions when applied in different cultural contexts. Through the model, a nurse can predict that intervention that treats each patient according to their culture will most likely be useful. However, a response that only focuses on results and puts all patients as if belonging to a common culture will eventually cause harm to the patient. It is expected that needs-based interventions that are sensitive to the difference in needs will provide extra opportunity to get the best results. As Leininger notes, nurses will come to understand that taking a holistic position and not just paying attention to one particular illness, considering how the patient perceives the problem, their cultural beliefs toward the intervention and support measure available will enhance patient-oriented care.
Betancourt, B., Daniel (2015). Madeleine Leininger and the Transcultural Theory of Nursing, downtown Review. Cleveland State University.
Leininger, M. M. (1988). Leininger's theory of nursing: Cultural care diversity and universality. Nursing science quarterly, 1(4), 152-160.
McFarland, M. R., Mixer, S. J., Webhe-Alamah, H., & Burk, R. (2012). Ethnonursing: a qualitative research method for studying culturally competent care across disciplines. International Journal of Qualitative Methods, 11(3), 259-279.
Sagar, P. L. (2011). Transcultural nursing theory and models: application in nursing education, practice, and administration. Springer Publishing Company.
Seaton, L. P. (2010). Cultural care in nursing: a critical analysis
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