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Nursing Theory Argumentative

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  • Pages: 8
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  • Category: Nursing

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In an ever-changing world, society tends to become increasingly diverse, in terms of behaviors, values beliefs and norms. With constant internal and environmental stimuli, such behaviors, values, beliefs and norms develop overtime which creates a mark in the mind of every individual, and is observed through social practices, religious structures and artistic expression. The end result of such change is what we recognize now as culture. Culture directs an individual’s thinking, doing and being. Within the context of nursing practice, cultural backgrounds can influence views on health and well-being and illness, which in turn might have an effect on their perceptions on healthcare and healthcare outcomes. Due to the recurrent concerns regarding the challenges encountered in the care for culturally diverse patients, transcultural care has become an important aspect of health care. Nowadays the goal of the medical system is to provide optimal and holistic care for all patients, to be culturally competent is an ingredient in order to accomplish quality care and health outcomes. The need for clinicians to become more sensitive to cultural differences and gain an understanding of transcultural concepts has been repeatedly stressed by Leininger (1988) and is the aim of this piece of writing.

Our group hails from diverse locations and is working in different parts of not only the Philippines, but also of the world. With different upbringings and different customs that we grew up with and encounter on a daily basis as nurses, we chose Madeleine Leininger, who was a pioneer in her time, as our nursing theorist.

When Madeleine Leininger’s name was suggested, the majority immediately agreed on her because of the concept that she has developed; the Theory of Culture Care. Culture Care or Transcultural Nursing deals with nursing and the culture of the clients. And as we are nurses who are working in various nursing fields, in different locations, the group saw how it can be adapted to our profession. Seeking further knowledge on it and how it applies to our specialization, will enhance each individual further as efficient nurses.

The concept is also applicable not only to our work but also to us, students of Masters of Arts in Nursing, because we are currently adapting to a new culture with a different study environment, having interactions with people in various locations by various forms of media. This concept would not only be applied in the work setting but also in our education.

With this, our group encourages you to read through our study and we hope that you will be able to understand and appreciate its contents. We feel confident that after going through our output, you will come to conclude that nursing transcends all cultures, providing care for every race and nation. Theory Definitions and Specifics of The Theory of Culture Care

Enrique Luis Nuguid

Dr. Leininger said that Illness and wellness are shaped by a various factors including perception and coping skills, as well as the social level of the patient. She also stressed that cultural competence is an important component of nursing and that religious and cultural knowledge is an important ingredient in health care. She stressed that value of culture is influential in all spheres of human life. It also defines health, illness, and the search for relief from disease or distress. Health concepts held by many cultural groups may result in people choosing not to seek modern medical treatment procedures and that health care providers need to be flexible in the design of programs, policies, and services to meet the needs and concerns of the culturally diverse population, groups that they likely to be encountered.

Most cases of illness have multiple causalities and may require several different approaches to diagnosis, treatment, and cure including folk and western medical interventions. According to her studies, the use of traditional or alternate models of health care delivery is widely varied and may come into conflict with western models of health care practice that is why being a-depth with different cultures guide the behavior into acceptable ways for the people in a specific group since culture originates and develops within the social structure through inter personal interactions. Effective intercultural communication must take place so that nurse can successfully provide care for a client of a different cultural or ethnic to background.


The practice of transcultural nursing addresses the cultural dynamics that influence the nurse client relationship. Because of its focus on this specific aspect of nursing, a theory was needed to study and explain outcomes of this type of care. Leininger creatively developed the Theory of Culture Care: Diversity and Universality with the goal to provide culturally congruent wholistic care. Some scholars might place this theory in the middle range classification. Leininger holds that it is not a grand theory because it has particular dimensions to assess for a total picture. It is a wholistic and comprehensive approach, which has led to broader nursing practice applications than is traditionally expected with a middle-range, reductionist approach. (Personal communication with Penny Glynn on September 12, 2003). Leininger’s theory is to provide care measures that are in harmony with an individual or group’s cultural beliefs, practices, and values. In the 1960’s she coined the term culturally congruent care, which is the primary goal of transcultural nursing practice.

Culturally congruent care is possible when the following occurs within the nurse-client relationship (Leininger, 1981): 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 generic and professional knowledge and ways to fit such diverse ideas into nursing care actions and goals. Care knowledge and skill are often repatterned for the best interest of the clients…Thus all care modalities require coparticipation of the nurse and clients (consumers) working together to identify, plan, implement, and evaluate each caring mode for culturally congruent nursing care. These modes can stimulate nurses to design nursing actions and decisions using new knowlwdge and culturally based ways to provide meaningful and satisfying holistic care to individuals, groups or institutions.

· Under Leninger’s theory, the enthohistory of a patient is also important when evaluating adequate care. Under Leninger’s theory, ethnohistory refers to “to the past events and experiences of individuals or groups, which explain human lifeways within particular cultural contexts over short or long periods.” For example, a person who may have been a member of an African tribe that does not traditionally believe in or trust medical professionals will require a nurse who is especially careful and slow to introduce medical treatments. Other Concepts

· Leninger’s theory also states that its cannot only be applied to the nurse-client relationship but also includes care for families, groups, communities, cultures and institutions. Her theory would be especially important in situations in which a nurse may be enlisted in the Army or a member of the Peace Corps, where there will be cultural as well as religious divides, and it would be of the utmost importance for the nurse to be able to address the differences provide care accordingly.

Flor Kenneth Alobin

Madeleine Leininger focused on care as an integral aspect of nursing. Unlike other nursing theorists, she did not emphasized on basic concepts of person, nursing, health and environment.

Instead, she formulated the following descriptions of these:

PERSON: refers to an individual human caring and cultural being as well as a family, group, a social institution, or a culture.

Human beings are best explained in her assumptions. Humans are thus believed to be caring and capable of being concerned about the desires, welfares, and continued existence of others. Human care is collective, that is, seen in all cultures.

Humans have endured within cultures and through place and time because they have been able to care for infants, children, and the elderly in a variety of ways and in many different environments. Thus, humans are universally- caring beings who survive in a diversity of cultures through their ability to provide the universality of care in a variety of ways according to differing cultures, needs, and settings.

Leininger (1991) also indicates that nursing, as a caring science should focus ahead of traditional nurse-patient interactions to include “families, groups, communities, total cultures, institutions,” as well as worldwide health institutions and ways to expand international nursing care policies and practices.

ENVIRONMENT: refers to the physical or ecological environment and a context in which individuals and cultural groups live

Instead of ‘environment’ Leininger uses the concept ‘environmental context’, which includes events with meanings and interpretations given to them in particular physical, ecological, sociopolitical and/or cultural settings.

Her description of culture centers on a particular group (society) and the patterning of actions, thoughts, and decisions that occurs as the result of “learned, shared, and transmitted values, beliefs, norms and lifeways.” This learning, sharing, transmitting, and patterning take place within a group of people who function in an identifiable setting or environment. Therefore, although Leininger does not use the specific terms of society or environment, the concept of culture is closedly related to society/environment, and is a central matter of her theory.

HEALTH: encompasses a broad spectrum of conditions, including well-being, illness, disability, and handicap

Madeleine Leininger discussed about components of health, specifically:
§ health systems
§ health care practices
§ changing health patterns
§ health promotions
§ health maintenance

Health is a key concept in transcultural nursing. Because of the weight on the need for nurses to have knowledge that is specific to the culture in which nursing is being practiced, it is acknowledged that health is seen as being universal across cultures but distinct within each culture in a way that represents the beliefs, values, and practices of the particular culture. Thus, health is both universal and diverse.

NURSING: a discipline and profession of transcultural human care. It is a learned humanistic and scientific profession and discipline that focuses on phenomena and activities of human care in order to assist, support, facilitate, or enable individuals or groups to maintain or regain their well-being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death

First, Leininger considers nursing a discipline and a profession, and the term ‘nursing’ thus cannot explain the phenomenon of nursing. Instead, care has the greatest epistemic and onto logic explanatory power to explain nursing. Leininger (1995a) views ‘caring’ as the verb counterpart to the noun ‘care’ and refers it to a feeling of compassion, interest and concern for people (Leininger 1970, Morse et al. 1990, Reynolds 1995, McCance et al. 1997). When Leininger’s definition of care is compared to other transcultural scholars’ definitions, it appears that her view of care is wider than, for example, that of Orque et al. (1983), who describe care as goal-oriented nursing activities, in which the nurses recognise the patients’ ethnic and cultural features and integrate them into the nursing process.

Leininger showed her concern to nurses who do not have sufficient preparation for a transcultural perspective. For that reason, they will not be able to value nor practice such viewpoint to the fullest extent possible.

She gave three types of nursing actions that are culturally-based and thus consistent with the needs and values of the clients. These are:

1. Cultural care preservation/maintenance
2. Cultural care accommodation/negotiation
3. Cultural care repatterning/restructuring

These three modes of action can lead to the deliverance of nursing care that best fits with the client’s culture and thus reduce cultural stress and chance for conflict between the client and the caregiver.

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