Transcultural Nursing Theory by Madeleine Leininger
Madeleine Leininger’s Transcultural Nursing Theory is critical in the modern-day nursing and healthcare sector in general amid the cultural diversity of both providers and recipients of care. The United States has witnessed a growth in the multicultural population, a reality that poses a challenge to providers in the holistic and customized patient care (Busher Betancourt, 2016). The multicultural environment engages nursing professionals with the capacity to understand and appreciate differences in culture and their effect on healthcare beliefs, values, and customs of individuals served in a particular health care setting. Therefore, nurses should develop skills and knowledge of cultural competency, which can support patient outcomes such as satisfaction. Although various nursing theories can enhance the role of a nurse in a multicultural health setting, Transcultural Nursing Theory is one of the most effective approaches in supporting quality care in the current multicultural healthcare system.
Transcultural Nursing Theory aims at highlighting the culturally important factors that affect the way nurses provide care and how patients receive care. The factors are critical because they have a direct impact on the health and wellbeing of individuals (Leininger, 2002). Therefore, the theory provides culturally congruent, safe, and quality care to diverse patients.
Transcultural Nursing Theory uses various concepts that form the foundation of the theory and are important in nursing practice. The concepts include culture, race, and ethnicity (Leininger, 2002). Other concepts, such as cultural competence, cultural awareness, and acculturation, are also part of the theory. As nurses provide culturally competent care, they should consider the effect of the above concepts in the care process and outcomes.
Culture is the most important and basic concept in theory, which affects all aspects of life. The concept determines beliefs and attitudes towards health, wellbeing, and illness. Culture defines values and assumptions that different people hold, which are transmitted from one generation to the next (Ray, 2016). Race and ethnicity are aspects of culture that determines the way people view themselves and others. Cultural competence, cultural awareness, and acculturation determine the level of the individual’s understanding and appreciation of cultural differences.
Relationship and Structure
Leininger’s sunrise model (Figure 1) shows the relationship and structure between the theory’s building blocks.
(Leininger’s Sunrise Model Adopted from Leininger, 2002)
Nurses should use the model as the rising sun when performing cultural assessments. The model links the concepts and creates a structure that nurses can use in practice (Ray, 2016). Furthermore, it presents a systematic means for identifying people’s values, beliefs, meanings, and behaviors. The structure includes various factors, such as technology, religion, social values, kinship, philosophy, education, and politics, among other aspects. Such factors affect language and the environment that, in turn, influences health and wellbeing.
The theory has various theoretical premises, which Leininger (2002) considered as assumptions. First, “care is the essence of nursing and a distinct, dominant, central, and unifying focus.” (Leininger, 2002, p. 192). Nurses should provide care with compassion and sensitivity. Second, “culturally based care (caring) is essential for well-being health, growth, survival, and in facing handicaps or death.” (Leininger, 2002, p. 192). Third, “culturally based care is the most comprehensive, holistic, and particularistic means to know, explain, interpret, and predict beneficial congruent care practices.” (Leininger, 2002, p. 192). Fourth, “culturally based caring is essential to curing and healing, as there can be no curing without caring, although caring can occur without curing.” (Leininger, 2002, p. 192). Fifth, “culture care concepts, meanings, expressions, patterns, processes, and structural forms vary transculturally, with diversities (differences) and some universalities (commonalities).” (Leininger, 2002, p. 192). The assumptions enable nurses to provide care in a culturally competent environment with biases that might negatively affect outcomes for patients and the healthcare organization.
Leininger conceived the theory of Transcultural Nursing early in her career when she realized that nurses had inadequate knowledge of culture, especially when providing patient care. In 2002, she proposed the theory that would include culture in the caring process to achieve compliance, healing, and wellness (Leininger, 2002). The theory has remained relevant to nurses since then.
Leininger’s theory has an exceptional focus that makes it relevant in the caring environment. It focuses on nursing as a humanistic and learned scientific profession that emphasizes on the phenomenon of human care and the caring process to facilitate, help, enable, or support patients to regain or maintain health in a cultural importance manner (Ray, 2016). The theory considers the role of culture in the continuum of care.
Leininger’s theory includes the four metaparadigm concepts of person, environment, health, and nursing. The person, in theory, is the patient who is a cultural actor with values, beliefs, and behaviors that affect health and the care delivery process. The environment is the patient’s surrounding. In the theoretical perspective, it is the multicultural setting that affects the patient’s health and wellbeing. Health is the patient’s overall wellbeing, while nursing is the caring process, including the ability to provide culturally competent care (Leininger & McFarland, 2010). The metaparadigm concepts collaborate to provide safe and quality patient-centered care in a culturally diverse environment.
Leininger’s theory is important in the development of culturally competent care in the modern multicultural health care environment. The theory challenges the nurse to apply cultural knowledge and skills when working with diverse clients (Leininger & McFarland, 2010). For instance, it plays an important role during cultural assessments conducted by nurses.
Leininger proposed a theory that could be easily understood and applied in research and practice. The complexity of the theory provides a vital tool for developing a comprehensive perspective of culture and the role it plays in nursing and health care in general (Leininger & McFarland, 2010). Regardless of complexity, the theory is easy to understand and use.
Leininger’s theory is consistently used in her publications and by other authors. It is applicable across cultures, ethnicities, and races (Leininger & McFarland, 2010). The theory is founded on the importance of communication, which means that it cuts across languages and cultures, eliminating many barriers to practice.
The theory has various concepts that Leininger describes clearly and uses consistently in nursing research. Various authors have used the theory in their research to provide useful evidence in nursing practice (Busher Betancourt, 2016). Thus, the theory is proven effective in supporting culturally based care.
Contribution to Nursing
The theory makes an important contribution to nursing education, research, and practice in a culturally diverse healthcare setting. It is based on a vital association between culture-related concepts that play a role in the use of cultural competence in education, research, and practice (Leininger & McFarland, 2010). The concepts are the research and practice standards that guide cultural-based care.
The purpose of the analysis was to describe, analyze, and evaluate Transcultural Nursing Theory by Madeleine Leininger, an effective theoretical framework in supporting education, research, and practice in the current multicultural health care environment. The theory includes significant concepts such as culture and other aspects that influence the development of culturally competent nursing care. From the analysis and assessment, the theory is significant in modern health care because of the need for nurses to work with diverse patients.