1. Madeleine Leininger’s Theory of Culture Care Diversity & Universality
Amy Boge & Lindsay Scholten
Nursing 324
Ferris State University

2. Introduction Objectives:
Madeleine Leininger developed the Theory of Culture Care Diversity and Universality. She described
Three dominant modes to guide nursing decisions and actions in order to provide cultural congruent care. They are (a) cultural care maintenance or preservation, (b) cultural care accommodation or negotiation, and (c) cultural care restructuring and repatterning. In sum, the purpose of the theory is to describe, account for, interpret, and predict cultural congruent care in order to attain the ultimate goal of the theory, namely to provide quality care to clients of diverse cultures that is congruent, satisfying, and beneficial to them (Leininger, 1988, p. 155).
Objectives:
Define how nursing theory is used for evidence based practice.
Define nursing, person, health, and environment according to Leininger’s theory.
Explore how Leininger’s theory can improve the contemporary health care environment.

3. How is Nursing Theory used for Evidence Based Practice?
Nursing theory combined with research helps to find the answers to difficult questions in nursing practice (Black, 2014).
Theoretical models are often used to develop research questions (Black, 2014).
Theory provides a solid base and history for nursing, while continued research ensures relevance and a future for nursing.
“In general, a theory is effective if it can discover, explain, interpret, and predict a phenomenon. There are different ways to define and use theories; there is no one right way to generate, test, analyze, and evaluate theories. More scientists are beginning to use qualitative approaches for inquiry to expand knowledge, especially in the human sciences” (Leininger, 1988, p. 154).
Watson (1991) stated that “nursing is a transcultural discipline and [Leininger’s] theory is a milestone to contribute to the unique nature of nursing… no other work has systematically linked theory, method and practice to address the culture care needs of human beings” (as cited in Leininger, 2007, p. 12).

4. The Metaparadigm concepts of Nursing Definitions based on Leininger’s theory
Person
Leininger (2007) believed care to be the “essence of nursing” ( p. 9) and the “central, dominant, and unifying feature of nursing” (Leininger, 1988, p. 152). She believed nurses should use “creativity to discover cultural aspects of human needs” (Black, 2014, p. 277).
The nurse must listen “with a very open mind to the informant, learning from them, and not imposing” (Leininger, 2002, p. 192) his or her own ideas on the patient.
Culturally based nursing care is essential to the “health and well-being” of patients (Black, 2014, p. 278).
Every individual is unique and has different needs, cultural beliefs, and values (Black, 2014).
Leininger’s (2007) theory focuses on discovering “diversities and universalities” (p. 10), or differences and similarities between people to improve wellness and quality of life through culturally congruent nursing care.

5. The Metaparadigm Concepts of nursing Definitions based on Leininger’s theory
Health
Environment
Leininger (2007) says culturally based care is necessary to “nurture the quality of life and health and to prevent illness or disabilities” (p. 10).
“Health refers to a state of well-being that is culturally defined, valued, and practiced and which reflects the ability of individuals (or groups) to perform their daily role activities in a culturally satisfactory way” (Leininger, 1988, p. 156).
Providing care with the patient’s cultural needs in mind will “prevent stress, conflicts, and imposition of practices” (Leininger, 2007, p. 10).
Environment refers to the “totality of an event, situation, or particular experience that gives meaning to human expressions, including social interactions and physical, ecological, emotional, and cultural dimensions (Leininger, 1988, p. 156).
Leininger’s (2007) theory focuses on this concept specifically by suggesting nurses provide holistic, culturally congruent care.
When patients’ environments are considered, they are more likely to accept care and cooperate with nurses to improve their health (Leininger, 2007).

6. How can Leininger’s theory improve the contemporary health care environment?
Local
Regional
Global
Leininger’s (2007) theory can…
help change nurses’ thinking about other cultures by eliminating biases and misconceptions.
promote health and make health services more fitting to the “cultural lifeways” (Leininger, 2007, p. 12) of clients.
Culturally competent nurses are needed as the United States is becoming more racially diverse (Black, 2014).
Understanding cultural backgrounds improves communication and helps create better nurse-patient relationships (Black, 2014).
Leininger (2007) believed that if “cultures, individuals, and nations would discover and practice culturally congruent care, then peaceful relations could prevail among all human cultures” ( p. 12).
Using Leininger’s theory, nursing can be a major contributor to meeting the “humanitarian and cultural needs in [the] global universe” (Leininger, 2007, p. 12).

7. References
Black, B.P.  (2014). Professional nursing: Concepts and challenges (7th ed.) Maryland Heights, MO: Saunders
Leininger, M. (2002). Culture care theory: A major contribution to advance transcultural nursing knowledge and practices. Journal of Transcultural Nursing, 13(3), doi: /
Leininger, M. (2007). Theoretical questions and concerns: Response from the theory of culture care diversity and universality perspective. Nursing Science Quarterly, 20(1), doi: /
Leininger, M. (1998). Special research report: Dominant culture care (EMIC) meanings and practice findings from Leininger’s theory. Journal of Transcultural
Nursing, 9(2), doi: /
Leininger, M.M. (1988). Leininger’s theory of nursing: Cultural care diversity and universality. Nursing Science Quarterly, 1(4), doi: /