untitled

nursing undergraduate and transcultural nursing
graduate courses and programs by the mid 1970s
and early 1980s. These offerings were gradually ac-
cepted by nurses and helped them to care for di-
verse cultures and enjoy the work with clients
(Leininger, 1989a, 1995).
Nurses were the largest and most direct health-
care providers, so great opportunities existed for
them to change health care to incorporate cul-
turally congruent care practices. Such was the
ultimate goal of transcultural nursing. Nurses
and those in other health-care disciplines urgently
needed to become transculturally prepared to
meet a growing multicultural world. Inadequate
culturally based services were leading to client dis-
satisfaction and new sets of problems. In fact, some
clients would not ever use health services because
the staff were not culturally sensitive to their needs
and care.
As more courses and programs in transcultural
nursing were offered to educate nurses to learn
basic concepts, principles, and practices, the inter-
est of nurses began to grow. As more nurses began
to study and use the Theory of Culture Care
Diversity and Universality, the concept of trans-
cultural nursing became meaningful. Leininger had
defined transcultural nursing as an area of study
and practice focused on cultural care (caring)
values, beliefs, and practices of particular cul-
tures. The goal was to provide culture-specific and
congruent care to people of diverse cultures
(Leininger, 1978, 1984, 1995). The central purpose

The central purpose of transcultural nurs-

ing was to use research-based knowledge

to help nurses discover care values and

practices and use this knowledge in safe,

responsible, and meaningful ways to care

for people of different cultures.

of transcultural nursing was to use research-based
knowledge to help nurses discover care values and
practices and use this knowledge in safe, responsi-
ble, and meaningful ways to care for people of
different cultures. Today the Culture Care Theory
has led to a wealth of research-based knowledge
to guide nurses in the care of clients, families,
and communities of different cultures or sub-
cultures.

MAJOR THEORETICAL TENETS

In developing the Theory of Culture Care Diversity

and Universality, Leininger identified several pre-

dictive tenets or premises as essential for nurses and

others to use with the theory.

Commonalities

A major principal tenet was that cultural care di-

versities and similarities (or commonalities) would

be found within cultures. This tenet challenges

nurses to discover this knowledge so that nurses

could use cultural data in order to provide thera-

peutic outcomes. It was predicted there would be a

gold mine of knowledge if nurses were patient and

persistent to discover care values and patterns

within cultures. It has been a major missing dimen-

sion of traditional nursing. Leininger has stated

that human beings are born, they live, and they die

with their specific cultural values and beliefs, as

well as with their historical and environmental con-

text and that care has been important for their sur-

vival and well-being. Leininger predicted that

discovering which elements of care were culturally

universal and which were different would drasti-

cally revolutionize nursing and ultimately trans-

form the health-care systems and practices

(Leininger, 1978, 1990a, 1990b, 1991).

Worldview and Social Structure Factors

Another major tenet of the theory was that world-

view and social structure factors—such as religion

(and spirituality), political and economic consider-

ations, kinship (family ties), education, technology,

language expressions, the environmental context,

and cultural history—were important influences

on health-care outcomes (Leininger, 1995). This

broad and multifaceted view provided a holistic

perspective to understand people and grasp their

world and environment within a historical context.

Data from this holistic research-based knowledge

was predicted to guide nurses for the health and

well-being of the individual or to help disabled or

dying clients from different cultures. These social

structure factors influencing human care from dif-

ferent cultures would provide new insights to pro-

vide culturally congruent care. They need, however,

to be studied systematically by nurse researchers.

Superficial knowledge would not be helpful with

culture. These factors, plus the history of cultures

and knowledge of their environmental factors, had

CHAPTER 20 Madeleine M. Leininger’s Theory of Culture Care Diversity and Universality 313