untitled

f. Choose key and general informants.

g. Maintain trusting and favorable relationships

with the people conferring with ethnonursing

research experts to prevent unfavorable devel-

opments.

h. Collect and confirm data with observations,

interviews, participant experiences, and other

data. This is a continuous process from the

beginning to the end and requires the use of

qualitative research criteria to confirm find-

ings and credibility factors.

i. Maintain continuous data processing on the

computer and with field journals, depicting

active analysis and reflections and discussions

with research mentor(s). Computer-assisted

data analysis with large volumes of qualitative

data may be performed with QSR NUD*IST 4

software as previously noted.

j. Frequently present and reconfirm findings

with the people studied to check credibility

and confirmability of findings.

k. Make plans to leave the field site, community,

and informants in advance.

5. Do final analysis and writing of research find-
   ings soon after completing the study.


6. Prepare published findings in appropriate
   journals.


7. Help implement the findings with nurses inter-
   ested in findings.


8. Plan future studies related to this domain or
   other new ones.
   Again, flexibility exists with the ethnonurs-
   ing data processing, but the above steps help to
   conceptualize the process and thus promote the re-
   searcher’s ability to perform a systematic investiga-
   tion that has credibility and meets other qualitative
   evaluation criteria.

Culture Care Theory

and Nursing Practice

Over the past five decades, the culture care theory,
along with the ethnonursing method, have been
used by nurse researchers to discover knowledge
that can be and has been used in nursing practice.
Nurses can use such knowledge to care for individ-
ual clients and to focus on care practices that are
beneficial for families, groups, communities, cul-

tures, and institutions. Our multicultural world has

made it imperative that nurses understand different

cultures to work and care for people who have di-

verse and similar values, beliefs, and ideas about

nursing, health, caring, wellness, illness, death, and

disabilities (Leininger, 1991a, 1995). As stated by

Dr. Leininger in the first part of this chapter, the

goal of the Theory of Culture Care Diversity and

Universality is to improve or maintain health and

well-being by providing culturally congruent care

to people that is beneficial and fits with the lifeways

of the client, family, or cultural group. The sunrise

enabler serves as a cognitive map depicting the

seven culture and social structure dimensions that

influence care, which in turn influence the health

and/or illness of clients. The culture care theory

and the sunrise enabler include what is similar

(universal) and different (diverse) between generic

or folk care and professional care, and provides a

focus on both types of care for the provision of cul-

turally congruent care for clients in diverse nursing

practice settings. Leininger (1991a) predicted that

culturally congruent care would prevent cultural

clashes, cultural illnesses, and other unfavorable

human conditions under human control. These

general ideas are kept in mind as one uses findings

related to the theory in clinical practice.

THE THREE CARE MODES

AND THE SUNRISE ENABLER

To provide a different focus from traditional nurs-

ing, Leininger developed the unique three modes of

care to incorporate theory findings (refer to sunrise

enabler, Figure 20–1). The three modes are: culture

care preservation or maintenance; culture care ac-

commodation or negotiation; and culture care

repatterning or restructuring. The theorist has pre-

dicted that the researcher can use ethnoresearch

findings to guide nursing judgments, decisions, and

actions related to providing culturally congruent

care (Leininger, 2002). Leininger prefers not to use

Leininger prefers not to use the phrase

nursing intervention because this term

often implies to clients from different cul-

tures that the nurse is imposing his or her

(etic) views, which may not be helpful.

CHAPTER 20 Application of Leininger’s Theory of Culture Care Diversity and Universality 327