regarding the benefits of regular prenatal care, in-
cluding emphasizing the health and well-being of
both the mother and the baby.
In 1999, Wehbeh-Alamah conducted a two-year
ethnonursing study using the culture care theory
and studied the generic health-care beliefs, prac-
tices, and expressions of Lebanese American
Muslim immigrants in two Midwestern U.S. cities.
Her findings, which confirmed many of Luna’s
from 1989, included the discovery of specific
generic folk care beliefs on practices that required
culture care accommodation/negotiation in the
home as well as in the hospital. These included pro-
viding for prayer while facing east five times a day;
having large numbers of visitors when in the hospi-
tal or at home; and eating only halal meat. Many
gender care findings were similar to those from
Luna’s study, revealing a persistence of many re-
lated care patterns over time as predicted in the
culture care theory. However, the women in
Wehbeh-Alamah’s study believed the absence of ex-
tended family members in the United States had in-
fluenced male family members’ thinking about the
appropriateness of men caring for family members.
The researcher reported that acculturation had
changed men’s view about providing care from the
more traditional belief that the hands-on caring for
the children, elderly, and sick belonged to women,
to the more contemporary belief in cooperation
and participation in direct caregiving by Muslim
men (Wehbeh-Alamah, in press). Currently,
Wehbeh-Alamah is conducting an ethnonursing
study of the culture care of Syrian American
Muslims living in a Midwestern U.S. city. In addi-
tion to discovering the culture care meanings, be-
liefs, and practices of this group, she will compare
this study with her previous studies to arrive at uni-
versal and diverse care findings among Muslim im-
migrants from diverse cultures living in the United
States.
CULTURE CARE OF ELDERLY
ANGLO AND AFRICAN AMERICANS
In the mid 1990s, the theory of culture care was
used to guide a study of the culture care of Anglo
and African American elders in a long-term care in-
stitution (McFarland, 1997). This study revealed
care implications for nurses who practice in retire-
ment homes, nursing homes, apartments for the
aged, and other long-term care settings. Many resi-
dents from both cultural groups participated in the
care of their fellow residents. Residents assisted
other residents to the dining room, checked on oth-
ers who did not appear for meals in the dining
room (care as surveillance of others), and assisted
in ambulation of those who were not able to walk
independently. This focus on other careversus only
self carewas a form of culturally congruent care
that residents desired in order to maintain healthy
and beneficial lifeways in an institutional setting.
Culture care preservation was practiced by nursing
staff as these generic care practices were integrated
into professional nursing care.
Within the retirement home, both Anglo and
African American residents desired spiritual or re-
ligious care and had some diverse aspects of such
care rooted in their respective cultures. The find-
ings of both universality and diversity within the
pattern of religious or spiritual care supported
Leininger’s theory, which states that “culture care
concepts, meanings, expressions, patterns,
processes, and structural forms of care are different
(diversity) and similar (toward universality) among
all cultures of the world” (Leininger, 1991a, p. 45).
African American residents received care from
church friends who ran errands, did banking and
laundry, paid bills, visited, and brought commun-
ion to them. Anglo American residents received a
more formal type of care from their churches, such
as a minister coming to the retirement home to
do a worship service or a church choir traveling
to the retirement home to entertain the residents.
The nurses at the retirement home practiced
culture care preservation by maintaining the in-
volvement of churches in the daily lives of both cul-
tural groups to help residents face living in a
retirement home with increasing disabilities related
to aging and handicaps, and even dealing with the
prospect of death. With an increase in the numbers
of elderly from both the Anglo and African
American cultural groups being admitted to long-
term care institutions, the knowledge of culture
specific care for both Anglo and African American
elders is important for nurses who practice in these
settings.
The generic care pattern of families helping
their elderly relatives enhanced the health and life-
ways of both Anglo and African American elders
in the retirement home setting. Anglo American330 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration