professional care. The goal is to provide
culturally congruent nursing care using the
three modes of nursing actions and decisions
that is meaningful, safe, and beneficial to
people of similar and diverse cultures world-
wide (Leininger, 1991a, 1995). The clinical
use of the three major care modes (culture
care preservation or maintenance; culture
care accommodation or negotiation; and cul-
ture care repatterning or restructuring) by
nurses to guide nursing judgments, decisions,
and actions is essential in order to provide
culturally congruent care that is beneficial,
satisfying, and meaningful to the people
nurses serve. The studies of the four cultures
just reviewed (Lebanese Muslim, Anglo
American, African American, and German
Americans) substantiate that the three modes
are care centered and are based on the use of
generic care (emic) knowledge along with
professional care (etic) knowledge obtained
from research using the culture care theory
along with the ethnonursing method. This
chapter has reviewed only a small selection of
the culture care findings from ethnonursing
research studies conducted over the past four
decades. There is a wealth of additional find-
ings of interest to practicing nurses who care
for clients of all ages from diverse and similar
cultural groups in many different institu-
tional and community contexts around the
world. More in-depth culture care findings
along with the use of the three modes can be
found in the Journal of Transcultural Nursing
(1989 to 2004) and in the numerous books
and articles by Dr. Madeleine Leininger.
Nurses in clinical practice are advised to con-
sult a list of research studies and doctoral dis-
sertations conceptualized within the culture
care theory for additional detailed nursing
implications for clients from diverse cultures
(Leininger & McFarland, 2002, in press).
The Theory of Culture Care Diversity and
Universality is one of the most comprehen-
sive yet practical theories to advance trans-
cultural and general nursing knowledge with
concomitant ways for practicing nurses to es-
tablish or improve care to people. Nursing
students and practicing nurses have re-
mained the strongest advocates of the culturecare theory (Leininger, 2002). The theory fo-
cuses on a long-neglected area in nursing
practice—culture care—that is most relevant
to our multicultural world.
The Theory of Culture Care Diversity and
Universality is depicted in the sunrise enabler
as a rising sun. This visual metaphor is par-
ticularly apt as the future of the culture care
theory shines brightly indeed, because it is
holistic, comprehensive, and fits discovering
care related to diverse and similar cultures,
contexts, and ages of people in familiar and
naturalistic ways. The theory is useful to
nurses and to nursing and to professionals in
other disciplines such as physical, occupa-
tional, and speech therapy, medicine, social
work, and pharmacy. Health-care practition-
ers in other disciplines are beginning to use
this theory because they also need to become
knowledgeable about and sensitive and re-
sponsible to people of diverse cultures who
need care (Leininger, 2002).References
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