The care values and beliefs are usually lodged into
environment, religion, kinship, and daily life
patterns.
The nurse can begin the discovery at any place in
the enabler and follow the informants’ ideas and
experiences about care. If one starts in the upper
part of the enabler, one needs to reflect on all as-
pects depicted in order to obtain holistic or total
care data. Some nurses like to start with generic and
professional care, and then look at how religion,
economics, and other factors influence these care
modes. One always moves with the informants’ in-
terest and story rather than the researcher’s interest.
Flexibility in using the enabler will lead to a total or
holistic view of care.
The three modes of action and decision (in
the lower part) are very important to keep in mind.
The nursing actions or decisions are studied until
one realizes the care needed. The nurse discov-
ers with the informant the appropriate actions,
decisions, or plans for care. Throughout this dis-
covery process, the nurse holds his or her own etic
views, presuppositions, and biases in abeyance, so
that the informants’ ideas will come forth, rather
than the researcher’s views. Transcultural nurses are
taught, guided, and mentored in ways to withhold
their biases or wishes and to enter the client’s
worldview.
The nurse begins the study by stating a specific
and explicit domain of inquiry. For example, the re-
searcher may focus on a domain of inquiry(DOI)
such as “culture care of Mexican American mothers
caring for their children in their home.” Every word
in the domain statement is important and is stud-
ied with the sunrise enabler and the theory tenets.
The nurse may have hunches about the domain
and care, but until all data have been studied
with the theory tenets, she cannot prove them.
Full documentation of the informants’ viewpoints,
experiences, and actions is pursued. Generally, in-
formants select what they like to talk about first,
and the nurse accommodates their interest or
stories about care. During the in-depth study of
the domain of inquiry, all areas of the sunrise
enabler are identified and confirmed with the in-
formants. The informants become active partici-
pants throughout the discovery process and in a
manner in which they feel comfortable and willing
to share their ideas.
The real challenge is to focus care meanings, be-
liefs, values, and practices related to informants’
culture, subtle and obvious, so differences and sim-
ilarities about care are identified among key and
general informants. The differences and similarities
are important to document with the theory. Such
differences may be with the historical, environmen-
tal, and social structure factors (differences about
care with religion, family, and economic, political,
legal, or other factors). If informants ask about the
researcher’s views, they must be carefully and
sparsely shared. The researcher keeps in mind the
fact that some informants may want to please the
researcher by talking about their professional med-
icines and treatments in order to satisfy the re-
searcher. Professional ideas, however, often cloud or
mask the client’s real interests and views. If this oc-
curs, the researcher must be alert to such tendencies
and keep the focus on the informants’ ideas and on
the domain of inquiry studied. The informants’
knowledge is always kept central to the discovery
process about culture care, health, and well-being.
If factors are unfamiliar to the researcher, such as
kinship, economics, and political and other consid-
erations depicted in the model, the researcher
should listen attentively to the informant’s ideas.
Getting the informant’s emic (insider’s) views, be-
liefs, and practices is central to studying the theory
(Leininger, 1985, 1991, 1995, 1997a; Leininger &
McFarland, 2002).
Throughout the study and use of the theory, the
meanings, expressions, and patterns of culturally
based care are important ideas to keep in mind. The
nurse listens attentively to informants’ accounts
about care and then documents the ideas. What in-
formants know and practice about care or caring in
their culture is important. Documenting ideas
from the informant’s emic viewpoint is essential to
arrive at accurate culturally based care. Unknown
care meanings, such as the concepts of protection,
respect, love, and many other care concepts, need to
be teased out and explored in depth as they are the
key words and ideas in understanding care. Such
care meanings and expressions are not always read-
ily known; informants ponder about care meanings
and are often surprised that nurses are focused on
care instead of medical symptoms. Sometimes in-
formants may be reluctant to share social structure
and factors such as religion and economical or po-
litical ideas as they fear they may not be accepted or
understood by health personnel. Generic (folk318 SECTION III Nursing Theory in Nursing Practice, Education, Research, and Administration