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and general informants (McFarland, 1997). The in-
formants told the researcher about themselves and
the cultural care within the environmental context
of a retirement home. Key informants were care-
fully and purposefully selected, often by the people
themselves (e.g., elderly residents suggested other
residents for the researcher to observe, interview,
and study about care, health, and well-being).
These informants were most knowledgeable about
the domain of inquiry and could give details to the
nurse researcher. General informants usually are
not as fully knowledgeable about the domain of in-
quiry as are key informants. They have general
ideas about the domain, however, and can offer
data from their emic and etic views. For instance,
general informants can reflect on how similar
and/or different their ideas are from those of the
key informants when asked by the researcher.


Enablers


In order to discover the peoples’ or insiders’ (in-
formants’) emic views of care, Leininger (1991b)
developed several enablers to tease out data bearing
on cultural care related to specific domains of
study. As the word denotes, enablers help tease
out ideas from informants in meaningful and nat-
ural ways. Leininger (2002) specifically makes the
point that enablers are different from tools, scales,
or measurement instruments used in quantita-
tive studies, which tend to cut off natural flow
of informant ideas. Some of the enablers that
serve as important guides to obtain data naturalis-
tically and holistically are: Leininger’s observation
participation reflection enabler (Table 20–1); the
stranger to trusted friend enabler (Table 20–2);
Leininger’s acculturation enabler (Leininger,
1991b); and specific enablers developed by the re-
searcher to tap into ideas of informants related to


the specific domain of inquiry (Table 20–3). The
sunrise enabler (see Part 1 of this chapter by Dr.
Leininger, as well as the discussion under the three
care modes later in this part of the chapter) assists
and guides the researcher to tease out culture care
and health data within each dimension of the en-
abler to discover holistic and yet specific cultural
findings (Leininger, 2002).
The observation participation reflection enabler
guides the nurse researcher to be an active observer
and listener before being a participant in any re-
search context. Researchers have found it most
helpful to observe informants and their environ-
mental contexts before and after the researcher be-
comes an active participant. This is quite different
from the traditional participant observation
method used in anthropology, because the process is
reversed(Leininger, 1997).
The stranger to trusted friend enabler is ex-
tremely helpful when a researcher enters and re-
mains in a strange and unfamiliar environment.
The researcher moves from being a stranger to
being a trusted friend and can eventually obtain
accurate, honest, credible, and in-depth data from
informants. Being a trusted friend leads to inform-
ants sharing their cultural secrets and their insights
and experiences. For instance, the author used the
stranger friend enabler to assess her relationship
with elderly residents and the staff in a study of cul-
ture care in a retirement home. She used this en-
abler to enter the informant’s world and get close to
the people who were being studied (McFarland,
1997). Initially the researcher worked with a staff
nurse while observing and interviewing the in-
formants for the first few weeks she was at the in-
stitution. The staff nurse was friendly and acted as
a guide but also watched the researcher and
planned her day in a general way. The researcher

CHAPTER 20 Application of Leininger’s Theory of Culture Care Diversity and Universality 323

Source:Leininger, M. (1997). Overview and reflection of the Theory of Culture Care and the Ethnonursing Research Method.
Journal of Transcultural Nursing, 8(2), 32–51.
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