Leininger’s Theory of Nursing, Research Paper Example

Abstract

In a constantly changing world, the social relationships have the tendency of becoming more diverse. In the context of behaviors, norms, values and belifes, more attention is required by the nursing professional with regards to cultural antecedence. The nursing theory that was selected is derived from the transaction and engagement in the grand and middle aged nursing theories. The theory that was proposed by Dr. Madeline Leininger will be explored. Leininger’s cultural care is based on the transaction and engagement grand and middle aged nursing theories. The perspectives of Clarke et al. (2009), Leininger (1981), Leininger (1988), Leininger & McFarland (2006), Morris (2005) and Rosenbaum (1990) were accessed in the formulation of the concept paper.

Introduction

The continuous internal and exterrnal stumili cause the development of behaviors, norms , beliefs and values within the patient and the nurisng staff members which are culturally directed.   The stimuli which is derived from internal and external sources have the tendency of formulating a mark on the cognitive functions of each individuals and group. These impressions are formed with regards to the artistic expressions, cultural  perspectives and religious observances. The outcome of the changes which take place within the cognitive domains of the patient and the members of the nursing staff are perceived as culture. The cultural perspective influences the individual’s behavior, perceptions and responses. In the conetext of the nursing profession, the cultural antecedences have an influence on the perceptions of health and illness.   These perspectives have an influence on the quality of health care and the patient outcomes. The aim of the concept paper is to review the requisiste of clinicians with regards to acquiring increased sensitivity to the cultural distinctions and to attain a higher level of comprehensions with regards to transcultural concepts which have been proposed (Leininger, 1981; Leininger, 1988; Leininger & McFarland, 2006).

The members of nursing staff in the majority of health care facilties originate from different parts of the country and the world.   Considering the distinct cultural perspectives that the members of the nursing staff possess and encounter in the patients on a daily basis , Dr. Madeline Leininger was chosen with regards to the nursing theory. The recommendation of Dr. Madeline Leininger causes many nursing professional to consider the theory of cultural care that she developed. The transcultural nursing perspective addresses the perceptions of the clinicians and the cultural view of the patients. The nurses can obseve the manner by which Leininger cultural care can be effectively applied. The outcomes are perceived in the responses and the health outcomes of the patients. The pursuit of additional knowledge with regards to the application of Leininger’s cultural care in the specialization will cause the enhancement of each nursing professional’s ability in the health care setting (Leininger, 1981; Leininger, 1988; Leininger & McFarland, 2006).

The concept of transcultural care can be applied not only to the nursing profession, it can also be apoplied to the clinicians. This is attributed to the multicuiltural perspective of the patients who are in the care of the nursing staff. The concept of transcultural health care can be applied to the nurses in the professional setting and the educational environment. In consideration of this concept, it is the goal of the concept paper to facilitate greater understanding of the Leininger cultural care model. The nursing profession has the quality of transcending all cultures while providing care to members of all ethnic backgrounds (Clarke et al., 2009; Rosenbaum, 1990).

Specifics and Definition of Transcultural Care

Dr. Leininger proposed that perceptions of health and illness are formed by a variety of factors which include coping abilities and individuals’ perception of culture. Furthermore, the social level of the client is an imporant consideration in transcultural health care model. Leininger recommended that the cultural competence level is an imporatnat element in the nursing profession. The cultural and religious knowledged are essential components in the health care delivery process. Dr. Leininger emphasized that the value of cultural influence is important in all domains of life. The value of cultural influence delineates illness, health and the quest that patients experience in order to become free from illness of discomfort (Clarke et al., 2009; Rosenbaum, 1990).

There are cultural health concepts which are held by patients which have the outcome of many of the clients refusing to seek conventional health care intervention. The clinicians have the requisiste of flexibility with regards to the planning of the services programs and policies that are designed to fulfill the health care needs of culturally diverse patient populations. The majority of the cases of sickness have a variety of causalaties and may have the requisite  of distinct approaches with regards to diagnosis, intevention and cure. In accordance with the theory proposed by Dr. Leininger, the application of alternate or traditional models of delivering health care are extremly diverse and have the potential of conflicting with the western paradigms of health care delivery.   This is the reason why being cognizant with regards to the distinct cultural perspectives provide guidance for the clinician into behaving in manners which are acceptable for those individuals who pertain to a specific group. This is attributed to the premise that culture starts and is produced in the social structure by means of interpersonal interactions. The successful intercultural communication must be achieved between the clinician and the patient in order to provide health care to a patient who originate from a different ethnic or cultural background (Clarke et al., 2009; Rosenbaum, 1990).

The transcultural nursing approach  addresses and respects the cultural dynamics which effect the relationship between the nurse and the client. As a result of this particular quality of nursing, a theory was required in order to review and detail the results of this category of nursing care. Leininger conceived the theory of transcultural care as an outcome of experince and creativity. The theory of transcultural care has the goal of providing universality and diversity with respect to the delivery of culturally congruent holistic health care. There are some academics who may position the Leininger transcultural health care model in the middle range category of nursing. Leininger asserts that the transcultural nursing theory  does not pertain to the classification of grand nursing theories due to the attribute of the theory to have the capacities of evaluating the complete patient scenario. The Leininger cultural care theory is an approach that is comprehenive and holistic in its perspective. This quality has  derived wider nursing practice implementations than would be traditionally anticipated with the approaches that are reductionist and middle range (Clarke et al., 2009; Rosenbaum, 1990).

The Leininger transcultural care theory provides applications which harmonize with the individual’s or group’s cultural perceptions, values and practices. Almost fifty years ago, Dr. Leininger initiated the use of the term culturally congruent care which is the fundamental objective of the transcultural nursing endeavor. It becomes possible to provide culturally competent care where the nursing professional and the client are able to plan a novel or distinct health care lifestyle in order to improve the well being of the patient. This modality has the requisite of the application of generic and professional knowledge and practices in order to adapt them to suit diverse concepts with regards to the nursing professional’s care activities and goals. The nursing professional’s skill and care experiential knowledge are frequently repatterned in order to achieve the best interests of the patients. Consequently, all of the care modalities have the requisite of the collaboration of the patient and the nursing professional in order to categorize, design, apply and assess each of the caring modalities for the culturally congruent delivery of professional nursing care. These modalities have the characteristics of motivating the nurses to plan occupational activities and decisions with the application of new knowledge that is founded upon cultural sensitivity to provide satisfying and meaningful holistic health care to individuals and groups (Clarke et al., 2009; Rosenbaum, 1990).

Ethnic  Antecedence

In the Leininger cultural care model , the ethnic antecendence of the patient is very significant with regards to the assessment of  adequate health care delivery. The ethnic antecedence infers to the previous life events and experiential knowledge of the individual or the group, which provide approximations to the lifestyles in the specific cultural context over brief or extended periods of time. An individual who may have had the antecedence of an African tribe probably does not place confidence in the conventional health care delivery system of the Western nations. The patient who has African cultural antecedence will  have the requisite of a nursing professional who is cautious and considerate  with regards to providing medical intervention  (Leininger, 1981; Leininger, 1988; Leininger & McFarland, 2006).

The transcultural nursing care theory proposed by Dr. Leininger emphasizes that the applications are not limited to the relationship between the nursing professional and the client.   The Leininger transcultural care theory can also be applied in the provision of quality nursing care to groups, families, communities and institutions. Dr. Leininger’s theory would be  particularly significant in situations where the nursing personnel may be serving in the Peace Corps or the United States Army. In these institutions, there  exist numerous cultural divisions. In addition, there may be some religious differences among individuals and groups. It would be beneficial for the effective delivery of high quality health care services if the nurse would have the capacity of being able to address the cultural distinctions accordingly (Clarke et al., 2009; Rosenbaum, 1990).

Leininger Cultural Care Case Study 1

Mrs.  E. is a thirty nine year old woman who is from the Oromo ethnicity in Ethiopia. She has been complaining of feeling lethargic and having hot flashes along with cardiac palpitations. The physical review demonstrates that Mrs. E. has a pallid appearance and has no taste buds which can be perceived. Furthermore, Mrs. E.’s cultural perspectives on health care and economic status must be determined by the clinician. Mrs. E. is receiving public assistance for the care of her children. Mrs. E. has an educational level that has enabled her to continue her studies toward a high school equivalency certificate in the U.S. (Morris, 2005).

As a result of the application of the Sunrise model of Leininger’s cultural care, the clinician understands that she must negotiate with Mrs. E. on an intervention program for her anemia. In order to avoid the processes of a rectal and pelvic examination which are forbidden under Islamic law, Mrs. E. agrees to take the vitamin supplements and to review her menstrual and stool processes over the next several weeks. The clinicians have been trained in the Oromo cultural perspective and respect Mrs. E.’s wishes with regards to the intervention. Mrs. E. is recommended to a nutritionist who suggests an increase in the food stamp subsidies provided to Mrs. E and her family. Two weeks later, Mrs. E. returns to the clinic and demonstrates a marked improvement in her physiological condition (Morris, 2005, p. 101).

Leininger Cultural Care Case Study 2             

A mother has just had a baby in a health care facility. She is 24 hours post-partum. The nurse enters the room to provide her morning evaluation on the condition of the baby. The mother is of Albanian heritage. Many Albanians perceive that the newborn babies should be kept covered with various layers of material. Shelly the nursing professional, details that she is aware of the Albanian custom of swaddling babies with various layers and does not criticize the mother’s actions. The mother is facilitated to have a relaxed perception of the nurses’ treatment of her baby as a consequence of Shelley’s positive affect and cultural empathy. This is an example of the cultural sensitivity required in the Leininger  care model (Clarke et al., 2009; Rosenbaum, 1990).

Leininger Cultural Care Invention 1

A mother who is unable to speak enters into the health care facility.   She is making hand motions which the physicians do not understand. The hand motions are American Sign Language. A nurse who has been trained in the interpretation of ASL reassures the mother that her child can be effectively treated in the health care facility. The mother is placed at ease and enables the physicians to treat her child. After the treatment, the mother who is unable to speak smiles at the nurse and utters the words “Thank you”. This is an example of the effective quality of the Leininger cultural care theory (Clarke et al., 2009; Rosenbaum, 1990).

Leininger Cultural Care Invention 2

A Jewish man is admitted to the hospital facility. He will be in the hospital for several days has he has recently experienced an epileptic seizure.  The man is a devout Jewish person who has a long beard and side locks. The nurse is sensitive and does not bring meat products to the room. The consumption of meat products and gluten which are not sanctioned by his religious representative is forbidden for the devout Jewish man. The nurses’ avoiding the delivery of meat based hospital meals to the patients room is an example of the sensitivity applied in the Leininger cultural care model (Clarke et al., 2009; Rosenbaum, 1990).         

Meta Model in the Nursing Profession

Dr. Leininger directed attention toward care as an essential component of nursing. Dr. Leininger’s theories are distinct from other nursing theorists. In the Leininger cultural care theory, the descriptions of the components are the following:

1. The person is referenced as an individual cultural and caring being. In addition, the family, group and culture are perceived from this perspective. Leininger perceived that human care was collective in its scope (Leininger, 1981; Leininger, 1988; Leininger & McFarland, 2006).
2. In addition, Dr. Leininger directed attention toward the environment. The environment is the ecological or physical surrounding in which the individual and the groups inhabit.   The environmental context that is applied by Dr. Leininger incorporates the interpretations and meanings which are delegated to the components of the environment in their cultural, socio- political, physical and ecological settings (Leininger, 1981; Leininger, 1988; Leininger & McFarland, 2006).
3. The definition of health proposed by Dr. Leininger includes a wide spectrum of circumstances. These circumstances include handicaps, health disability and illness. Leininger detailed the elements of health. The particular elements that were detailed were the health matrices, the health care delivery practices, the modifying patterns of health, the health care delivery promotions and the health maintenance of the individuals and the groups. Health is an important concept in the nursing profession with regards to transcultural nursing. The nursing profession is a discipline which incorporates transcultural care.   Dr. Leininger placed great significance on care. Care is perceived as a perception of concern, interest and compassion.   Leininger’s definition of care is more ample than other nursing theorists (Leininger, 1981; Leininger, 1988; Leininger & McFarland, 2006).

Concluding Statements

The perspectyive and nursing theory introduced by Dr. Leininger have caused  review with regards to the effective delivery of health care services by clinicians.  Dr. Leininger proposed that the patient be perceived as a cultural and sentient entity.  Dr. Leininger also considered the modalities of environment and the peripheral implications of elements that are found in the environment. These elements include the cultural, physiological, ecological and socio- political quality of the surroundings. The review of the theories of Dr. Leininger have differed from many of the other nursing theorists in her perspective of the patient as a cultural and caring system. The Leininger cultural care method has contributed to ther body of knowledge with regards to the adaptation of the nursing professional to the cultural perspective of the patient. The contribution has been with regards to the respect of the patient as a cultural entity, the negotiation with the patient with regards to the cultural perception of medical interventions and the adaptation of the medical intervention to the patient’s cultural perspective.

References

Clarke, P. N., McFarland, M. R., Andrews, M. M., & Leininger, M. (2009). Caring: Some reflections on the impact of the culture care theory by McFarland & Andrews and a conversation with Leininger. Nursing science quarterly, 22(3), 233-239.

Leininger, M. M. (1981). Caring, an essential human need: Proceedings of the three National Caring Conferences. Wayne State University Press.

Leininger, M. M. (1988). Leininger’s theory of nursing: Cultural care diversity and universality. Nursing Science Quarterly, 1(4), 152-160.

Leininger, M. M., & McFarland, M. R. (Eds.). (2006). Culture care diversity and universality: A worldwide nursing theory. Sudbury, MA:  Jones & Bartlett Learning.

Morris, K. (2005). Chapter 10 Applying Leninger’s cultural care theory. In M. de Chesnay (Ed.), Caring for the Vulnerable: Perspedctives in nurswing theory, practice and research (95- 102). Sudbury, MA: Jones & Bartlett Publishers.

Rosenbaum, J. N. (1990). Cultural care of older Greek Canadian widows within Leininger’s theory of culture care. Journal of Transcultural Nursing, 2(1), 37-47.