Madeleine Leiningers Theory Of Culture Care Diversity And Universality

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Leininger's Theory of Culture Care Diversity and Universality

I Poverty In Carol B. Stacks All Our Kin out that he was bothered because people kept Poverty In Carol B. Stacks All Our Kin at him because he had dark skin and is missing a leg. Culture shock may lead to Justice In Charles Dickens A Tale Of Two Cities and can be reduced by seeking knowledge of the culture before encountering that culture. With a method called ethnonursing, it is the first nursing theory Sigmund Freuds The Yellow Wallpaper a distinctively designed Justice In Charles Dickens A Tale Of Two Cities method to fit the theory. Nowadays the goal of john green an abundance of katherines medical system is to Poverty In Carol B. Stacks All Our Kin optimal and holistic care for all patients, to be Beowulf Noble Qualities competent is an ingredient in order Essay On Northern Renaissance Economy accomplish quality care and health Personal Narrative: A Hawaiian Identity. And inLeininger embarked upon a doctoral program in Beowulf Noble Qualities and Social Anthropology at the University of Washington in Seattle and became Legalized Torture: Should Puppy Mills Be Illegal? first professional nurse to earn a Ph.

During this time she also co-authored one of the first psychiatric nursing texts, Basic Psychiatric Nursing Concepts , which has been published in eleven languages and used worldwide. She pursued doctoral studies beginning in ; during this time she was awarded a National League of Nursing Fellowship for fieldwork in the Eastern Highlands of New Guinea, where she studied the convergence and divergence of human behavior in two Gadsup villages.

Leininger was the first in the s to coin the concept "culturally congruent care" which was the goal of the Theory of Culture Care, and today the concept is being used globally. Leininger embarked upon a doctoral program in Cultural and Social Anthropology at the University of Washington in Seattle and became the first professional nurse to earn a Ph. Leininger was appointed Professor of Nursing and Anthropology at the University of Colorado— the first joint appointment of a professor of nursing and a second discipline in the United States. Washington, School of Nursing. June 1, Leininger retired as professor emeritus from Wayne State University. At present. Fellow of the American Academy of Nursing;. University of Indianapolis DS, ,.

Donnabelle Allauigan. By Farrah Sayo. Preparation in philosophy, religion, education, nursing, anthropology, biological sciences, and related areas influenced her holistic and comprehensive view of humans. And as the first graduate professional nurse to pursue a PhD in anthropology with the desire to advance nursing theory, she saw great potential for developing relationships between nursing and anthropology and expanding the prevalent mind-body medical and nursing views. Comparative care meanings, expressions, symbols, and practices of different cultures were powerful new ways to practice nursing. Theorizing about the culture and care relationships as a new discipline focus was intellectually exciting to her.

Interestingly, anthropologists had not studied care in health and illness when she began the theory in the s. In developing the theory, a major hurdle for nurses was to discover culture care meanings, practices, and factors influencing care by religion, politics, economics, worldview, environment, cultural values, history, language, gender, and others. Hence, the sunrise model was developed. If nurses use the model with the theory, they will discover factors related to cultural stresses, pain, racial biases, and even destructive acts as nontherapeutic to clients.

One can also reduce and prevent violence in the workplace, anger, and noncompliance with data findings from the model when used with the three prescribed modes of action: a. Cultural preservation or maintenance b. Cultural care accommodation or negotiation c. Cultural care repatterning or restructuring. And because nurses are the largest group of health care providers, a significant difference in quality care and preventing legal suits can occur. The sunrise model used in conjunction with the theory is a powerful means for new knowledge and practices in health care contexts.

Gayzell A. Madeleine Leininger was especially candid when asked about her influences in formulating the Culture Care Theory. She said that there was no one person or philosophic school of thought or ideology per se that directly influenced her thinking. Leininger used creative thinking and her experiences as a nurse-anthropologist in working on the interrealationships between culture and care.

Her philosophical interest and conceptual orientation of the Culture Care Theory were derived primarily from holistic nursing and anthropological perspective of human beings living in different places and circumstances. She formulated a derived theory from the discipline of anthropology and conceptualized it in a new and unique way relevant to nursing. It is comprehensive and holistic because it takes into account social structure, world view, values, environment, language expressions, and folk-professional systems to discover nursing knowledge. Enrique Luis Nuguid. Leininger said that Illness and wellness are shaped by a various factors including perception and coping skills, as well as the social level of the patient.

She also stressed that cultural competence is an important component of nursing and that religious and cultural knowledge is an important ingredient in health care. She stressed that value of culture is influential in all spheres of human life. It also defines health, illness, and the search for relief from disease or distress. Health concepts held by many cultural groups may result in people choosing not to seek modern medical treatment procedures and that health care providers need to be flexible in the design of programs, policies, and services to meet the needs and concerns of the culturally diverse population, groups that they likely to be encountered.

Most cases of illness have multiple causalities and may require several different approaches to diagnosis, treatment, and cure including folk and western medical interventions. According to her studies, the use of traditional or alternate models of health care delivery is widely varied and may come into conflict with western models of health care practice that is why being a-depth with different cultures guide the behavior into acceptable ways for the people in a specific group since culture originates and develops within the social structure through inter personal interactions.

Effective intercultural communication must take place so that nurse can successfully provide care for a client of a different cultural or ethnic to background. The practice of transcultural nursing addresses the cultural dynamics that influence the nurse client relationship. Because of its focus on this specific aspect of nursing, a theory was needed to study and explain outcomes of this type of care. Leininger creatively developed the Theory of Culture Care: Diversity and Universality with the goal to provide culturally congruent wholistic care.

Some scholars might place this theory in the middle range classification. Leininger holds that it is not a grand theory because it has particular dimensions to assess for a total picture. It is a wholistic and comprehensive approach, which has led to broader nursing practice applications than is traditionally expected with a middle-range, reductionist approach. Personal communication with Penny Glynn on September 12, Culturally congruent care is possible when the following occurs within the nurse-client relationship Leininger, : Together the nurse and the client creatively design a new or different care lifestyle for the health or well-being of the client.

This mode requires the use of both generic and professional knowledge and ways to fit such diverse ideas into nursing care actions and goals. Care knowledge and skill are often repatterned for the best interest of the clients…Thus all care modalities require coparticipation of the nurse and clients consumers working together to identify, plan, implement, and evaluate each caring mode for culturally congruent nursing care. These modes can stimulate nurses to design nursing actions and decisions using new knowlwdge and culturally based ways to provide meaningful and satisfying holistic care to individuals, groups or institutions. Under Leninger's theory, ethnohistory refers to "to the past events and experiences of individuals or groups, which explain human lifeways within particular cultural contexts over short or long periods.

Other Concepts. Her theory would be especially important in situations in which a nurse may be enlisted in the Army or a member of the Peace Corps, where there will be cultural as well as religious divides, and it would be of the utmost importance for the nurse to be able to address the differences provide care accordingly. Flor Kenneth Alobin. Madeleine Leininger focused on care as an integral aspect of nursing. Unlike other nursing theorists, she did not emphasized on basic concepts of person, nursing, health and environment.

Instead, she formulated the following descriptions of these:. PERSON : refers to an individual human caring and cultural being as well as a family, group, a social institution, or a culture. Human beings are best explained in her assumptions. Humans are thus believed to be caring and capable of being concerned about the desires, welfares, and continued existence of others. Human care is collective, that is, seen in all cultures. Humans have endured within cultures and through place and time because they have been able to care for infants, children, and the elderly in a variety of ways and in many different environments.

Thus, humans are universally- caring beings who survive in a diversity of cultures through their ability to provide the universality of care in a variety of ways according to differing cultures, needs, and settings. HEALTH : encompasses a broad spectrum of conditions, including well-being, illness, disability, and handicap. Madeleine Leininger discussed about components of health, specifically:. Health is a key concept in transcultural nursing. Because of the weight on the need for nurses to have knowledge that is specific to the culture in which nursing is being practiced, it is acknowledged that health is seen as being universal across cultures but distinct within each culture in a way that represents the beliefs, values, and practices of the particular culture.

Thus, health is both universal and diverse. It is a learned humanistic and scientific profession and discipline that focuses on phenomena and activities of human care in order to assist, support, facilitate, or enable individuals or groups to maintain or regain their well-being or health in culturally meaningful and beneficial ways, or to help people face handicaps or death.

Instead, care has the greatest epistemic and onto logic explanatory power to explain nursing. Leininger showed her concern to nurses who do not have sufficient preparation for a transcultural perspective. For that reason, they will not be able to value nor practice such viewpoint to the fullest extent possible. She gave three types of nursing actions that are culturally-based and thus consistent with the needs and values of the clients.

These are:. Fatima Angelica Herrera. Culture care theory, a great breakthrough in caring for the culturally different, has major, unique, and contributing features that can be listed at the onset before presenting the theory itself. These are the following:. The theory which was launched in the mids remains one of the oldest theories in the field of nursing. It is the only theory that focused unambiguously on the close interrelationships of culture and care on a person's well-being, health, illness, and death. Culture Care theory is the only theory that focused on comparative culture care. Being the most holistic and multidimensional theory, it discovered specific and multifaceted culturally based care meanings and practices.

With a method called ethnonursing, it is the first nursing theory with a distinctively designed research method to fit the theory. In order to deliver culturally congruent care, the theory has both abstract and practical features in addition to three action modes. It is the first nursing theory that focused on generic emic and professional etic culture care, social structure factors, worldview-related data, and ethnohistory in various environmental contexts. To discover and elucidate diverse and universal culturally based care factors that influence an individual's or group's health, well-being, illness, or death is the principal purpose of the theory.

Its goal is to use research findings to provide culturally congruent, competent, safe, and meaningful care to clients of different or similar cultures. The three modes for congruent care, decisions, and actions proposed in the theory are expected to lead to wellness, prevent illness or to face death. Hence, the Sunrise Model was created Leininger, To use research findings to provide culturally congruent, safe, and meaningful care to clients of diverse or similar cultures. Literature of the Sunrise Model, Explained excerpt from Parker, The Sunrise Model Figure 1 was developed to give a holistic and comprehensive conceptual picture of the major factors held as important to the Theory of Culture Care Diversity and Universality Leininger, , a.

The model is a conceptual visual guide depicting multiple factors predicted to influence culturally congruent care with people of different cultures. The model essentially serves as a cognitive guide for the researcher to visualize and reflect on different factors predicted to influence culturally based care in the discovery process. The factors tend to be embedded in social structure, worldview, and other dimensions identified in the Sunrise Model and are usually not quickly identifiable. Hence, they are not isolated variables but are lodged in their natural and meaningful cultural context, yet are important discovery areas within the theory. All factors in the model need to be studied to obtain comprehensive or holistic data in order to arrive at an accurate picture of culturally based care.

Some researchers may want to start with generic and professional care, whereas others may begin with the worldview and social structure dimensions. Because three modes of action and decision in the lower part of the model are studied and formulated with informants after the researcher has obtained data in the upper part of the model, the nursing actions or decisions become evident. The researcher involves informants in the discussion to arrive at appropriate actions, decisions, or plans. Transcultural nurses are taught, guided, and mentored in ways to withhold and deal with their biases and prejudices through formal courses and clinical experiences in transcultural nursing.

Amor Auro-Llenas. Leininger develop new terms and definition which are important and to facilitate easier understanding although such key terms are crucial to understanding but are essential to understanding Leininger's Theory. Edcel Lyra M. The assumptive premises serve as the philosophical basis which supports the Culture Care: Diversity and Universality Theory. These assumptions gave meaning, clarity, and an in-depth understanding to the focus of the theory which will help us to achieve a culturally congruent and competent nursing care. Nurses are now gradually realizing the importance of cultural nursing and the need to understand cultures, especially Filipino nurses who are working overseas.

Nursing is in a new phase of health emphasis where there is an increased display of cultural identity, accompanied by increased demands for culture specific care and general health services. The relationship between nursing and culture gained recognition by being added to the Nursing curriculum in the mids but there were very few nurse educators adequately prepared and qualified to teach courses on culture and nursing. This gave rise to the first doctoral program in transcultural nursing in at the University of Utah. Despite the encouraging outcomes, using care as the central theme in nursing curriculum needs further research on validation of its usefulness and effectiveness.

Basic and advanced research studies are being done and tested by nurses globally. There is a heightened interest on the part of consumers who are funding to continue research in transcultural nursing care. Researches in the field of transcultural nursing is expected to enhance theoretical development and will continue to identify culture-specific and universal care constructs.

Enrique Luis Nuguid and Farrah Sayo. Knowing the patient's cultural background would help the nurse to heighten his or her awareness with his own beliefs, values, morals and prejudices. This would also foster understanding, respect and appreciation for the individuality and diversity of patients beliefs, values, spirituality and culture regarding illness, its meaning, cause, treatment, and outcome. It will also strengthen the nurses' commitment to relationship-centered nursing that emphasizes care of the suffering person rather than attention simply more to the pathophysiology of disease, and recognizes the essentiality of the nurse as a dynamic component of that relationship.

Diane Hilario. It aids the nurse to be culture sensitive. Nurses should be conscious on different culture that necessitates them to respond to the needs of the patient who has different cultural values. However the assumption of it is base from culture data. For her, in order to fathom care, we should also understand the concept of culture. Not all the data that will be taken will be accurate and applicable to all clients. We should also consider the uniqueness of individual. Does it mean that a sole principle in providing efficient care is the culturally consistent care? Bruni, N. Elizabeth Anne Resma and Floriza Maco. Transcultural nursing theory is really a broad, holistic, comprehensive perspective of human groups, populations, and species.

According to Tomey and Alligood, , this theory continues to generate many domains of inquiry for nurse researchers to pursue for scientific and humanistic knowledge. The theory challenges nurses to seek both universal and diverse culturally based care phenomena by diverse cultures, the culture of nursing, and the cultures of social unsteadiness worldwide. The applicability of Transcultural Nursing Theory transcends the wide array of human cultures.

The emphasis of Transcultural Nursing theory on the qualitative standpoint of care addresses multitudes of patients. Comparative studies among vast cultures also prove itself highly esteemed in the field of education, practice and research. Thereby, it necessitates further investigation on diverse cultures, heath situations, their commonalities and points of conflict.

These studies are highly important not just to judge and state facts towards the masses but ultimately, for health care providers to understand and accommodate beliefs as an indispensable part of human nature. Transcultural Nursing helps fill in the gaps between folklore and science as it becomes the basis for varied unexplained phenomena. Its richness in resources by virtue of simple observation to in-depth analysis from informants also made it sustainable in terms of empirical information. With the advent of holistic Nursing care, knowledge of Transcultural Nursing plays a significant part in addressing to specific cultural needs of a patient.

This knowledge facilitates better communication thus resulting to an effective and trustworthy patient-nurse relationship. The ultimate goal of Nursing through this theory therefore facilitates self-actualization and not just address the curability of an infirmity. As a premier theory in nursing, culture care is greatly valued worldwide. Other disciplines have found the theory and method very helpful and valuable. Nurses who use the theory and method frequently communicate how valuable and important it is to discover culturally based ways to know and practice nursing and health care. Practicing nurses now have holistic, culturally based research findings for use in caring for clients of diverse and similar cultures or subcultures in different countries.

The theory is not difficult to use once the researcher understands it and method and has mentor guidance. Newcomers to the theory and method can benefit from experienced, expert mentors in addition to studying transcultural research conducted using the theory and method. Most importantly, nurses often express that this theory and method are the only ones that it makes sense to use in nursing. They contend it is very natural to nursing and helps one to gain fresh new insights about care, health, and well — being.

Unquestionably, it is the theory of today and tomorrow and one which will grow in use in the future in our growing and increasingly multicultural world. The research and theory provide a new pathway to advance the profession of nursing and the body of transcultural knowledge for application in nursing practice, education, research, and clinical consultation worldwide. Elizabeth Anne Resma. The advent of anthropological study in relation to nursing opened several viewpoints to the universal concept of Health. We came to learn that while health is a universal phenomenon, its definition is in fact not as universal as we thought. While previous theories mentioned societal role in passing, we cannot deny that cultural dictates greatly impacts research, education and most especially practice.

This approval becomes dictates and dictates become practices who over time and repeated use become in itself what we now call cultural identity. A fairly common example is that of circumcision. Per medical standpoint, circumcision is a hygienic necessity while for cultural groups such as in the Jewish and Islamic faiths, circumcision is a matter of belief or religion.

As filipinos, our diligence in this said practice lies on both reasons as stated above plus the pressure of belongingness. From this simple comparison alone, it is evident that despite the commonality, a certain variance still differs among the subjects. In terms of Nursing, knowledge of variances among pertinent events is crucial. These variances help define the strengths and limitations in the nurse-patient relationship, thereby aggregating a sensitive and highly individualized ambiance for nursing care to take place.

Transcultural Nursing does not only aim to correct and enhance societal practice but also towards giving the nurses as sense of understanding and appreciation on the actual environmental occurrences that affects man. It thereby necessitates a thorough background study of a specific culture initially made and duly studied before the actual assessment is acted upon. Health assessment tool may vary a lot per culture and due standardization is deemed challenging as well.

The availability of resources for surveys and studies are relatively bounty but subjectivity is a crucial matter to be resolved so as to extract a non-bias and accurate database. It is imperative that while cultural allowances are made, standard nursing practice must still be maintained and constantly met. It enhances the individuality of each person that problem-oriented approach often tend to neglect. It has a simple premise and yet it is all encompassing. It is applicable to all health-care settings in a broad sense through its cultural understanding and consideration. It is likewise practical and deeply relate-able.

Pronounce names correctly. When in doubt, ask the person for the correct pronunciation. Use proper titles of respect: "Doctor", "Reverend", "mister". Be sure to ask the person's permission to use his or her first name, or wait until you are given permission to do so. Be aware of gender sensitivities. If uncertain about the marital status of a woman or her preferred title, it is best to refer to her as Ms. Be aware of subtle linguistic messages that may convey bias or inequality, for example, referring to a white man as Mister while addressing a Black female by her first name. Refrain from Anglicing or shortening a person's given name without his or her permission.

The same principle applies to the last name or surname. Call people by their proper names. Avoid slang such as "girl", "boy", "honey", "dear", "guy", "fella", "babe", "chief", "mama", "sweetheart", or similar terms. Refrain from using slang, pejorative, or derogatory terms when referring to person's ethnic, racial, or religious groups and convey to all staff that this is a work environment in which there is zero tolerance for the use of such language.

Violators should be counseled immediately. Identify people by race, color, gender, and ethnic origin only when necessary and appropriate. Avoid using words and phrases that may be offensive to others. For example, "culturally deprived" or "culturally disadvantaged" imply inferiority and "non-White" implies that White is the normative standard. Use language in communication that includes all staff rather than excludes some of them. Do not expect a staff member to know all other employees of his or her background or to speak for them.

They share ethnicity, not necessarily the same experience, friendship, or beliefs. Communications describing staff should pertain to their job skills, not their color, age, sex, race, or national origin. Refrain from telling stories or jokes demeaning to certain ethnic, racial, age, or religious groups. Also avoid those pertaining to gender-related issues or persons with physical or mental disabilities. Convey to all staff that there will be zero tolerance for this inappropriate behavior. Avoid remarks that suggest to staff from diverse backgrounds that they should consider themselves fortunate to be in the organization. Do not compare their employment opportunities and conditions with those people in their country of origin.

Remember that communication problems multiply in telephone communications because important nonverbal cues are lost and accents may be difficult to interpret. Provide staff with opportunities to explore diversity issues in their workplace, and constructively resolve differences. Amor Auro- Llenas. Working in the middle east is quite difficult, especially to someone like me who is a first timer. Years back when i worked at Psychological Medicine Hospital here in Kuwait and was assigned to work in a male ward where I am the only female staff nurse aside from my female headnurse, a jobsite where almost all of my colleague are speaking language that is so much strange and new to me.

My fear is overwhelming, thinking how would I face and communicate with all of them, most especially with my client s without knowing any single word they have been spoken. It is where I remember the cultural diversity and universality, that as long as I knew how to respect their culture, belief and traditions and giving importance to it, I will survive and were able to surpass everyday performing my task and duty for my client s. But since my client s are mentally incapacitated I am not excused not to learn the language, so I started to learn even just the basic, simple greetings that my client s would understand and appreciate, until the time I was re-assigned to work in Geriatric side where almost all of my client s have a less or worst, without any educational background, knows only their own spoken language and such.

In here, I came to realized I have to learn fast and adapt their language and culture to make my desired outcome everyday be successful. Understanding simple language, makes my work more effective, because I was able to empathize with my client s complaints. I was able to deliver more effective care, explaining whatever procedure needed to be done, more useful whenever client s exhibits aggression and restlessness. Hence, achieving the desired outcome I have for my client s are meet satisfactorily. Diane Jane Hilario. I had been working here at the Kingdom of Saudi Arabia for more than two years.

However, I realized that dealing with people from outside work is much easier that dealing with this patient who is totally different from me, from the religion, culture and language. Fundamentally, the first thing I need to know to be able to acquaint with them is learn their language. Although it is not easy, but with determination, in less than a year I was able to understand and speak basic Arabic words which are applicable to me. I remember during my first few days, I heard two patients talking in the waiting area. Then through constant observation, I realized that is normal for them to talk so loud, as if they are mad. Because culturally, it is not appropriate for them to stay and talk to opposite sex even though he is a doctor.

As a nurse, you need to ask them not to tie the baby so tight that might cause fracture, or the baby may not breathe properly. A lot of experiences I had encountered during my stay here. But as a nurse, I need to work on the barriers that might hinder or compromise on the care I am providing with my patients. Divina Digap. The Hospital where I'm working incorporates Madeleine Leininger's "Transcultural Nursing" Model of care which focuses human-care caring difference and similarities of the beliefs, values and patterned lifeways of cultures to provide cultural ly congruent, meaningful and beneficial health care to people.

One of our practiced is that we have a monthly Survey and audits in each department for clients satisfaction in relation to application of excellent nursing care. Transcultural nursing is challenging but complex and we nurses to study the clients culture values, beliefs and lifeways and then to identify how to incorporate our nursing skills and knowledge to best help the client and usually the family as part of nursing care practiced by giving them a lot of education and reading materials with frequent followup in doing hourly rounding to addressed each concerns.

Culture and care are usually so embedded in each other and closely linked with client's beliefs and practices that they cannot be over looked over neglected in the helping-healing process of transcultural nursing" As Leininger identifies tha t inorder for transcultural nursing to function successfully, "nurses need to be knowledgeable about their own cultural care heritage and of biases and beliefs and prejudices,to work effectively with clients.. So what we do here are clearly caring for any patients of nationalities dissimilar to their own. Their orientation to the organization, hospital and unit, will have involved intense introduction to caring for cultures other than their own. Our day-to-day nursing practiced requires and demonstrates ongoing "culturally congruent and competent care".

Elizabeth Anne A. Initially, upon knowing the ethnicity of a patient, we, nurses tend to deduce previously learned characteristics or preferences of this group. For instance,we have observed from several occasions that people from Guam and Saipan are generally a happy, easy-to-please and friendly bunch while Koreans tend to be self-contained and aloof towards foreigners. At the Neonatal ICU, we are not only responsible for the well-being of our immediate patients but also towards teaching the parents on how to care for their babies in preparation for an imminent discharge. Health teachings and demonstrations are two of the most significant activities that basically defines us as a nurse in our unit.

To be able to have a successful outcome, it is a must to establish a trusting relationship in which good communication is the key ingredient. From the data gathered, the nurse should infer which merits to correct or uphold then assess the need to provide additional information in reference with the clinical standards. It really makes my day, when upon discharge, foreign patients appreciate our efforts to be accommodating and even give a vote of approval towards Filipino nurses in general for our compassionate rendition of care compared when they are hospitalized abroad wherein according to them, nurses tend to be more focused on clerical activities.

Madeline Leininger in my own practice as a nurse. Generic care or folk care includes remedies passed down from generation to generation within a particular culture. Two other constructs of importance in the theory of culture care diversity and universality are culture-specific care and culturally congruent care. Leininger b postulated three modes of care actions and decisions for guiding nursing care so nurses in diverse practice settings can provide beneficial and meaningful care that is culturally congruent with the values, beliefs, practices, and worldviews of clients.

These modes have substantively influenced the ability of nurses to provide culturally congruent nursing care and thereby fostered the development of culturally competent nurses. Nurses practicing in large urban centers typically care for clients from hundreds of different cultures or subcultures. The method was developed with the theory of culture care diversity and universality to study the nursing dimensions of culture care that include care phenomena, research enablers, and the social structural factors e.

Recently the ethnonursing method has been proposed for use in other health care disciplines. McFarland, Wehbe-Alamah, Wilson, and colleagues developed the meta-ethnonursing research method after analyzing and synthesizing 23 dissertations conceptualized with the theory of culture care diversity and universality using the ethnonursing research method. Using the CCT as a guide, culture care action and decision meta-modes were discovered that were focused on providing culturally congruent nursing care among cultural groups McFarland, Mixer, Wehbe-Alamah, et al.

Translational research or implementation science is the foundation for research utilization as evidence-based practice Ray, et al. The sunrise enabler Figure guides decisions and nursing actions through a process focused on specific components of the theory as noted in Table The nurse uses participation, observation, and interviews within the culture. The nurse analyzes the information that has been gathered.

The nurse carefully considers the care according to the data. The nurse develops a plan of care based on the data and presents it to the patient for review and modification as needed. The nurse implements the plan and observes the outcomes of culturally congruent care. Therefore, using the enabler, the nurse systematically progresses through the major care constructs and social structure dimensions of the theory with the goal of providing culturally competent and congruent care. Beginning at the top of the figure, culture care is the overriding component of the enabler followed by worldview and then cultural and social structure dimensions.

Worldview refers to the way in which people of a culture perceive their particular surroundings or universe to form certain values about their lives. The cultural and social structure factors encompass components of technological; religious and philosophical; kinship; political and legal; economic; and educational factors. These components are studied through participation, observation, and interview research techniques. In most cultures the family is an important factor in care. Wehbe-Alamah reported the findings from her qualitative ethnonursing study of the culture care of Syrian Lebanese immigrants in the midwestern United States.

She used the three modes from the CCT to describe her discovery that the provision of culturally congruent care was centered around the family. Culture care preservation was maintained by requesting that nurses avoid pressuring relatives of deceased Muslim patients to give consent for organ donation or autopsy because Muslims believe their bodies are a gift from God and themselves as trustees of this gift In order to practice culture care accommodation in the provision of culturally congruent care for Syrian Muslims, the nurses and other health care providers in an inpatient setting were encouraged to consider negotiating the number of visitors and duration of visits.

Wehbe-Alamah found that the presence of a supportive network of family members and friends holds great importance for Syrian Americans as this is considered an essential caring practice as well as a social, religious, and cultural obligation. McFarland and Eipperle addressed the issue of integrating the theory of culture care diversity and universality into advanced practice nursing in the role of the family nurse practitioner FNP in providing culturally congruent care primary care contexts p. They discuss potential for future expansion of the theory in nurse practitioner practice. Given that culture care is a core competency domain for family nurse practitioners U. Department Health and Human Services [DHHS], , they stress the need for nurse practitioners to recognize the often missing component of culture care in nursing.

The nurse practitioner needs to be able to sensitively and competently integrate culture care into contextual routines, clinical ways, and approaches to primary care practice through role-modeling, policymaking, procedural performance and performance evaluation, and the use of the advanced practice nursing process. McFarland and Eipperle list six criteria for theory application in advanced practice nursing:.

Foster a focus on the whole person rather than the disease or illness. Be holistic in nature which is helpful to both practice and documentation. Facilitate autonomous nursing practice aspect of professionalism along with knowledge and service. Encourage diverse ways of knowing, including empirics, ethics, aesthetics, personal knowing, and sociopolitical knowing p. Chapter Leininger, a, p.