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Marcia Bates posted Sep 8, 2020 1:10 PM

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Madeline Leineger – Culture Care: Diversity and Universality Theory

Leineger’s theory, according to Parker (2005), “envisioned that transcultural nursing care could provide meaningful and therapeutic health and healing outcomes” (p. 310). The basis of the theory is that the nurse will understand what cultural diversity is and how, in my opinion, it needs to be factored into every patient’s care.


Nursing is essentially a transcultural care profession and discipline (Parker, 2005).

Different cultures perceive and understand patient care in different ways, although commonalities remain about care for all persons of the world

Patient care is universal across cultures, although, nursing care should be demonstrated through their diverse actions to reflect the patient’s cultural lifestyle.

Therapeutic nursing care can only occur when client culture care values, expressions, and/or practices are known and used explicitly to provide human care (Parker, 2005).

The care that a patient receives will become beneficial when that care reflects the patient’s cultural beliefs/values, and the values are appropriately considered throughout that care.

If the patient receives nursing care that does not reflect their cultural beliefs/lifestyle, the patient will most likely show signs of stress, become non-compliant, and develop moral inner conflict.

Application in research:
According to Clarke et al., (2009), “the goal of the culture care theory is to provide culturally congruent nursing care, which refers to care that fits with or has beneficial meanings and health outcomes to people of different or similar cultural backgrounds” (p. 234). As Leininger’s research has concluded, while caring for patients from many different cultural backgrounds, nurses must integrate her theory into their clinical practice to facilitate the best outcome for their patients. This will also demonstrate cultural respect towards the patient.
As a result of Leininger’s culture theory, many other disciplines are finding that the theory and method are natural ways to relate to cultures and can lead to a wealth of meaningful data to improve patient care and increase patient satisfaction (McFarland & Wehbe-Alamah, 2015). The transcultural nursing concept has become a subject that is now a part of the nursing curriculum, and, it should be considered during any interaction with patients. Leininger’s culture care theory provides practicing nurses with an evidence-based, versatile, useful, and helpful approach to guide them in their daily decisions and actions regardless of how many clients they care for or how complex the care needs (Clarke et al., 2009). Leininger’s theory has made an impact on the nurses’ ability to provide nursing care that reflects their patient’s cultural beliefs and has helped to develop culturally-competent nurses.

This theory is applicable to any nurse-patient interaction, regardless of what type of facility the nurse-patient interaction takes place. Leininger’s theory has practical applicability in the care of clients from racially and ethnically diverse backgrounds, but also enables nurses to meet the culture care needs of those belonging to cultures and subcultures (Clarke et al., 2009). It reminds nurses to remain mindful that every patient potentially has a different cultural value/belief that deserves to be honored while being cared for. This is also to include spiritual differences affiliated with cultures that must be observed. For example, if a patient needs assistance choosing a meal, it is important to understand any dietary restrictions that may be a part of their cultural or religious backgrounds. Additionally, for example, it is customary for Muslim women not to shake hands with men. According to Jafar (2017), “when approaching a Muslim woman (whether she wears the hijab, or not), it’s respectful to wait for her to offer her hand and give her the opportunity to show you if she doesn’t mind shaking hands (para. 2).
Although nurses must assist their patients with various needs, it is also important to build a trusting relationship with their patient. If the nurse doesn’t respect the patient’s cultural beliefs, it will immediately change the patient’s perspective about the care giver and may also be interpreted as a sign of disrespect. While the nurse may not be aware of certain cultures, it remains his/her responsibility to become familiar of their patient’s cultural lifestyle. This will establish a trusting nurse-patient bond as the plan of care will also yield a more compliant result.


Clarke, P., McFarland, M., Andrews, M., & Leininger, M. (2009, July). 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.

Jafar, H. (2017, November 27). Hugs and handshakes as a Muslim woman-where I draw the line. Medium.

McFarland, M. & Webhe-Aalamah, H. (2015). Culture Care Diversity and Universality. (3rd ed.). Burlington, MA: Jones & Bartlett.

Parker, M. (2005). Nursing Theories and Nursing Practice, (2nd ed.). Philadelphia, PA: Davis.

Question 2

Ana Rodriguez posted Sep 11, 2020 4:30 PM

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A middle-range theory that can find meaningful application in nursing practice is the Theory of Caring developed by Kristen Swanson. This is a middle-range theory because it includes fewer propositions and concepts. In addition, it represents a limited or partial view of nursing reality and is more appropriate for empirical testing. Swanson (1991, p. 162) defines caring as “a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility”. The five caring processes as envisioned by Swanson’s theory are enabling, knowing, being with, doing for and maintaining belief.

There are various assumptions underpinning the Theory of Caring. One of the main assumptions of this theory is that persons are unique beings whose wholeness is manifest in feelings, thoughts and behaviors. The other assumption of the theory is that caring is an essential component of the client-nurse relationship in any setting (Jansson & Adolfsson, 2011). Another theoretical assumption of this theory is that regardless of the amount of nursing experience, various factors such as the nurse’s attitude, understanding of client’s experiences and interaction with clients influence the caring process.

The Theory of Caring finds direct application in my area of practice. According to Swanson (1991), application of this theory in the clinical setting leads to strong patient-nurse relationships. In addition, practicing in a caring way enhances the personal and professional growth of the nurse practitioner. Jansson & Adolfsson (2011) reiterate that some of the personal outcomes of caring include feeling important, whole and accomplished. Professionally, practicing in a caring manner leads to enhanced intuition, clinical judgment and work satisfaction (Butts & Rich, 2014). In the process of dispensing care, I always strive to be emotionally present and empathetic, all of which are critical components of Swanson’s Theory of Caring. I also emphasize on offering realistic optimism to the patients, a factor that is essential for guaranteeing positive outcomes in the caring process.


Butts, J. B., & Rich, K. L. (2014). Philosophies and theories for advanced nursing practice (2 ed.). Sudbury, Mass.: Jones and Bartlett Publishers.

Jansson, C., & Adolfsson, A. (2011). Application of “Swanson’s Middle Range Caring Theory” in Sweden after Miscarriage. International Journal of Clinical Medicine , 2, 102-109. Retrieved from:…

Swanson, K. (1991). Empirical development of a middle range theory of caring. Nursing Research , 40 (3), 161-166. Retrieved from:

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