NURSING THEORY PRESENTATION Denise Broghamer Noranne Morin Kim

NURSING THEORY PRESENTATION Denise Broghamer Noranne Morin Kim Kerridge Mark Witteveen Laura Zwagerman Nursing 324 Ferris State University Ms. Susan Fogarty February 26, 2012

Culture Care Diversity & Universality

Introduction “Culture competent care can only occur when culture care values are known and serve as the foundation for meaningful care (Transcultural Nursing, 2012). ” Nursing theorist Madeleine Leininger believed that a patient’s culture had a direct impact on their health and well-being. In the “sunrise model” developed by Leininger the correlation between health and well-being is demonstrated utilizing key factors such as, technological, religious and philosophical, kinship and social factors cultural values and lifeways, political and legal , economic and educational. These factors combined with the nurses knowledge, recognition of health beliefs and folk practices, and the culture of traditional health services (Chitty & Black, 2011), lead to sound care decisions and actions. The outcome of these practices is culturally congruent care (Chitty & Black, 2011).

Leininger’s Sunrise Model

Origins of the Culture Care, Diversity and Universality Theory � Theorist’s motivation for developing the model Early in her career, she noticed that typical interventions were ineffective in addressing the needs of children from different cultural backgrounds (Madeleine Leininger Papers, 1953 -1995). � Theorist’s philosophic values about nursing and knowledge development. Madeleine Leininger believes that care is the essence of nursing. To expand on that she believes that, “culture care is the broadest holistic means to know, explain, interpret, and predict nursing care phenomena to guide nursing care practices” (Clarke, Mc. Farland, Andrews, Leininger, 2009). She goes on to state that having knowledge of a culture’s values and systems will result in culturally congruent beneficial care (Clarke, Mc. Farland, Andrews, Leininger, 2009). Knowledge of a particular culture in which you are providing care seems to be essential in successfully providing for their health needs. � What influenced the Theorist’s philosophy? Her early experiences with psychiatric care of children certainly seemed to play a role in her philosophy. Margaret Mead, the renowned anthropologist, also played a pivotal role as well. Madeleine encouraged the head of the Psychoanalytic Program to bring her on board in order to assist with caring for the children appropriately.

Information and Concepts “Globalization of transcultural nursing means that nurses must expand their world view from a narrow perspective to a world view of nursing which shows concern for and interest in diverse cultures and their expectations of health care in relations to their patient’s beliefs” (Leininger, 1992).

Global Concepts � Human being: In transcultural nursing theory, human beings, are viewed holistically as related to their cultural beliefs and differences in their health care expectations. � Environment: In transcultural theory the nurse will place the patient in a physically and mentally acceptable environment in order to enhance a healthier outlook and recovery, in other words, the nurse will have the family members bring items from home to make his hospital room more comforting, while including the family in the patient’s plan of care.

Global Concepts con’t � Health: “Caring is formed by culture. ” “Transcultural nursing, care is the core of nursing, and is essential for the well-being, health, growth, recovery and survival of the patient. ”(Eriksson, 2008). Health is viewed differently within cultures, the road to recovery could inevitably involve not only the care of the body, but also the soul, and spirit. � Nursing: Based on cultural beliefs, the intra-cultural nurse, will collaborate with the patient and family on the best way to proceed with hospitalization and treatment that will best fit the patients’ expectations of a complete recovery, or reasonable outcome.

Global Concepts con’t � In conclusion, the nurse who practices the transcultural care theory views her patient as a holistic being with multifaceted life experiences and realizes that recognizing and accepting culture differences will play a big part in that patient’s understanding and compliance to hospitalization and eventual recovery.

Evaluation of the Nursing Model The origin of Leininger’s work is stated best by Welch, as she writes “Leininger finds that today, cultural blindness, shock, imposition, and ethnocentrism by nurses still greatly reduce the quality of care to clients of different cultures” ( 2005, p. 507).

Evaluation con’t The content of the transcultural nursing theory addresses the four global concepts � Human beings in this theory are the patients or clients, their families and communities, and the nurse. The human beings are considered unique in their communities and diverse within their culture. Great respect is given to each cultures “lifeway”. � The Environment in transcultural nursing theory is the culture or subculture to which the human beings belong.

Evaluation Con’t � The Health model has enhanced nursing globally. This concept is evidenced by the study and application of theory in 50 different cultures throughout the world. Nurses have been educated in transcultural nursing in all of these cultures (Clarke, 2009. P. 237). � In the global concept of nursing, Leininger says it best herself, “I wanted it to be a theory that could be used worldwide in nursing because I knew nursing would have to go global (Clark, 2009, p. 237).

Evaluation con’t Narrow View � � � � � Leingingers theory can be used anywhere, it has been studied in many different cultures but it can also be applied to subcultures within a practice setting. The idea that providing care that is culturally congruent is what make clients, or patients feel satisfied with the quality of the care they receive has been adopted by scholars in: Theology, Religious studies Engineering, Management, Business, Education, Sociology Anthropology

Case Study One A Middle Eastern man is receiving end of life care. The nurse caring for this patient is uncomfortable and unsure what this family needs. Leininger would say the best way to know how to care for this patient and family is to: A. Ask them B. Do a Google search for Middle Eastern end of life beliefs C. Do what you would do for your family D. Follow hospital policy strictly Answer: A. Leininger’s theory is “based on the belief that people of different cultures can inform and are capable of guiding professionals to receive the kind of care they desire or need from others” (Alligood and Tomey, 2010, p. 459).

Case Study Two A woman presents in labor at 33 weeks and experiences complications. She is informed that the baby needs to be delivered by C-section, which is against her belief of childbirth as a natural phenomenon. The nurse’s role in this situation is: A. Culture Care Preservation and Maintenance B. Culture Care Accommodation or Negotiation C. Culture Care Repatterning or Restructuring Answer: B. This refers to “assistive, supportive, facilitative, or enabling professional actions and decisions that help people of a designated culture (or subculture) to adapt to or to negotiate with others for meaningful, beneficial, and congruent health outcomes” (Alligood and Tomey, 2010, p. 461). The C-section may not be a choice, however the nurse can advocate for the patient not having general anesthesia, so the baby can go to breast immediately after birth.

Question Leininger believes “that nursing theory must take into account creative discovery about individuals, families, and groups, and their caring, values, expressions, beliefs, and actions or practices based on their cultural lifeways to provide effective, satisfying, and culturally congruent care. If nursing practices fail to recognize the cultural aspects of human needs. . A. There will be less beneficial or efficacious nursing care practices B. There will be evidence of dissatisfaction with nursing services, which limits healing and well-being C. Both A and B Answer: C. (Alligood and Tomey, 2010, p. 459).

References Alligood, M. R. , Toomey, A. M. (2010). Mc. Farland, M. R. , Madeleine M. Leininger: Culture Care Theory of Diversity and Universality. Nursing theorists and their work (7 th Ed. ). St. Louis, MO. Mosby Chitty, K. , & Black, B. , (2011). Professional Nursing: concepts & challenges (6 th Ed). Maryland Heights, MO: Saunders Elsevier Clarke, P. M. , Mc. Farland, M. R. , Andrews, M. M. , Leininger, M. (2009). Caring: Some reflections on the impact of the culture care theory. Nursing Science Quarterly, 22 (3), 233 -239. doi: 10. 1177/0894318409337020

References con’t Leininger, M. (1992). “Globalization of Transcultural Nursing: A Worldwide Imperative”. Journal of Transcultural Nursing, 3: 2. doi: 10. 1177/104365969200300201 The Madeleine M. Leininger Collection. (1953 -1995). Wayne State University Archives. Retrieved from https: //www. reuther. wayne. edu/files/WSP 000725. pdf. Tomey, A. M. , Alligood, M. R. , (2005). Welch, A. , Madeleine Leininger: Culture care: Diversity and Universality Theory. Alexolopolis, Y. (Eds. ), Nursing theorists and their work (pp. 501 -123). St. Louis, MO. Mosby

References con’t Transcultural nursing society. (n. d. ). Retrieved from http: //www. tcns. org/ Transcultural nursing models and theories. (n. d. ). Retrieved from http: //www. tcns. org/society/models. shtml Wikberg, A. , Eriksson, K. (2008). Intercultural caring-an abductive model. Theoretical studies Department of Caring Science journal: 22, 485 -496. doi: 10. 1111/j. 1471 -6712. 2007. 00555. x