Madeleine Leininger was a nurse and anthropologist who developed the Culture Care Diversity and Universality Theory. The theory proposes that nursing care should be provided in a culturally congruent manner. It aims to increase cultural awareness among nurses and incorporate a patient's cultural values, beliefs, and practices into their care plan. The theory also recognizes that while cultures differ in some ways, they also share universal concepts of care that are essential to health and well-being.

1. Madeleine Leininger’s Culture Care:
Diversity and Universality Theory

2. Theorist Background
– Madeleine was born in Sutton, Nebraska July 13, 1925
– Daughter of a German father and an Irish Mother
– Obtained diploma from St. Anthony’s School of Nursing,
Denver Colorado in 1948
– Madeleine obtained BS from St. Scholastica at Benedictine
College, Atchison, Kansas in 1950
– MS in psychiatric and mental health nursing from the Catholic
University of America in Washington, D.C. in 1954
– PhD in social and cultural anthropology from University of
Washington, Seattle in 1965

3. What is transcultural nursing?
– “A substantive area of study and practice focused on comparative cultural
care (caring) values, beliefs, and practices of individuals or groups of
similar or different cultures with the goal of providing culture-specific and
universal nursing care practices in promoting health or well-being or to
help people to face unfavorable human conditions, illness, or death in
culturally meaningful ways.”(P.58)

4. Basic Tenets of the Theory
 Care
 Caring
 Culture
 Cultural care
 Cultural care diversity
 Nursing
 Worldview
 Cultural and social structure
dimensions
 Health
 Cultural care Presentation(
maintenance)
 Cultural care accomodation
 Cultural care repatterning
(restructuring):

5. Assumption of Theory
 Care - central focus of nursing.
 Caring - essential for health and well-being, healing, growth.
 Culture care - broad, wholistic perspective to guide nursing care practices.
 Nursing’s central purpose is to serve human beings in health, illness, and
dying.
 There are similarities and difference in culture care
 No cure without the giving and receiving care
 Awareness of folk remedies
 Influence of practices by cultural beliefs, practices, worldview, religious,
among others

6. Reason for the theory
– Increase migration
– Realizes patient of different
cultures required different needs
– -Cultural shock- at children
guidance center
– Doctoral work in cultural
anthropology

7. Goal of the theory
– To provide cultural congruent care or
care that fits the culture
– Comprehensive approach in patient
care
– Consideration of Cultural dynamics
– Patient involvement in his or her
care- culturally congruent care
– Should focus on patient values,
beliefs, and practices
–

8. Culturally Competent Care
– Incorporate client beliefs and practices into the plan of care
– Provides wholistic, cultural based care
– Integrate appropriate cultural practices into patient care
– Knowledgeable about culture differences.

9. Cupping

11. Primary color:
cohesive cultures that intermingle
with others in a limited way.
Primary color
Primary color
Mixed colors: different
cultures that are influenced
by multiple cultures.
Mixed colors
Mixed colors
Leininger’s Mandala

12. Sunrise Enabler
Method to assess culture and healthcare
determinants
Level 1: Worldview
Level 2: Individual’s view
Level 3: Health
Traditional beliefs, practices
Level 4; How patient should be cared

13. Case Study
– An Asian American male client is operated on for gallstones. On the
postoperative night, the nurse finds that the client is not sleeping and is tossing
and turning. When asked about pain medication, the client expresses that he
does not have pain.
– Which nursing action is most appropriate?
– Which characteristics of culture should the nurse consider when planning
culturally competent care?

14. Application of Theory in practice
– As nurses working on medical oncology, we encounter a lot of patient with
different culture, beliefs and practices. It is therefore important to be
knowledgeable about these beliefs and practices to be able to provide
individualized care.
– An element in the ANA Code of Ethics

15. Analysis of Theory using
BarnumInternal Criticism
– Clarity- it is easy to understand
– Consistency- defined key concepts throughout the theory
– Adequacy- It’s adequate, no gaps
– Logically developed
External Criticism
– Reality convergence- represents real world
– Appropriate in all healthcare settings
– Complexity- very straight forward
– Significance- it is very relevant to nursing
– Discrimination- have precise and clear boundaries
– Scope of theory- very broad

16. Conclusion
– Culture affects nurse- patient interactions .
– Nurses should ask about each client cultural practices and preferences when providing care.
– Integrate the client’s cultural needs/beliefs, practices, into the plan of care when necessary .
– Respect and recognize cultural diversity.
– Be more knowledgeable and sensitive with cultural diversity
– Failure to be congruent with client’s ,values, beliefs can lead to cultural conflict, stress,
noncompliance, ethical moral concern.

17. References
– Black, B. P (2014). Professional nursing: Concepts and challenges (8Th ed.).
University of North Carolina. Elsevier: WB Saunders.
– Leininger, M.M (1991). Culture care diversity and universality: A theory of
nursing. New York: National League for Nursing.
– Leininger, M. (2001) Cultural Care diversity and universality: A theory of nursing.
Sudbury, MA: Jones and Bartlett Publishers.
– Leininger, M (2002). Transcultural nursing: Concepts, theories, research, and
practices (3rd ed.) Blacklic, OH: McGraw-Hill Professional.
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