Madeleine Leininger’s theory has been at the forefront of modern day nursing practice. The framework of this theory serves a guideline for professional nurses to provide a holistic approach to caring. The concepts that she introduced paved the way in considering a broader aspect of healthcare service and not merely concentrating on the physiological aspect of human well being.
The concept of Cultural Care Preservation or Maintenance deals on the nursing care aspect with the goal of helping in the preservation or maintenance of favorable health and caring lifestyle. This entails that in maintaining homeostasis, the nurse or the healthcare provider must be sensitive in the idiosyncrasies and uniqueness of the patient. Paying special attention to cultural beliefs and traditions will aid in a more efficient facilitation of caring for the individual.
Another concept introduced by Leininger is about Cultural Care Accommodation or Negotiation. The guiding principle of this concept is based on the realization that in providing quality care, the nurse must be able to adapt or negotiate with the client by taking into account the particular culture the client belongs to. The nurse must recognize that in order to be effective, he must take into account the possible differences of the client’s beliefs from his own. By acknowledging this fact, the nurse will not come across too strong and will not appear as imposing. Striking a balance between what is the universally accepted balance and the traditions and customs of a particular client is the aim of this theory. Accepting the differences and managing to reach into a compromise can eventually lead to a more sustainable healthcare plan for the client because encroachment on beliefs is minimized.
There is also the notion on Cultural Care Restructuring or Repatterning. It dwells on idea that people are capable of modifying their lifestyles to accommodate new healthcare ways or patterns. It further expounds that individuals have the capacity to change and are open to try new practices as long as they think that the results are culturally meaningful and satisfying. For the nursing practice, the repatterning aspect of this model is a useful tool in trying to “bend” or flex some of the stringent beliefs or habits of the client by including them in their own healthcare plan. This further implies that considering the cultural background of an individual does not necessarily mean being certain practices are better left alone. In actuality, the model guides the nurse on how to be culturally sensitive and try to find creative ways of persuasion without being drastic and radical.
The Sunrise Model has a very significant contribution in terms of specific and individualized nursing care. The recognition, that each individual should be treated as a unique entity, with different social and cultural background, provides an impetus to improve the nursing profession.
Understanding culture care diversity and universality theory helps nurses to be culturally competent who can work effectively across cultures. They can consciously address the fact that culture affects nurse-client exchanges; with compassion and clarity, ask each client what their cultural practices and preference are; incorporate the client’s personal, social, environmental, and cultural needs/beliefs into the plan of care wherever possible; and respect and appreciate cultural diversity, and strive to increase knowledge and sensitivity associated with this essential nursing concern. Putting these things in to consideration is important because of the following:
- the world is constantly changing and it will be more diverse in the future. Our clients, patients and even other people that we work with came from diverse background and experiences.
- in order to provide optimum or best care to our client we must practice cultural competency
- being culturally competent and valuing diversity will help us be more sensitive to those we are caring for.
COMPONENTS OF THE THEORY
1. The nurse uses participation, observation and interviews within the culture
To discover the worldview of the member or members of the culture, the cultural and social dimensions considering the cultural values and the lifeways such as technological, religious, philosophical, kinship and social, political and legal, economic, and educational factors, and the influence of language, the ethnohistory, and the environmental context.
2. The nurse analyzes the information gathered
To discover patterns and themes related to health and well-being based on the factors from the model.
3. The nurse considers the care indicated according to the data
To discover generic (folk) care, nursing care and professional systems of care indicated according to the data.
4. The nurse develops a plan of care based on the data and presents it to the patient
To plan for culture care preservation or maintenance, accommodation or negotiation, repatterning or restructuring.
5. The nurse observes the outcome of culturally congruent care
To promote health and well- being
Care is the very heart of nursing. Nurses provide holistic care to patients in several ways but this should be culturally sensitive in order to be effective and to promote patient satisfaction. Nowadays, nurses are challenged by the complexities of a multicultural environment wherein they are faced with patients from diverse cultural backgrounds.
Through Leininger's Theory, nurses are able to open their minds to the concept of culturally congruent care which is the primary goal of transcultural nursing practice. Transcultural nursing has been defined as 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. Thus, culture plays a vital role in person’s view of health and how he will react on it.
It is crucial for a nurse to study his feelings, beliefs, and views in life before he may understand the client’s feelings, beliefs and perceptions in their cultural context. In this way, any conflicts, stresses and noncompliance will be avoided in a nurse-client relationship. A thorough understanding and research about the client’s cultural background will help in providing quality and culturally congruent care. That type of care can possibly happen when the nurse and client will create together a new lifestyle that acknowledges the client’s practices, values and beliefs. In this way, the client actively participates in the nursing process and the nurse serves as patient advocate, leading to effective care and fast patient recovery.
As diversity from race, ethnicity, disability, sexual orientation, age, gender, social economic background, religion, and geographic may exist between the nurse and the patients, being conscious and respectful is important. We must understand the impact of the care provided to them. Effective communication will help in providing cultural responsive services, such as developing cultural awareness, having cultural knowledge, and practicing cultural skills are also useful in proving the best possible care to our clients.
Nurses who understand and value the practice of culturally competent care are able to arrive at positive changes in healthcare practices for clients of specific cultures. Sharing a cultural identity requires knowledge of transcultural nursing concepts and principles, along with an awareness of current research findings. Culturally competent nursing care can only occur when client beliefs and values are thoroughly incorporated into nursing care plans. Caring is the core of nursing. Culturally competent nursing guides the nurse to provide optimal holistic, culturally based care. These practices also help the client to care for himself and others within a familiar, supportive, and meaningful cultural context.
Continuous improvement and expansion of appropriate modern technologies and other nursing and general science knowledge are integrated into practice. Nurses nowadays are faced daily with unprecedented cultural diversity. Commitment to learning and practicing culturally competent care offers great satisfaction. This culturally congruent care will be an edge for nurses who practice it and a way of building a strong foundation in a nurse-client relationship.