Madeline Leininger's Culture Care-Nursing Theory

The use of the theoretical framework known as Leininger’s Theory of Culture Care Diversity and Universality is emphasized in the nurse practitioner’s role. The theory’s 3 modes of care: culture care preservation and-or maintenance, culture care accommodation and-or negotiation, and culture care restructuring and-or repatterning are the basic components in providing culturally congruent care (51). The authors discuss being able to see the patient as a whole person, known as the Sunrise Enabler, assessing their situation, and other

the undeniably assorted, multicultural population in the United States is putting forth new difficulties in the arrangement of cultural care by nurses in general. An immediate relationship exists between a patients way of life and their well being; of the numerous factors known to impact health beliefs and practices, culture is a standout amongst the most compelling. In the event that the arrangement of the most ideal care to all patients is the objective, nurses must have aptitude and ability in the conveyance of culturally proper and cultivation equipped nursing care. Each nurse must play a dynamic part in getting a data base whereupon to build up a social competency. The capacity to convey nursing care that will permit powerful communications

Health literacy has been demarcated as the measurement of the individual’s capacity to obtain, understand and process simple health information. It is needed to make satisfactory health decisions and determine services needed to treat or prevent illness. Health literacy requires knowledge from many topics, comprising the patient’s own body, appropriate conducts towards healthy results and the difficulties to understand the health system. It is influenced by many conditions such as our communication skills, age, socio-economic status, and cultural background, past experiences, educational level and mental health status (U.S. Department of

Health literacy has been a problem with our patients. The most vulnerable populations are the elderly, people with low-income levels, those with limited education, non-native speakers of English, those with chronic mental and physical health conditions, minority, and immigrant populations. Nurses have a great role in helping our patients succeed in understanding their health conditions. Nurses can be of great help in promoting health literacy. Sykes, Wills, Rowlands and Popple (2013) defined health literacy as the ability of individuals to access, understand, appraise, and apply health information. The three domains of health literacy, according to Bennett and Perkins (2012) as adapted from the (WHO) (1998) are functional health literacy, interactive literacy, and critical health literacy. Functional health literacy is basic reading and writing skills to be able to function effectively in a health context. Interactive health literacy is the used of more advanced cognitive and literacy skills to participate in health care. Critical health literacy is the ability to analyze critically and to use information to participate in action, to overcome structural barriers to health (p.14). The U.S. Department of Education published the findings of the National Assessment of Adult Literacy conducted in 2003. The result showed that 36 % of adults have basic or below-basic skills for dealing with health material, 52 %

A healthcare disparity is a limitation of healthcare availability, usually among a certain racial or socioeconomic demographic (Black, 2013). However, there are disparities that don’t have a specific demographic and affect the entirety of the United States, which are potentially most detrimental to the overall health of our country. One of those disparities is health literacy, or the exchange of complex information from the healthcare provider to the patient or client (Black, 2013). The lack of health literacy in America poses as a problem, especially with the chronically ill. Without proper knowledge of how to treat their illness and what to do when the disease process worsens or ameliorates can potentially cause millions of unnecessary hospitalizations,

Madeleine Leininger’s cultural care theory is one of the most influential modern day theories in nursing. Leininger describes her theory as one that is cultural sensitive that is tailored to address patients of different cultures, backgrounds, or origins. Leininger develops the cultural care theory due to the fact that she believes that nurses are caring for their patients as a one hat fits all, and not taking into consideration the patient 's background or their culture.

A big problem today in health care for many people is health literacy. Health literacy is when a person is able to understand and process medical information they are given. Having low health literacy can affect how a person understands, and uses information about their health and health services (Batterham 2016). Low health literacy rates lead to big issues in communication. Limited literacy impacts health behaviors, decisions, and ultimately outcomes. Many people have low health literacy which leads to bad health outcomes. Research shows that low literacy is linked with the lower likelihood of people being able to manage their own health conditions, and less access to health care services which can lead to poor health outcomes. There are many reasons people have low health literacy, A lack of formal education and poor reading ability aren't the only causes of low health literacy. Low health literacy is associated with a number of things like poor engagement in health services, health knowledge, and overall health status. People with low health literacy may feel ashamed and try to hide it from professionals and family members. Most health care professionals are unaware of the level of health literacy their patient has. (Greenhalgh 2015) There is a need to identify individual health literacy needs and address how to work on solutions to benefit them and whole groups of people. Differences in health literacy

Nursing theory is foundational to nursing practice; however, there exists a reciprocal relationship between practice and theory. Through examining nursing theory, the nurse can make better-informed decisions about the patient’s care. In addition, the theory will influence the care for future patients as well. One theorist that changed the landscape of nursing is Madeleine Leininger. Her culture care theory changed the dialogue of healthcare regarding care. This paper will discuss the importance of theory in nursing theory. Next, a summary of Leininger’s theory will precede a discussion about how the theory will be applied in a nursing context. Finally, the correlation between Leininger’s theory and the practice of a nurse practitioner will ensue. Her culture care theory will inform the practice of a nurse practitioner and how culturally competent care will be given.

The Theory of Culture Care Diversity and Universality is founded on the principle the compassion is the crux of nursing (Black, 2014, p.277). In order to provide care effectively, one must demonstrate empathy toward his or her patient. Additionally, Leininger’s theory calls for transcultural nursing, which is centered on culture as the basis for care delivery; essentially, it is the provision of culturally competent care (Narayanasamy, 1999). To allow the nurse to assess a patient culturally, Leininger devised the sunrise model, which encompasses multiple traits specific to an individual’s cultural background.

Health literacy is defined as "The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (Michael K. Paasche-Orlow, 2010), the word Health literacy first appeared in 1974 in a paper which calls for “education standards for all grade school levels in USA” (Carolyn Speros, 2004) . Some recent works suggest that there is a relation between literacy, low health and premature deaths (Christina Zarcadoolas et al, 2005).

This can alleviate stress, which contributes to physical and emotional imbalance. Providing holistic care states Maier-Lorentz (2008), is defined as formulating a care plan that meets the individual needs of the patient. Leininger’s theory is the holistic model that supports such care and allows for advancement in transcultural nursing through research (Maier-Lorentz, 2008). To provide such care, while remaining culturally aware, the nurse must be void of any biases and stereotypes as a result of his or her own socialization. Lowe and Archibald (2009), state that there is no formulary approach in nursing practice to adequately deal with cultural diversity, because of preconceived notions and stereotypes. This practice has to be achieved through training and acquired knowledge. Training in providing culturally competent care promotes cultural self-awareness, knowledge of other cultures as well as recognizing the impact of culture on the nurse-patient relationship (Pesquera, Yoder & Lynk, 2008).

“It was estimated in 1998 that between $35-73 billion was wasted in prolonged hospital stays and frequent doctors visits related to low health literacy” (Ickes, MEd & Cottrell, DEd, CHES, 2010, p. 492). With all of the previously mentioned problems of poor health literacy, individuals who fall into these categories are also more likely to die at an early age.

Health literacy is an essential determinant of health. Health literacy is the degree in which people have the ability to obtain process and understand fundamental health services and information in order to make informed health decisions throughout different phases of life. Patients who are better educated and informed about their options and who understand the evidence behind certain methodologies may have better health outcomes. On the other hand, low health literacy leads to many health problems. In fact, it seems to be the “single biggest cause of poor health outcomes” (Kickbusch 208). Low health literacy inhibits self-advocacy in health care settings. Patients with limited literacy cannot actively participate in health-related decisions

Care and culture are the key constructs that make up the Culture Care Theory. This theory differed from other nurses’ work or mindset because nurse leaders relied heavily up on the four metaparadigm concepts of person, environment, health, and nursing to explain nursing (McFarland and Wehbe-Alamah, 2015). Leininger realized that those four metaparadigm concepts were to limited in its scope regarding nursing and culture and care ideologies. Interestingly, care and culture were excluded from the metaparadigm. “It is not logical to use nursing to explain nursing” (McFarland and Wehbe-Alamah, 2015). That is definitely a contradiction in terms and represents scholarly research

The final assumption is the fact that nursing care that is culturally beneficial can only be provided when the nurse providing the care has knowledge of cultural care expressions, patterns, and values (Kardong-Edgreen & Campinha-Bacote, 2008).