Running head: MADELEINE LEININGER 1

Madeleine Leininger Wiki

Kimberly D. Anderson, Kayla Diehl, Aubree Lemarr, Gabrielle N. Idos
Missouri State University

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Madeleine Leininger Wiki
Madeleine Leininger was the mother of culturally competent care. She saw the
importance of providing nursing care in accordance with a person's culture and beliefs to fulfill
the right to individualized care. Leininger started her career path in nursing by attending the
School of Nursing at St. Anthony Hospital in Denver, Colorado. She furthered her nursing
education before beginning cultural research in New Guinae. It was then that Leininger saw the
importance of including the patient's culture when providing care. Knowing someone's
background and values can affect and completely change nursing and care practices. Her theory
is meant to give full respect to the patient and their beliefs, while also helping patients adopt new
health practices when they are beneficial to their health. Leninger's transcultural theory is
significant regarding education and research for nursing practice. Her theory provides a
foundation for giving care to the patient holistically by considering their values. Leininger's
theoy has proven to be effective in applying the theory to an individual, the environment, health,
and the nursing practice. She believed that when viewing the culture of a person, one needed to
look at the similar individuals of race and ethnicity. In addition, she believed that excellent
nursing care could not be provided to individuals without considering the person's culture when
planning the care. One of Leininger's main concerns was that nurses do not receive adequate
training in the various cultures he or she will experience in their practice. Nurses need to strive to
be culturally competent to achieve the optimal level of nursing.
Education and Nursing Specialty:
Dr. Madeleine Leininger started working as a third grade elementary teacher in Nebraska,
with World War II beginning shortly after. During World War II. Dr. Leininger jumpstarted her
nursing career by attending the School of Nursing at St. Anthony Hospital in Denver, Colorado.
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While she attended school, she joined the United States Army Nurse Cadet Corps. Dr. Leininger
completed a Bachelors of Science degree in Biological Science at Benedictine College in
Atchison, Kansas. In addition to a bachelors in biological science, Dr. Leininger obtained a
Minor in Philosophy and Humanities. She later went on to complete a Master's of Science degree
in Psychiatric Nursing at the Catholic University of America, located in Washington D.C. in
1954. Dr. Leininger decided to attend University of Washington, Seattle in search of a Doctorate
of Philosophy in Anthropology with a focus on Cultural, Social, and Psychological Material
(Ray, 2012). After finishing her education, she was able to find her true passion in nursing.
During her studies at the University of Washington, Seattle, Dr. Leininger participated in
two years of research. Her research involved studying an indigenous culture from New Guinea,
called the Gadsup, and observed their care practices. By watching this group of people, Dr.
Leininger realized how important it is for nurses to study care (Ray, 2012). She then focused her
research on caring phenomena and the study of care. As her research carried on, Dr. Leininger
went on to create the new course of study called Transcultural Nursing at the University of Utah.
Transcultural Nursing became Dr. Leiningers specialty area of nursing and she was a professor
at several schools where she implemented her program on the campus (Ray, 2012). Through her
research and teaching, Dr. Madeleine Leininger went on to make many advancements in the
profession of nursing including culturally competent care.
Nursing Theory, Concepts, Propositions
Leininger was an anthropologist that focused on and emphasized culturally competent
care. She proposed that without knowing the background and culture of a patient, proper care
cannot be given. All cultures have specificities related to how they give and perceive care. This
known as Diversity in her theory, but there is also a common thread through all cultures related
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to care, which she labelled Universality (George, 2011). These two concepts make up her theory
of how culture relates to giving quality care.
Leininger emphasized the importance of nursing care to be culturally knowledgeable and
understanding, because it is both beneficial and healthy to the patient. Inversely, if care is not
culturally competent, then the patient will demonstrate signs of stress, noncompliance,
cultural conflicts, and/or ethical or moral concerns (George, 2011, p. 409). Leininger believed in
tying culture and care together in a holistic sense. It is keeping in mind the perspective of the
patient and their culture to give appropriate care, which involves looking at the view of the
patient and his/her personal ideas of health. The foundation is in understanding the culture first,
then looking at problems and situations from a nursing perspective. The key is understanding
what "Care" and "Health" mean to the individual based on his/her culture (HCR Home Care,
2012). If a nurse os able to put those tings together, then he or she will be able to provide a
complete and individualized care plan.
Nursing is more than simply doing something for someone. The "doing" has to have a
link with a Dominant Care Construct, of which, there are around 60, and no single one will be
appropriate for every situation. One of the most universal Dominant Caring Constructs is
Respect. After finding this, one can use Leiningers Sunrise Enabler. This is a guide that shows
areas that one should take into consideration when providing care (George, 2011). Leininger
once found that when working with a Middle Eastern woman who was in labor, she was terribly
frightened and would not even speak. She was scared due to the bright lights focused on her
perineal area and only having male healthcare professionals caring for her. Leininger got a
female nurse and physician to come, instead. Leininger was careful to note the cultural values
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and beliefs of this woman to provide good care (HCR Home Care, 2012). This is just one
example of how cultural competence plays a large role in proper nursing care.
The ultimate goal, to Leininger, was to provide culturally congruent care. This is done
through three basic modalities for helping the nurse in decision-making with the patient and then
finding what actions to take while continuously working with the patient. The first mode is
cultural care preservation and maintenance. This is preserving what functions well and is both
acceptable and congruent between the cultures. The second mode is culture care accommodation.
This is accommodating what the patient values or negotiating with them. The third mode is
cultural care patterning or re-structuring. This can be the most difficult, but it is changing
lifestyles or behaviors of the patient that would benefit them if they are willing to adapt (HCR
Home Care, 2012). For example, Leininger worked in the south in two villages in the 1960s.
Soon she discovered that the people were using gasoline to heal their wounds, because the
doctor was prescribing it. This caused a lot of swelling, pain and infection in some people.
Instead of telling them they were completely wrong and needed to change their ways, she
negotiated with the people. She inquired if they thought it was working and suggested the use of
antibiotic ointment, instead. After working with the local doctor, he eventually adapted his
perspective on the use of gasoline and started emphasizing the use of antibiotic ointment. Ten
years later, Leininger returned to the village to discover that people now carry tubes of antibiotic
ointment around instead of gasoline, because that was now what the culture valued (HCR Home
Care, 2012).
Theorys Implication
Madeleine Leininger believed, It is amazing what some men and women can do with
their ideas in many places of the world. Creative thinking and actions is what the world needs
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most" (Andrews, 2008). Transcultural nursing has been an example of these attributes. The
transcultural theory can be defined as "the discipline of study and practice in nursing that focuses
on cultural care differences and similarities among and between cultures in order to help human
beings attain and maintain meaningful and theraputic culturally based on heal care practices"
(George, 2011, p. 405). This theory is important to nursing practice because it emphasizes on the
individualization of care. It is also a theory that is applicable to the increase demand of programs
like Doctors Without Borders. In addition, this theory is one of the oldest theories of nursng and
is inclusive of both ethnic and etic values.
The transcultural theory had many implications regarding education. They can be broken
down into five different themes: communication, transportation, culinary practices, religion, and
environment (Easterby, 2012). Communication that is not effective can result in frustration and
mistakes in the patients care. Transportation between different nations differs dramatically and
can cause obstacles. European transportation has revolved around public bus and train systems,
whereas the United States has individual cars and rush hour. Nutrition is an essential part to the
healing practice. Patient's need adequate vitmain and mineral intake. For example, adequate
protein in the diet can help aid in wound healing. Culinary practices in different cultures can be
interpreted differently depending on the location. The United States tends to have larger portion
sizes and more frequent meals than other cultures. Religion is a part of a patients identity and
can be crucial to their healing. For example, some denomentations encourage non pharmological
interventions or very little medical intervention at all. The last theme is environment and
investigates the difference in perception of public displays of affection and drinking in public.
These five themes are important for the implication of nursing practice in the United States
because of the large spectrum of diversity. It is important for health care professionals to be
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conscious of the different cultures tendencies to provide adequate care (Easterby, 2012). This
means that healthcare professionals who take cultural values into consideration are able to
provide a more individualistic and complete form of care.
Going further than education, the theorys implication on nursing research is important in
understanding how to give the best care possible to patients. Different cultures experience
different kinds of medical interventions. Some Asian cultures choose to participate in more non-
pharmaceutical interventions like massage therapy and herbal remedies. Medical interventions in
the United States include physical therapies, support groups, and self-management programs.
The transcultural theory encourages research in these medical interventions. In addition, as the
world becomes more connected, it becomes more essential to research other cultures. More now
than a few decades ago, people are able to travel more. Since it is more common to experience
different cultures in a health care setting, continuing to research different populations is pertinent
to hospitals. Another factor that makes research of culture experience essential is the emotion
that is attached with it. "Outsiders of cultural norms are likely to experience feelings of
discomfort and helplessness and some degree of disorientation because of the differences in
cultural values, beliefs, and practices" (George, 2011, p. 413). For this reason, it is essential to
make patient's feel included despite different cultural backgrounds.
Research for the transcultural theory is also important in helping provide education to
decrease limitations on this theory. A limitation on this thoery includes the small number of
graudate nurses who are acaemically prepared to conduct the investigations needed to provide
transcultural care (George, 2011). Research will establish foundations that will educate more
nurses on how to appropriately care for people holistically.

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Theorys Meta-paradigms
The four meta-paradigms of nursing include: Individual, Environment, Health, and
Nursing. Madeleine Leininger applied her nursing theory to all four of these categories.
Individual: Throughout Leiningers career she focused on the relationship between culture and
care. She believed that a person is not the central aspect of a culture, but instead looked more
directly at the human race in general. Through this, she sought to provide the care needed while
basing their care on the culture. Every individual, and the human race, has unique characteristics
and by looking at these characteristics the nurse is able to provide the best care possible to the
patient. Nursing is a patient centered occupation, and Leininger believed this is one of the key
aspects to providing care. She believed every experience a nurse has with an individual allows
the patient centered care to be improved by the nurse. Leininger believed that the culture of an
individual changed the way a person perceived healthcare, and also influenced his or her health
beliefs and practices (George, 2011).
Environment: One of the phrases Leininger teaches in her theory is Culture care
accommodation (George, 2011, p.408). This principle is also known as negotiation in todays
world. It implies that the healthcare setting, comprising the environment the individual receives
care in, needs to be accommodating to all individuals of all cultures. This includes the physical
setting of the hospitals and assisted living facilities, the staff employed by the facilities, and the
decisions the facility makes regarding the health and well being of the patients. Leininger also
coined the phrase Culture Care Preservation (George, 2011, p.408). This states that healthcare
facilities should base their decisions and professional acts on the need to help cultures retain and
preserve their unique identifying characteristics for the individuals even during the time of death.
It is up to the healthcare facility to create the correct environment necessary to achieve this goal.
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The final phrase is Culture care repatterning (George, 2011, p.408). This is the responsibility
of the healthcare facility to provide an environment and resources necessary to allow individuals
the opportunity to change his or life for the better in a way that is still fulfilling to their culture
(George, 2011).
Health: Culture is the way people look at their values and beliefs, what they have learned
throughout life, and how they live their daily lives. All of these factors that comprise culture
influence the health of patients. By applying Leiningers theory, nurses are to look at these pieces
of their patients lives to see how exactly his or her culture is affecting or influencing his or her
health. Leininger believed, health is viewed as being universal across cultures but defined
within each culture in a manner that reflects the beliefs, values, and practices of that particular
culture (George, 2011, p.412). As explained by Leininger, values and beliefs can determine if a
patient seeks medical help, how a patient responds to pain, and what a patient considers
abnormal health conditions. Also, people learn by watching the people around them. If a persons
mother never showed emotions of pain during childbirth, it would not be uncommon for the
patient to hold back from expressing the pain they are feeling. While not showing pain in
alternative situations, patients can affect their health by not seeking adequate healthcare. In
addition, daily living can have a drastic effect on individuals health. From the food the patient
eats, to the value he or she places on exercise, the culture of the person can determine his or her
health status (George, 2011).
Nursing: Madeleine Leininger was a woman who shaped the face of nursing to what it is
known as today. Her Cultural Care Theory provided a new insight to the importance of providing
people with the correct care they want and need based on their expectations of care and their
definition of health. Leininger believed that there is a standard of care that each patient should be
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provided, but it is the standard of care can be shown through diverse perspectives, action, and
feelings that make nursing care individualized to the patient and based on his or her culture.
Leiningers goal of care is to use culture care research findings to provide specific and/or
general care that would be culturally congruent, safe, and beneficial to people of diverse or
similar cultures for their health, well-being, and healing, and to help people face disabilities and
death (George, 2011, p.409). She was concerned that nurses do not receive adequate training in
transcultural nursing and do not put forth enough effort to learn the cultures of the patients they
are working with. The nursing profession continues to strive to enhance the knowledge known of
the various cultural and ethnic groups to allow nurses to provide the top notch nursing care in
any facility (George, 2011).













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References
Andrews, M. M. (2012). "Global leadership in transcultural practice, education, and
research." Commentary 28.1: 16. Print.
Easterby, L. M.; Gilbert, P.; Holloway, K.; Siebert, B.; Woodfield, C. J.; and Zoucha, R. (2012).
"Implications for nursing education" A Transcultural Immersion Experience 23.4: 5.
Print.
HCR Home Care. (2012). Madeleine leininger interview part 1 [Video File]. Retrieved
from http://www.youtube.com/watch?v=a4GTo_uthZ
George, J. B. (2011). Nursing Theories: The base for professional nursing practice (6th ed.)
Lake Street Upper Saddle River. Pearson Education, Inc..
Ray, M. A. (2012). "Remembering madeleine m. leininger, PhD, LHD, DS, RN, CTN, FAAN,
FRCNA". International Journal For Human Caring, 16(4), 6-8. Retrieved from
http://content.ebscohost.com.proxy.missouristate.edu/ContentServer.asp?T=P&P=AN&K
=2011906156&S=L&D=c8h&EbscoContent=dGJyMNXb4kSep7Q4yOvqOLCmr0yeqL
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