Nursing History & Trends Notes

Leininger

• clinical practice; specialist in child psychiatric nursing
• Cultural differences between patient and nurses mad a difference in health outcomes.
• PhD in cultural anthropology in 1959
• Concept of holism and has as their objective knowledge of human phenomenon
• Concept of caring-identification of care diversities and care universals

Application

• Goal of theory is to provide culturally congruent nursing care to person of diverse cultures
• Important for nurse to understand the patient’s view of illness (how pt understands illness, wants to be helped and ways health personnel can help)
• Preservation
• Accommodation
• Repatterning
• Nursing education (patient education)
• care meanings and practices are difficult to ascertain because they are imbedded in social structure

Leininger (1991) additional findings

• Cultural context & care values influence the expression and meaning of care.
• To understand care meanings and uses often require knowledge of the culture.
• High technology nursing practices in Western cultures increase the distance between clients and nurses.
• Generic care is little understood and valued by nurses and other health providers.
• Key and general informants for the studies have expressed positive feelings about the research.
• Clients believe that their ideas, beliefs, and lifeways must be understood by health providers before clients can be helped appropriately.

• Transcultural nursing- a learned subfield or branch of nursing which focuses upon the comparative study and analysis of cultures with respect to nursing and health-illness caring practices, beliefs and values with the goal to provide meaningful and effacious nursing care services to people according to cultural values and health illness context.
• Ethnonursing- the study of nursing care beliefs, values, and practices a cognitively perceived and known by a designated culture through their direct experience, beliefs, & value system.
• Cross-cultural nursing

Foundation of Nursing Theory. Ed. Chris Metzger McQuiston & Adele A. Webb. Sage Publications. Thousand Oaks. Copyright 1995 article by Cheryl L. Reynolds & Madeleine M. Leininger.

Human beings are believed to be caring and to be capable of being concerned about the needs, well-being, & survival of others

1. Theories can interrelate concepts in such a way as to create a different way of looking at a particular phenomenon. (holistic view of people)
2. Theories must be logical in nature. (inherent logic- more known about client, increased opportunity to provide care)
3. Theories should be relatively simple yet generalizable. (necessary concepts are incorporated in such a manner that the theory and its model can be applied to many different settings)
4. Theories can be the bases for hypotheses that can be tested or for theory to be expanded. (Theory is based upon qualitative rather than quantitative research; nursing science should be defined Òas the creative study of nursing phenomena which reflect the systematization of knowledge using rigorous and explicit research methods within either the qualitative or quantative paradigm in order to establish a new or to advance nursingÕs discipline knowledge.Ó)
5. Theories contribute to and assist in increasing the general body of knowledge within the discipline through the research implemented to validate them. (Table 21-1. p. 385)
6. Theories can be utilized by the practitioners to guide and improve their practice. (example of research finding which can guide and improve nursing practice; care is universal, the meaning of care diverse)
7. Theories must be consistent with other validated theories, laws, principles but will leave open unanswered questions that need to be investigated. (concept of importance of knowing client as a person rather than as a problem)

Limitations- limited number of graduate nurses who are academically prepared to conduct the investigations needed to provided transcultural nursing care.

Nursing Theories: The Base for Professional Nursing Practice. 4th Ed. Editor Julia B. George. Appleton & Lange. Norwalk, Connecticut. Copyright 1995.