The atypical piece of this theory is the intent of the theorist to criticize the already developed metaparadigms of person, environment, health, and the nursing profession. For example, the concept of “person” should not be too limited because a person is any individual who is in need of human care after being recognized as a cultural being. Health is the concept that covers culturally valued well-being and reflects the possibility of patients to complete their regular activities in regards to their own life-ways. There is no clear term “environment” in Leininger’s theory. The theorist introduces the term “environmental context” to cover all events and situations with the help of which meanings to people’s expressions and interpretations can be given. It is important to consider cultural, social, political, and ecological settings in the environmental context. Finally, nursing is explained by Leininger a profession with human care phenomenon being its focus. Its goal is to provide care in accordance with patients’ cultural values and practices.
Significance of the Theory
The central goal of the theory that Madeleine Leininger developed was to improve the quality of nursing care for patients. In an attempt to find answers to the question of how to achieve better outcomes, Leininger learned that the cross-cultural approach demonstrated the highest possible performance. Nurses use the patient’s cultural and traditional characteristics, in addition to classical medicine tactics, to personalize the approach. In turn, patients become more involved, which positively affects the quality of care.
Leininger’s prospective theory encompasses the realm of patient-nurse interaction, and thus the overall scope of its influence extends to the entire clinical practice of care. Among others, the focus on a cross-cultural approach creates the conditions for this model to be used anywhere in the world, since medical tourism, the use of the nurse during travel, and living in ethnically diverse communities all result in the need to consider sociocultural traditions and patient characteristics. Doubts are created as to what type this model should be categorized as. As a high-level theory, Leininger’s model focuses on a qualitative change in the well-being of all patients in society, and it is also quite abstract. As a middle-level theory, the model focuses on the specific patient-nurse relationship and uses the knowledge gained to guide the nurse in making critical clinical decisions.
Complexity or Parsimony
Madeleine Leininger’s Transcultural Nursing Theory involves transcultural nursing, ethnonursing, professional nursing care, and culturally congruent nursing care. Transcultural nursing is a sub field of nursing that is focused on the comparative studies of cultures that are concerned with nursing and other health-illness care practices, values, theories, and beliefs. Ethnonursing is the study of nursing care values, beliefs, and practices perceived and recognized by a chosen culture. Professional nursing care refers to the formal and learned professional care knowledge through educational institutions (Gonzalo, 2021). Lastly, cultural congruent nursing care refers to the supportive and cognitively-based acts that are customized based on an individual’s cultural values, beliefs, and lifeways to deliver or support meaningful, beneficial, and satisfying health care, or well-being services. Another essential theory concept is the sunrise model. This model, shown in the Figure, helps nurses make critical decisions and structure clinical care based on sequential steps. The same system shows that the model is fully interconnected, which means that nurses need to consider as many factors as possible when creating an individualized plan for culturally different patients. On this basis, Leininger’s model is not difficult to grasp, especially since its postulates are intuitively understandable. Nevertheless, it should not be assumed that this theory is highly flat or simplified.
Logicality and Clarity
This theory’s clarity and logical development derive from the assumption that patient culture plays a decisive role in shaping worldviews that are reflected, among other things, in treatment practices. From the position from which Leininger explained her theory, it seems quite clear and even intuitively coherent. However, the model itself relies on many abstract concepts: cultural care, environmental context, or client well-being. Precisely measurable are the national traditions of communities, be it the use of spiritual practices, local herbal ointments, or rituals of unconventional medicine to treat the patient. It is also clear that in order to use this model effectively, the nurse must be familiar with the patient’s culture, which means she needs to do outside research. If the patient in the U.S. is Indian, the nurse must be well versed in the basics of Indian culture in order to offer clinical solutions that would improve care. This seems logical, but it can be complicated because already busy nurses may not have free time to study different cultures.
Social Utility and Significance
This model is entirely socially relevant because its ultimate goal is to create conditions where the maximum number of patients will have the best quality clinical services. Nurses will perceive people from different regions, whether developing or developed countries, equally since the same research on their culture should be performed for everyone. In addition, this approach reduces stigma and discrimination by the treating staff because the nurse becomes more loyal and aware by learning about the patient’s culture. Leininger’s model is meaningful in part because it improves nursing theory and the overall experience of clinical staff by gaining additional knowledge. This is similar to the realization of globalizing practices, as greater integration occurs through learning the basics of other cultures. This may lead to new theories and research that take a cross-cultural approach in the long run.
From the perspective of verifiability and reliability, a medical practice must be based entirely on scientifically sound methodologies and principles. From this perspective, it seems that the synthesis of national healing practices and classical medicine may be questionable. However, we should not forget the existence of the placebo effect, in which the belief in the effect of practice (if it is not harmful) can lead to recovery. The presence of community traditions in terms of patient care may be realized as this placebo effect, reinforced by actual practices of clinical recovery. Meanwhile, Leininger’s theory is easily tested on different patients because it was not developed for just one sample. The sample of this model is all of humanity, and therefore no systematic error or subjectivity is created. Finally, Leininger’s theory is easily embedded in broader models, which allows us to judge its high validity.
Leininger’s model is actively practiced in clinical settings in ethnically diverse communities. When nurses have sufficient experience and knowledge, and time to learn about new cultures, they interact with the patient based on the patient’s cultural framework. For example, if a Muslim patient asks to change from a male to a female nurse, the clinic may go along with it. If an Asian patient asks for a national herbal ointment to be included in her care (and if such an ointment does not negatively affect her care), then the nurses can do so. In a world where migration and tourism are becoming increasingly important, the use of Leininger practices brings legitimate results.
Berhanu, Tesema, Deme, & Kanfe (2021) were chosen for analysis, which examined nurses’ transcultural self-efficacy. The article measured nurses’ subjectively perceived ability to influence assess their skills and knowledge to care for ethnically diverse patients cross-culturally. The overall finding of this study was that nurses generally moderated their perceived transcultural self-efficacy, with the specific outcome always depending on social and demographic characteristics. Thus, the more experience a nurse had in treating ethnically diverse patients, the higher her transcultural self-efficacy was. In addition, men were more likely than women to be more loyal to patients from other backgrounds. Finally, the more inclined a nurse was to have effective interpersonal communication, the more likely she would be transcultural self-efficacious later on.
Application of Leininger’s Theory Today
Today, in the context of extended globalization, the application of transcultural nursing theory proves to be critical. It is necessary to eliminate stigmatization and pressure from nurses to treat patients from other cultural communities. This helps to improve care, increases patient engagement, and creates a positive impression of the clinic. Thus, the use of this theory today brings significant benefits to medical practice.