'Madeleine Leininger: Bridging the Cultural Divide Essay\r'

'Abstract\r\nThis paper result unwrapline Madeleine Leininger’s prominent surmise, its origins, and its purpose. The issue of trans pagan treat, its unequivocalive diction, ethnobreast feeding query method, and good morning Enabler tool bequeath similarly be explored. These components equipped defys to provide patients with individualized, appropriate divvy up; this led to improved health startcomes. Finally, the nitty-gritty of Madeleine Leininger’s contributions to treat will be examined. Her idea of congruent criminal maintenance was the gun for a multitude of federal statute law making refining a requisite, ratified consideration and convinced society of the benefits of pagan conversion. Madeleine Leininger: Bridging the ethnical Divide through mete out The hallmark of a true work is the ability to confront its unique corpse of familiarity (Mensik, Martin, Scott, & adenineere; Horton, 2011).\r\nMadeleine Leininger’s trans heathen breast feeding flying field and its revolutionary company scheme meets this threshold. Counted as â€Å"the most prodigious breakthrough in breast feeding…in the 20th century,” she forever changed how carrys estimation and talk near health vexation (Leininger, 2002, p. 190). This paper will present a high-level everywhere idea of Madeleine Leininger’s contributions to breast feeding and their charm, as well as reveal the author’s fellowship to the theorist.\r\nCultural explosive charge Diversity and catholicity: The supposition\r\nThe surmisal of market-gardening helper Diversity and Universality (hereinafter â€Å" horticulture plow speculation”), Madeleine Leininger’s seminal work, was conceptualized in the mid-1950s and want to describe, explain, and predict keeping for similarities and differences in relation to fearfulness and its authority in gentlemans gentleman culture (Leininger, 2001). To provide of import and effective carry on, the theorist reasonsed, a hold had to k straight off what various cultures valued about wellness, health, unsoundness, etc. and use this understanding to drive their treat tasks (Clarke, McFarland, Andrews & international deoxyadenosine monophosphateere; Leininger, 2009).\r\nInspiration for the conjecture\r\nThe scheme grew out of the theorist’s observations during her tenure as a ply draw in the mid-1940s (Leininger, 2001). Numerous patients exclamatory the â€Å"breast feeding manage” condition and remarked how implemental it was to their recovery from illness (Leininger, 2001, pp. 8, 13). This struck Leininger as curious, since the activities traditionally associated with providing feel for were just evaluate at this point in the training of nursing (Leininger, 2001). The concept of cope was sure never taught, critically explored, or given much credence (Leininger, 2001). Based on the encouraging patient feed posterior rece ived, deal became an intrinsic component of the theorist’s nursing practice (Leininger, 2001). Her patients’ health flourished (Leininger, 2001). Leininger deduced that outstanding caregiving unsocial was non enough to facilitate affirmatory health outcomes while working on an adolescent psychiatric ward in the mid-1950s (Leininger & angstrom; McFarland, 2002).\r\nHer clinical floor was a mini-United Nations, with patients from a variety of cultural backgrounds (Leininger & axerophthol; McFarland, 2002). The children responded divers(prenominal)ly to her care efforts and, after a period of snip, she realized their behavior followed distinct cultural patterns (Leininger & antiophthalmic factor; McFarland, 2002). For ex angstromle, the Russian, Lithuanian, German, and Slovenian children would never admit to being in infliction, though they had very obvious injuries or signs of b former(a)ation (Leininger & group A; McFarland, 2002). The Jewish and Italian child ren, in contrast, always cried fervently, at even the slightest chevvy prick, without solace (Leininger & McFarland, 2002). Her customary pain interventions were useless and obviously needed to be changed, but she was non sure how (Leininger & McFarland, 2002).\r\nConceptualizing the system.\r\nThe theorist experienced â€Å"culture rape” (a concept she introduced into common vernacular) and was concerned at being ill-equipped to respond to her patients’ limited needs even though she had obtained her passe-partout’s in nursing (Leininger & McFarland, 2002). There was no question writings available to help contain finger of the incidents witnessed, and her colleagues were of limited help (Leininger & McFarland, 2002). subsequently establishing her concerns with the renowned cultural anthropologist and provocateur Margaret Mead, Leininger obtained a Ph.D. in anthropology (Clarke, et al., 2009); she was the first nurse to do so (Leining er & McFarland, 2002).\r\nThe theorist performed theatre of operations studies in non-Western cultures for several years afterwards to hone her bare-assed skill-set (Leininger & McFarland, 2002). Having remedied her cultural ignorance, Leininger formalized the Culture Care surmisal, establishing the new discipline of transcultural nursing (Leininger & McFarland, 2002). Her goal was to provide knowledgeable care in an increasingly multicultural instauration (Leininger & McFarland, 2002).\r\nPurpose of the supposition\r\nThe opening’s main purpose was to â€Å" cave in and explain different and universal culturally based care factors influencing the health, wellbeing, illness, or wipeout of individuals or groups” (Leininger, 2002, p. 190). It stressed the use of â€Å" enquiry findings to provide culturally congruent, safe, and meaningful care to those of diverse or similar backgrounds” (Leininger, 2002, p. 190). Theory Application Tools. The theorist did not sine qua non to espouse platitudes; she wanted her discipline to put nurses and promote their autonomy (Leininger, 2002). To this end, she outlined xiii assumptive beliefs to explain the focus of the theory and move nurses in their practice (Leininger, 2001). some(prenominal) pick out beliefs are outlined on a lower floor: 1. Care is the essence of nursing and a… unifying focus\r\n2. Care (caring) is demand for well being, health, healing, growth…or slipmakers last 3. Culture care is the broadest holistic operator to know, explain, interpret, and predict nursing care… to guide nursing care practices 4. nursing is a transcultural…care discipline and traffic with the central purpose to serve human beings ballwide 5. Care (caring) is essential … for in that location can be no solidifying without caring (Leininger, 2001, pp. 44-45). These assumptions formed the crux of transcultural nursing and what it was intended to do . Leininger in addition drapedional three theoretical modalities to guide culturally-based nursing decisions and actions (Leininger, 2001). The first sense modality, â€Å"cultural care saving and/or maintenance,” referred to generic/ federation of tribes behaviors and practices that promote wellness and did not need to be changed when planning nursing care (Leininger, 2001, p. 41; Literature review, n.d.).\r\nThe next modality, â€Å"cultural care accomodation and/or negotiation,” involved nursing care activities which help patients of diverse cultures adapt or negotiate professional care activities (Leininger, 2001, p. 41). It turn out the nurse to integrate generic/folk behaviors and practices when planning care to encourage brawny outcomes (Leininger, 2001). Under this modality, for example, a nurse would provide a patient to hang a healing amulet above their be intimate in the hospital because they believed in it and it calmed them (Literature review, n. d.). The lowest modality that nurses could utlize was â€Å"culture care repatterning and restructuring” (Leininger, 2001, pp. 41-42).\r\nThis modality involved activities which see with the extensive modification, change, or repattering of a patient’s sickly behavior while remaining line up with their cultural values and beliefs (Literature review, n.d.). This was the most unmanageable of all the modalities to employ because the nurse must know a great pot about the patient’s culture to have an optimal outcome (Leininger, 2001). As with any plan of care, the nurse had to discuss their choices with the patient and obtain their jeerment (Leininger, 2001).\r\nMetaparadigms of the Theory\r\nSince the introduction of Florence Nightengale’s Environmental Theory, nursing frameworks had traditionally think on quaternion metaparadigms: person, environment, health, and nursing (Dayer-Berenson, 2011). However, the Culture Care Theory broke with conventio n and selected care and culture as its foundational concepts (Leininger, 2001). Leininger found the standard quartet metaparadigms limited in scope and contrary for use in new discipline (Leininger, 2001). For instance, the theorist could not believe nursing’s pundits still forsweard to acknowledge the indispensible role of care, though they had obviously witnessed its successful move on health (Leininger, 2001). She also considered the trustworthy trend of trying to explain nursing phenomenon with more nursing phenomenon a consistent fallacy akin to answering a question with another question (Leininger, 2001).\r\nFurther, Leininger pointed out that the Western concept of person would be problematic in transcultural nursing because more cultures focused on the family or an institution, rather than the individual (Leininger, 2001). While Leininger thought environment was important, she opted not to use it as a pillar of her theory because it was not unique to nursing or inflammatory enough to garner scarce seek funding (Leininger, 2001). She discounted the use of health for a similar rationale, citing its commonness and the plethora of existent research (Leininger, 2001). Leininger apsired to enlighten, not simulate (Leininger, 2001).\r\n happen upon definitions\r\nOther nursing theorists and researchers tried to shoe horn themselves into existing medical examination computer simulations as a means of gaining legitimacy, prestige, and funding (Fawcett, 2002). Leininger, conversely, sought to distinguish her theory from the disease-focused philosophies of the period by not seeking input from other disciplines; it functioned independently (Leininger, 2001). Always seeking to demonstrate the skill and intellect of nurses, Leininger authored a serial of definitions to provide clinicians with their own distinct language and, thus, avoid the incongruous use of medical terminology when practicing transcultural nursing (Leininger & McFarland, 20 02). several(prenominal) of the theory’s key explanations are highlighted below: 1. Culture Care refers to…culturally…assistive, supportive, and facilitative caring acts…\r\n2. Culture Care Diversity refers to cultural…differences in care beliefs, meanings, patterns, values, symbols, and lifeways…between cultures and human beings 3. transcultural nurse refers to a formal orbit of humanistic and scientific knowledge and practices focused on holistic culture care…phenomena..to assist … in culturally congruent…ways 4. Culturally Competent Nursing Care refers to…culturally based care and health knowledge in sensitive, creative, and meaningful ways …for beneficial… health and well-being… (Leininger & McFarland, 2002, pp. 83-84). â€Å"Cultural diversity” and â€Å"culturally competent care”, terms so common today, were penned by the theorist over 50 years ago (Leininger & McFarland, 200 2, p. xvii).\r\nInfluence of the Culture Care Theory\r\nLeininger’s theory generated little involution when it was introduced in the 1950s (Leininger, 2002). Nurses’ practices had begun to shift to involve more administration of medication and help with complex medical treatments (Leininger, 2001). Additionally, they tried to emulate physicians by wearing stethoscopes, focusing on curative measures, and being very punctilious in their tasks (Leininger, 2001). Nurses, during this era, were medicine’s constant â€Å"shot givers” (Leininger & McFarland, 2002, p. 76). Needless to say, this mental capacity was nurtured by physicians, who wanted nurses to remain on the periphery of healthcare, subservient to them (Fawcett, 2002).\r\nNurses, in Leininger’s opinion, willingly relinquished their power and debased their professional value by congruous so immersed in physicians’ procedures (Leininger, 2001). With nurses so intent on obtain ing medical logicalation, it was no impress they found the Culture Care Theory â€Å"soft,” â€Å"fuzzy,” and â€Å"too feminine” (Fawcett, 2002, p. 133; Leininger, 2002, p. 75). The theorist banteringly recalled thinking, â€Å"Nurses have no time to rent about care and cultures, as they must keep to medical tasks!” (Fawcett, 2002, p. 113). Patient care was not a priority (Fawcett, 2002).\r\n reservation the Theory Relevant\r\nUndeterred by the initial chilly reception, Leininger resolved to make the discipline more relevant to nurses (Leininger, 2001). She knew the web site would change gradually over time and utilized the lull to cast up the make out of transcultural nurses in practice and civilized the harvest of more cultural selective information for use in the field (Fawcett, 2002). transcultural Programs of Study. She developed and taught courses in transcultural nursing (Leininger, 2001). Building upon this momentum, the theorist then c ompleted several degree programs of study in transcultural nursing (Leininger, 2001). She steered nurses toward graduate-level courses in anthropology as well, and served as their advisor when several of them keep on to doctoral studies (Leininger, 2001; Leininger & McFarland, 2002). Soon, she had amassed a hardy band of transcultural devotees to assist in her tireless promulgation and support of the discipline (Leininger, 2001).\r\nEthnonursing Research Method. As her followers began to utilze the theory, Leininger was compelled to develop a natural, inducive, and open research method to help â€Å"tease out” complex, covert, elusive cultural data (Leininger & McFarland, 2002, pp. 85, 89). It was called the ethnonursing research method (Leininger & McFarland, 2002). At the time, clinicians utilized research tools and methods borrowed haphazardly from other fields (Leininger & McFarland, 2002). Enablers. The theorist upset(a) that valuable cultural knowledg e was lost, concealed, or rendered useless from the improper use of duodecimal instruments to perform qualitative research (Leininger & McFarland, 2002). In response, Leininger invented five tools she called enablers to facilitate the tap of cultural data (Leininger & McFarland, 2002). each(prenominal) enabler was designed to collect a different type of qualitative information (Leininger & McFarland, 2002). The most popular enabler, The Sunrise Enabler to tell on Culture Care, was a conceptual model of the entire theory (Appendix A).\r\nIts purpose was to systematically guide nurses through seven areas of knead to find relevant cultural knowledge and provide a holistic view during the health assessment process (Leininger & McFarland, 2002). Qualitative Criteria. To and support exact interpretations and credible research findings, Leininger identified six-spot criteria by which qualitative studies, like those performed with her ethnonursing method, could be ev aluated (Leininger & McFarland, 2002). The criteria â€Å"credibility, confirmability, meaning-in-context, recurrent patterning, saturation, and transferability” received the phiz of research experts, which led to qualitative data’s acceptance as valid scientific evidence. (Leininger & McFarland, 2002, p. 88) Dedicated Re generators. Leininger also established the transcultural Nursing club in 1974 as a gathering for intelligent discussion among nurses in the discipline, as well as to aid the dispersal of transcultural information (Clarke, et al.). Finally, Leininger launched the daybook of transcultural Nursing in 1988 to serve as a dedicated publishing source for transcultural nursing research, ensuring the entire nursing profession also had access to her protegés’ useful findings (Clarke, et al.).\r\nRise of the Theory\r\n aft(prenominal) existing in near profoundness for several decades, the Culture Care Theory was thrust into the spotlight in the mid-1980s (Murphy, 2006). Several factors prompted its emergence from the shadows. First, just as Leininger predicted back in 1950, geographic borders shrank and the U.S. became the adopted countrified of choice for immigrants from all over the world (Leininger, 2002). The healthcare system became innudated with people clinicians did not understand and could not effectively assist (DeRosa & Kochurka, 2006). Desparate to address patients’ needs in a culturally respectful manner, they notice Leininger’s blueprint for congruent care (DeRosa & Kochurka, 2006).\r\nThe federal mandates of the 1990s further catapulted the Culture Care Theory into swelling (Murphy, 2006). The directives were designed to resolve disparities in healthcare and ensure equitable treatment for those from diverse backgrounds (Maier-Lorentz, 2008). This meant that schoolman programs, clinical settings, and healthcare agencies now had to promote, incorporate, and enforce Leiningerâ⠂¬â„¢s ideas of cultural competence (Murphy, 2006).\r\nImpact of the Theory on the informant\r\nThe Culture Care Theory, developed organically from one woman’s perceptive observations, has left an indellible mark on not only nurisng, but education, medicine, law, social science, religion, and so forth (Leininger, 2002). It would be far easier to break the areas of society that the theory has not impacted, for that would be a much shorter list. Amazingly, the author also owes Madeleine Leininger a tremendous amount of personal gratitude. While conducting research, the author was stunned to let on that Leininger’s theory was the motivation for her academic comprehension. The theorist’s emphasis on congruent care and its positive influence led to the Health Resources and Services presidency’s (HRSA) campaign to significantly increase the number of culturally competent healthcare professionals in critical shortage areas. The adjudge Corps Scholarship Program, which offers a abounding tuition grant, monthly stipend, and full-time mesh to intellectually outstanding nursing students, was founded to follow up this objective.\r\nBecause of the theorist’s tenacity and zeal, this proximo clinician’s ambition to serve the underrepresented was do a debt-free reality. Leininger passed away in imperious of last year (Ray, 2012). Ironically, the author was awarded her scholarship during this same month. Janet Jones wrote in Leininger’s obit guest book entry, â€Å"She truly was a visionary and her work will bear to be of great significance to many more generations of nurses” (Madeleine M. Leininger, Ph.D., 2012). The author could not agree more with this statement and, in tribute, intends to commit to Leininger’s legacy of nursing honesty by maintaining a culturally-informed practice, performing research that offers innovative knowledge to the profession, obtaining an advanced degree, and share as a staunch suggest for the marginalized. Similar to the theorist, the author also pledges to refuse to accept limitations as to what a nurse can accomplish. The author believes Madeleine Leininger would expect no less.\r\nReferences\r\nClarke, P., McFarland, M., Andrews, M., & Leininger, M. (2009). Caring: some reflections on the impact of the culture care theory by McFarland & Andrews and a communion with Leininger. Nursing Science Quarterly, 22(3), 233-239. doi:10.1177/0894318409337020 Dayer-Berenson, L. (2011). Cultural\r\ncompetencies for nurses: Impact on health and illness (pp. 9-39). Sudbury, Mass: Jones and bartlett pear Publishers. DeRosa, N., & Kochurka, K. (2006). see culturally competent healthcare in your workplace. Nursing Management, 37(10), 18-18, 20, 22 passim. Fawcett, J. (2002). Scholarly dialogue. The nurse theorists: 21st-century updates †Madeleine M. Leininger. Nursing Science Quarterly, 15(2), 131-136. Jeffreys, M. R. (2010). Teaching cul tural competence in nursing and health care inquiry, action, and innovation (2nd ed.). (pp. 9-10). New York: customs publish Company. Leininger, M. M. (Ed.). (2001). Culture care diversity and universality: A theory of nursing. capital of Massachusetts: Jones and Bartlett Publishers. Leininger, M., & McFarland, M. (2002). transcultural nursing in the new millennium: Concepts, theories, research & practice (3rd ed.). New York: McGraw-Hill. Leininger, M. (2002). Culture care theory: a major(ip) contribution to advance transcultural nursing and practices. Journal Of Transcultural Nursing, 13(3), 189-192. Literature review. (n.d.). Retrieved from http://uir.unisa.ac.za/bitstream/ extend/10500/1555/02chapter2.pdf Madeleine M.Leininger, Ph.D. (2012). Retrieved from http://www.heafeyheafey.com/newobituary/display.asp?id=7022 McFarland, M., & Eipperle, M. (2008). Culture care theory: a proposed practice theory guide for nurse practitioners in primary care settings. Contemporar y Nurse: A Journal For The Australian Nursing Profession, 28(1-2), 48-63. doi:10.5172/conu.673.28.1-2.48 Maier-Lorentz, M. (2008). Transcultural nursing: its importance in nursing practice. Journal Of Cultural Diversity,15(1), 37-43. Mensik, J. S., Martin, D., Scott, K. A., & Horton, K. (2011). victimization of a Professional Nursing mannikin: The Journey Toward Nursing Excellence. Journal Of Nursing Administration, 41(6), 259-264. doi:10.1097/NNA.0b013e31821c460a Murphy, S. (2006). Mapping the literature of transcultural nursing. Journal of the Medical Library draw : JMLA, 94(2 Suppl), E143-51. Ray, M. A. (2013). Madeleine M. Leininger, 1925â€2012. Qualitative Health Research, 23(1), 142-144. doi:10.1177/1049732312464578 Sagar, P. (2011). Transcultural nursing theory and models: application in nursing education, practice, and administration. New York: Springer Publishing Company. Sitzman, K., & Eichelberger, L. W. (2011). Understanding the work of nurse theorists: a c reative beginning (2nd ed.). (pp. 93-98). Sudbury, Mass.: Jones and Bartlett Publishers.\r\nTranscultural Nursing Society. (n.d.). Theories and models. Retrieved from http://tcns.org/Theories.html\r\nAppendix A\r\nFigure. Adapted from Transcultural Nursing Society. (2013). Theories and models. http://tcns.org/Theories.html. Reprinted with permission.\r\n'