MarceloTheoryAnalysisPaperNURS502.docx.pdf

Running head: THEORY ANALYSIS PAPER 1

Theory Analysis Paper

Jonna Marcelo

Liberty University

THEORY ANALYSIS PAPER 2

Theory Analysis Paper

Theory analysis involves a systematic, objective, and detailed examination of a theory for

its content, structure, and function with the main aim of acquiring a deeper understanding of a

theory’s framework (McEwen & Wills, 2014). This paper will examine Leininger’s Cultural

Care Diversity and Universality Theory using the two-part approach of Theory Description and

Critique designed by Chinn and Kramer for theory analysis. Leininger’s theory has been

the most specific focus and is concrete in its level of abstraction. Chinn and Kramer’s model

involves the use of the six concepts of theory description: purpose, concepts, definitions,

relationships, structure and assumptions (McEwen & Wills, 2014). Critical reflection transpires

The purpose of Leininger’s theory is to identify, determine, detail, and explain the

interdependence of care and culture phenomena with differences and similarities between and

among cultures (McFarland & Wehbe-Alamah, 2015). The aim of the theory is to discover

human care differences and similarities in relation to cultural dimensions to provide culturally

congruent care with people of various cultures to maintain or regain their health or well-being, or

to face death in a culturally appropriate way (Alligood, 2018). It is also intended to generate

knowledge regarding the nursing care of people who place importance on their cultural heritage

and lifeways (McEwen & Wills, 2014).

THEORY ANALYSIS PAPER 3

Concepts

The major concepts discussed in Leininger’s theory are culture, culture care differences

(diversities) and similarities (universals) related to culturally congruent care (McEwen & Wills,

2014). Other major concepts are care and caring, emic view and etic view, culture care modes,

and worldview (Alligood, 2018).

Definitions

expressions of assistive, supportive, enabling, and facilitative ways toward self or others

(Alligood, 2018). Caring, on the other hand, is defined by Leininger in two ways: generic and

professional. Caring, in the generic sense, refers to those assistive or supportive acts towards or

direct actions, decisions and thinking in a patterned way (McFarland & Wehbe-Alamah, 2015).

Culture care refers to the synthesis of culture and care that promotes the discovery and

explanation of the health, well-being, care expressions and other human conditions (Alligood,

2018). Culture care diversity refers to inconsistencies or differences in culture care beliefs,

values, meanings, patterns, and other features among human beings associated with providing

valuable care for clients in a designated culture (Alligood, 2018). Culture care universality, on

the other hand, refers to commonly shared cultural care phenomena features of human beings

that serve as a guide in providing assistive, supportive, and facilitative care for healthy outcomes

THEORY ANALYSIS PAPER 4

(McFarland & Wehbe-Alamah, 2015). Leininger wanted to identify differences and similarities

between and among cultures to differentiate between the client’s insider knowledge (emic) in

contrast with the researcher’s professional knowledge (etic). Emic view refers to specific

language expressions, beliefs, perceptions, and practices of a particular culture in regard to

certain events (McEwen & Wills, 2014). Etic view, on the other hand, refers to collective

language expressions, beliefs or practices in regard to certain events that pertain to several

out on their world or universe to generate a picture or value stance about life or the world around

them (Alligood, 2018). Culturally congruent care is the use of sensitive, creative and meaningful

ways to aptly fit the cultural values, beliefs, and lifeways of clients for their health and well-

influencing care patterns and expressions (McFarland & Wehbe-Alamah, 2015). This model

interconnects Leininger’s concepts and forms a structure that is functional in practice, especially

when conducting cultural assessments. The model provides a systematic way to ascertain the

beliefs, values, meanings, and behaviors of people. The dimensions of the Sunrise Model

include technological, religious/philosophical, kinship/social, cultural values, beliefs and

lifeways, political/legal, economic, and educational factors. These factors influence culture care

expressions and patterns concurrently with the folk, professional, and nursing care systems

depicted in the Sunrise Enabler model (Alligood, 2018).

THEORY ANALYSIS PAPER 5

Structure

Nurses use the three culture care modes for providing culturally congruent nursing care:

culture care preservation or maintenance, culture care accommodation or negotiation, and culture

care repatterning or restructuring as illustrated in the Sunrise Enabler to Discover Culture Care

model. McFarland & Wehbe-Alamah (2015) defined these three culture care modes as follows:

culture care preservation refers to the actions and decisions of a nurse that help cultures to retain,

negotiation requires the nurse to help cultures adapt or to negotiate with others for culturally

congruent, safe, and effective care; and culture care repatterning or restructuring refers to the

nurse’s professional actions and mutual decisions that would help people to reorder, change,

Assumptions

The assumptions of Leininger’s theory are explicitly stated. According to McFarland &

Wehbe-Alamah (2015), the assumptive premises of the theory are the following:

1. Care is the essence of nursing and a distinct, dominant and unifying focus. It is essential

for well-being, health, healing, growth, and to face death. Caring is essential to curing

and healing. There can be no curing without caring.

2. Culture care is the broadest holistic means for a nurse to explain, interpret and predict

nursing care phenomena to guide nursing practice.

THEORY ANALYSIS PAPER 6

3. Nursing is transcultural, humanistic and scientific care profession with the central

purpose of serving human beings worldwide.

4. Culture care concepts, meanings, expressions and structural forms of care are different

and similar among all cultures of the world. Every human culture has lay care knowledge

and practices and usually some professional care knowledge and practice which vary

among cultures.

community values, expressions and patterns are known and used appropriately, and in

meaningful ways by the nurse with the people.

Critical Reflection

constructs utilized in the development of the theory. Several terms were created in the theory’s

development such as lifeways and worldview, but these were explicitly and clearly defined and

identified in the theory.

Semantic consistency means that the concepts in the theory are used in ways that are

consistent with their definition (McEwen & Wills, 2014). The purpose of Leininger’s theory,

definitions of the concepts and the relationships between the concepts are consistent all

throughout in the theory. The same concepts developed in the theory are still widely applicable

with relevance in diverse clinical settings encountered in nursing practice.

THEORY ANALYSIS PAPER 7

Structural Clarity and Consistency

Structural clarity refers to how identifiable, apparent, and easily understandable the

connections and reasoning within the theory are (McEwen & Wills, 2014). The conceptual

network can be readily identified and the concepts are interconnected. Culture care theory is

structured as a whole and has been independently developed and thoroughly constructed as a

highly relevant theory to determine the care and health needs of diverse cultures in hospitals,

Structural consistency refers to the consistent use of structural forms within a theory

(McEwen & Wills, 2014). The culture care theory is directed towards individuals, families, and

groups in diverse healthcare settings. It is a broad scope theory that is useful and applicable, not

worldwide to help guide nurse researchers to conceptualize theoretically based research

questions, leading to results that steer and shape nursing practice (McFarland & Wehbe-Alamah,

2015). It is holistic and comprehensive, with key constructs related to worldview and key

cultural and social structure dimensions as represented in the Sunrise Enabler allowing for

illustrations of conceptual interrelationships and diverse social structures that impact care and

health (McFarland & Wehbe-Alamah, 2015). Even if multiple concepts are presented in the

theory, its simplicity lies in the applicability, relevance, ease of understanding and usefulness of

the theory’s constructs in nursing research and education.

THEORY ANALYSIS PAPER 8

Generality

The culture care theory demonstrates the criterion of generality because it is broad,

comprehensive, and worldwide in scope. The theory allows the nurse to provide nursing care

from the viewpoint of a multicultural worldview. It is functional and suitable for groups and

individuals with the goal of providing culture-specific nursing care (McFarland & Wehbe-

Alamah, 2015). Numerous features such as culture, care, and health have been recognized as

for research, and findings are appropriate for nurses in any setting who work with individuals,

families, and groups from a cultural background that is different from the nurse’s (McEwen &

Wills, 2014).

study and research conducted in various cultural settings. In the last 20 years, research on

assorted cultural groups was conducted and Leininger has listed cultural values and culture care

meanings and action modes for 23 cultural groups in her books (McEwen & Wills, 2014).

Ongoing and future research is expected to reveal additional culture care and health findings with

repercussions to the provision of culturally congruent care practices. The essence of

transcultural nursing knowledge that has been discovered has had an impact on professional

nursing care practices and on the composition and function of many health care systems

(Alligood, 2018).

THEORY ANALYSIS PAPER 9

Importance

The theory of culture care diversity and universality has guided the provision of nursing

care for significant and valuable client outcomes, culture care knowledge acquisition and

application (McFarland & Wehbe-Alamah, 2015). The theory is highly functional, pertinent,

and crucial to nursing practice, consultation, education, leadership, research, and administration.

The concept of care as the central focus of nursing and the basis for building nursing knowledge

care practices (Alligood, 2018). The social structure factors of the Sunrise Enabler and the three

culture care modes of decisions and actions serve as a guiding framework in the provision of

culturally congruent care. The theory of culture care diversity and universality supports a sound,

Kramer for theory analysis. It is a holistic human care theory in nursing with a lasting impact in

nursing practice and is valued worldwide. It influences interpersonal nursing care practices by

considering cultural differences, resulting in cultural sensitivity, cultural awareness, and cultural

competence. The theory reflects innate nursing values and helps one gain fresh insights about

care, health, and well-being in a culturally appropriate manner. It also specifically guides

nursing research to further broaden the knowledge and understanding of different cultures. The

theory will continue to evolve and remain useful in the future to guide the provision of culture

care in our increasingly diverse world (McFarland & Wehbe-Alamah, 2015).