Madeleine Leininger Theory: Transcultural Nursing

Madeleine Leininger: Transcultural Nusing Theory

Madeleine Leininger has defined Transcultural Nursing as a legitimate and imperative field of study and practice that focuses upon the comparative study and analysis of cultures with respect to nursing and health-illness caring practices to provide culturally congruent, safe and therapeutic care that is meaningful to people from culturally diverse backgrounds.

One of the origins of this theory is the increasing multiculturalism around the globe. With so many diverse cultures, each of them having different conceptions and methods of care, it is important for nurses to expand the dimension of care they have traditionally have utilized.

Leininger has named her nursing theory Cultural Care Diversity and Universality. The theory includes an enabler, serves as a conceptual guide or cognitive map to guide nurses in the systematic study of all dimensions of the theory. This map or guide is called the Sunrise Enabler.

Madeleine Leininger: Transcultural Nusing Model / Sunrise Enabler

madeleine leininger transcultural nursing sunrise model

Major Ideas of Cultural Care in Madeleine Leininger’s Transcultural Nursing Theory

Care – The Conceptual phenomena related to helping, supporting, or empowering experiences or behaviors toward others with evident or anticipated needs to improve a human condition.

Culture – The studied, shared, and handed values, beliefs, norms, and lifeways of a certain group that directs their thinking, decisions, and actions in certain ways.

Cultural Care – The subjectivity and objectivity obtained values, beliefs, and outlines of the lifeways that assist, support, facilitate, or empower another individual/group to maintain well being, health, and deal with illness, handicaps, or death.

Cultural Care diversities – indicates the variability of meaning, patterns, values or symbols of care that are culturally derived by humans for their well-being.

Cultural Care universality – The common, general definitions of care with its patterns, values, and symbols that is observed among many cultures and reflect assistive ways to help people.

World View – is the way in which people look at the world, or at the universe.

Social Structure – is defined as the interrelated factors that give meaning and structural order.

Environmental context – is the totality of the event, situation or particular experience that gives meaning to human expressions including social interactions, physical, ecological, emotional and cultural dimensions.

Folk health system – are traditional or local indigenous health care or cure practices that have special meanings and uses to heal or assist people.

Professional Health System – is defined as professional care or cure services offered by diverse health personnel who have been prepared through formal professional programs of study.

Cultural Values – are derived from the culture and identity desirable ways f acting or knowing and serve to guide decision making for members of the culture in application of culturally congruent care.


Madeleine Leininger identified three nursing decision and action modes to achieve culturally congruent care. All three modes of professional decisions and actions are aimed to assist, support, facilitate, or enable people of particular cultures. The three modes for congruent care, decisions, and actions proposed in the theory are predicted to lead to health and well being, or to face illness and death.

  1. Cultural preservation or maintenance: Retain and or preserve relevant care values so that clients can maintain their well-being, recover from illness, or face handicaps and/or death.
  2. Cultural care accommodation or negotiation: Adapt or negotiate with the others for a beneficial r satisfying health outcome.
  3. Cultural care repatterning or restructuring: Records, change, or greatly modify client’s life ways for a new, different and beneficial health care pattern.

This model may be viewed as having four level with the first level being the most abstract and the fourth level the least abstract. Levels one through three provide the knowledge base needed for the planning and delivery of culture congruent care. Level one is the world view and social system level, which directs the study of perceptions of the world outside of the culture. Level two provides knowledge about individuals, families, groups and institutions in diverse health systems. Level three focuses on the folk system, professional system, and nursing. Level four is the level of nursing care decisions and actions. It is in this level that care is delivered.


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