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CHAPTER 22 Madeleine M. Leininger 421

limits healing and well-being (Leininger, 1991b, 1995a, knowledge (1991b). The theory is neither a middle-
1995c; Leininger & McFarland, 2002a, 2006). range nor macro theory but is best viewed broadly with
Leininger (1991b) developed her Theory of Cul- specific domains of interest (1991b, 1995c; Leininger
ture Care Diversity and Universality, based on the & McFarland, 2002a, 2006). According to Leininger
belief that people of different cultures can inform and (2002c), the Theory of Culture Care Diversity and
are capable of guiding professionals to receive the Universality has several distinct features. It is focused
kind of care they desire or need from others. Culture explicitly on discovering holistic and comprehensive
is the patterned and valued lifeways of people that Culture Care, and it can be used in Western and non-
influence their decisions and actions; therefore, the Western cultures because of multiple holistic factors
theory is directed toward nurses to discover and found universally. It is purposed to discover compre-
document the world of the client and to use their emic hensive factors influencing human care such as world-
viewpoints, knowledge, and practices with appropri- view, social structure factors, language, generic and
ate etic (professional knowledge) as bases for making professional care, ethnohistory, and the environmental
culturally congruent professional care actions and context. It has three theoretical practice modalities
decisions (Leininger, 1991b, 1995c). Culture Care is a to arrive at culturally congruent care decisions and
broad nursing theory because it takes into account actions to support well-being, health, and satisfactory
the holistic perspective of human life and existence lifeways for people. The theory is designed to ulti-
over time, including the social structure factors, mately discover care—what is diverse and what is
worldview, cultural history and values, environmental universally related to care and health—and has a com-
context (Leininger, 1981), language expressions, and parative focus to identify different or contrasting trans-
folk (generic) and professional patterns viewed in cultural nursing care practices with specific care
terms of culture. These are some of the essential bases constructs. The ethnonursing method has enablers
for discovery of grounded care knowledge, which is designed to tease out in-depth informant emic data
the essence of nursing leading to the well-being of that can be used for cultural health care assessments.
clients and therapeutic nursing practice. The theory may generate new knowledge in nursing
The Culture Care Theory is inductive and deduc- and health care for culturally congruent, safe, and
tive, derived from emic (insider) and etic (outsider) responsible care.

MAJOR CONCEPTS & DEFINITIONS
Leininger developed terms relevant to the theory. or institutions that are learned, shared, and usually
The major terms are defined here, and one can access transmitted from one generation to another.
the full theory from her works (Leininger, 1991b,
1995c; Leininger & McFarland, 2002a, 2006). Culture Care
Culture Care refers to the synthesized and culturally
Human Care and Caring constituted assistive, supportive, enabling, or facili-
The concept of human care and caring refers to the tative caring acts toward self or others focused on
abstract and manifest phenomena with expressions evident or anticipated needs for the client’s health
of assistive, supportive, enabling, and facilitating or well-being, or to face disabilities, death, or other
ways to help self or others with evident or antici- human conditions.
pated needs to improve health, a human condition,
or lifeways, or to face disabilities or dying. Culture Care Diversity
Culture Care diversity refers to cultural variability or
Culture differences in care beliefs, meanings, patterns, values,
Culture refers to patterned lifeways, values, beliefs, symbols, and lifeways within and between cultures
norms, symbols, and practices of individuals, groups, and human beings.
Continued