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CHAPTER 22 Madeleine M. Leininger 429

related to improper care. Leininger’s demand for culture- Leininger & McFarland, 2002a, 2006). Funds to support
specific care based on theoretical insights has been criti- transcultural nursing are limited because biomedical
cal for the discovery of diverse and universal aspects and technical research funds head the priority list.
of care (Leininger, 1995c, 1996a, 1996b; Leininger & Transcultural nurses and other nurses interested in
McFarland, 2002b). A critical need remains for nurses to transcultural nursing research are continuing their
be educated in transcultural nursing in undergraduate research with limited funds. These nurses are leaders in
and graduate programs and for faculty prepared in sharing their research at conferences and instructional
transcultural nursing to teach and guide research in programs related to transcultural nursing. They have
nursing schools within the United States and in other been instrumental in opening doors to transcultural
countries (Leininger, 1995c, 1996b; Tom-Orne, 2002). nursing in many organizations. Transcultural nurses
An increasing number of nursing curricula em- have stimulated other nurses to pursue research and
phasize transcultural nursing and human care. One of discover new knowledge in nursing as reported in the
the early programs to focus on care was presented Journal of Transcultural Nursing.
during the 1970s at Cuesta College in San Luis Obispo, The ethnonursing study by McFarland (1995,
California, where care was developed as a central 2002), covered 2 years in the late 1980s, and compared
theme for an undergraduate program in nursing. Anglo-American and African-American groups living
Course titles included Caring Concepts I & II, Caring in a residence home for the elderly in one large Mid-
of Families, and Professional Self Care (Leininger, western United States city. This in-depth emic and etic
1984a). During the late 1980s, four master’s and culture care investigation revealed significant findings
four doctoral programs in the United States offered and highlighted the importance of using the three
transcultural nursing courses, research experiences, action and decision modes of the theory when caring
and guided field study experiences (Leininger, 1995c). for older adults. The culturally congruent care findings
Leininger received numerous requests to give courses, were as follows:
lectures, and workshops on human care and transcultural • Anglo-American and African-American older adults
nursing in the United States and other countries. The expect Culture Care preservation and maintenance
demand for transcultural nurses exceeded available of their lifelong generic or folk care patterns.
faculty, money, and other resources. As the last cen- • Doing for other residents rather than having a self-
tury ended, Leininger put out a call for schools care focus was a major care maintenance value for
of nursing to offer transcultural programs to meet both cultures and was a dominant finding.
the worldwide demand for many nurses and cultures • Protective care was more important to African-
(Leininger, 1995a, 1995b, 1996b). The programs are American than to Anglo-American older adults,
needed for practice and preparation for certification but nursing staff provided protective care and
of transcultural nurses. There is a need for research practiced Culture Care accommodation for both
and worldwide consultation. There are still inade- groups, such as accompanying them when they
quate research funds to study transcultural nursing desired to go for walks in the surrounding inner-
education and practice. Although the societal de- city neighborhood.
mand for transcultural nurses is evident, educational • African-American nurses practiced culture accom-
preparation remains weak and limited for nurses modation when they linked their emic care with
worldwide. generic care values and practices.
Culture Care maintenance-preservation and Cul-
Research ture Care accommodation-negotiation were new ways
Nurses today are using Leininger’s Culture Care Theory for nurses to provide culturally congruent and safe
worldwide. This nursing theory is focused specifically lifeways care practices for older adults of both cultures.
on Culture Care and with a specific research method Based on the findings, several institutional Culture
(ethnonursing) to examine the theory (Leininger, Care policies were developed to guide professional
1991b, 1995c; Leininger & McFarland, 2002a, 2006). older adult care. Application of the Culture Care
Approximately 100 cultures and subcultures had been Theory to advanced practice nursing has been expli-
studied as of 1995 (Leininger, 1991b, 1995c, 1996a; cated by McFarland and Eipperle (2008) proposing the