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430 UNIT IV Nursing Theories

theory as a “ . . . foundational basis for the educational Burk, 2012). The method has been adapted for use in
preparation, primary care contextual practice, and out- retrospective metasynthesis studies as the Metaeth-
comes-focused research endeavors of advanced prac- nonursing Research Method. McFarland, Webhe-
tice nursing” using the three modes of care, the Alamah, Wilson, and Vossos (2011) conducted a
enablers, and the ethnonursing method. The authors retrospective analysis of 24 doctoral dissertations
emphasized integration of culturally congruent or sen- based on the Culture Care Theory, presenting a syn-
sitive care through direct and explicit approaches to be opsis of their findings which were found to be “...both
used by the nurse practitioner, who “ . . . needs to be interpretive and explanatory, and further conceptu-
able to sensitively and competently integrate Culture alized from the themes and patterns of the original
Care into contextual routines, clinical ways, and dissertation studies” and entailed “...new theoretical
approaches to primary care practice through role mod- formulations based on the Culture Care Theory [with
eling, policy making, procedural performance and discovered] recommendations related to nursing
performance evaluation, and the use of the advance practice . . . . [which were] predicted to make a sig-
practice nursing process” (McFarland & Eipperle, nificant contribution to the discipline and practice of
2008). Concepts and methods for integrating emic and nursing as well as the epistemic and ontologic basis
etic care approaches into primary care practice mo- of culture care knowledge and evidence-based best
dalities and the use of the education-research-practice practices” (p. 24).
continuum as the basis for clinical actions and deci- Leininger calls for all professional nurses in the
sions are presented. world to be prepared in transcultural nursing and
demonstrate competencies in transcultural nursing
(Leininger, 1981, 1995c; Leininger & McFarland,
Further Development 2002a, 2006; McFarland & Eipperle, 2008). Trans-
Leininger continues to develop the theory and the cultural nursing must become an integral part of
application of the theory and the ethnonursing education and practice for nurses to be relevant in
research method. The theorist further explicated the the twenty-first century (Mixer, 2011). Currently,
concept of Father Protective Care, which is manifested the demand for prepared transcultural nurses far
differently in Western and non-Western cultures. exceeds the numbers of nurses, faculty, and clinical
Leininger (2011) focused her research “ . . . on the specialists in the world. More transcultural nurse
subtle, hidden, obscure, and diverse expressions and theorists, researchers, and scholars are urgently
examples of father protective care” in Western and needed to continue to develop the body of transcul-
non-Western cultures (p. 1). The construct of Collab- tural knowledge and transform nursing education
orative Care was presented by McFarland (2011) in and practice. By the year 2020, all nurses will need
her keynote address “The Culture Care Theory and a basic knowledge about diverse cultures in the world
Look to the Future for Transcultural Nursing” at the and in-depth knowledge of at least two or three
37th Annual Conference of the International Society cultures (Leininger, 1995c, 1996a). Leininger be-
of Transcultural Nursing in which Dr. Leininger lieves that transcultural nursing research has begun
participated via videotape. The construct of Collab- to lead to some highly promising and different
orative Care refers to those values, meanings, and ways to advance nursing education and practice
expressions by persons that reveal a desire for work- (Leininger & McFarland, 2002a, 2006). All health
ing together in order to attain and preserve health and disciplines, including medicine, pharmacy, and so-
well-being for oneself and others. cial work, are incorporating transcultural health
The Ethnonursing Research Method “can be useful knowledge and practice into their programs of
for research that addresses providing care in other dis- study. This trend is increasing the demand for com-
ciplines including education, administration, physical/ petent faculty in transcultural health care. Leininger
occupational/speech therapy, social work, pharmacy, (1995c) believes that the development of transcul-
medicine, and disciplines in which the meaning of tural institutes is essential to fill the growing need
research findings has implications for human care for transcultural nurses prepared to work with other
and health” (McFarland, Mixer, Webhe-Alamah, & disciplines.