Madeleine Leininger’s Transcultural Nursing Theory

 Description of Transcultural Nursing Theory
	Since its adoption into nursing in the mid-1950’s, TCN has improved the care nurses offer their clients around the world. As one of the oldest and widely used theories, TCN continues to improve upon patient outcomes (Leininger, 2002). Chinn and Kramer’s (2010) evaluation method offers six focuses to assist in defining theory. 
Purpose and Concepts
	TCN recognized the commonalities of care but emphasizes the need to apply cultural care differences in improving client outcomes (Leininger, 1996). Leininger believed care is the essence of nursing and there can be no curing without caring (Leininger, 1999). Leininger (1996) formed three dominant action and decision modes essential for the nurse to apply TCN to their care: culture care preservation and maintenance, culture care accommodation and/or negotiation, and culture care restricting and repatterning (Leininger, 1996).
Definitions
	Leininger (1999) created TCN to be incorporated into nursing practice foundations to maintain or regain the health of clients applying sensitivity to cultural beliefs. Leininger (1996) defined all aspects of TCN including the meaning of culture, care, culture care, and nursing. Definitions are informative and simple leaving little to be assumed. Leininger defines the problems of nursing care without TCN and the improvements available when the correct application of TCN is utilized (Leininger, 1996).
Relationships and Structure
	Leininger’s TCN theory focuses on bringing the health practices learned in nursing school and applying them to the cultural backgrounds of clients (Leininger, 1999). To improve upon the application of TCN Leininger formed the sunrise model and the ethnonursing qualitative research method. The sunrise model demonstrates and guides a holistic view of TCN (Leininger,1996). The sunrise model helps to educate and direct nurses through multiple factors while utilizing TCN in clinical practices (Leininger, 1996). The ethnonursing method was developed to obtain detailed information on cultural needs and the evolution of those needs (Leininger,1996). Other research methods were used from different practices but failed to meet the application needed for nursing (Leininger,1996).
Assumptions
Leininger focused her assumptions of TCN on the improved well-being of a client when nursing care met cultural needs. Leininger (1999) defines 11 premises’ that relate to improving patient outcomes combining caring, curing, and culture. TCN assumes sensitivity for cultural needs will help guide the care of patient needs. 
Critical reflection of Transcultural Nursing Theory
The second phase offered by Chinn and Kramer (2010) for evaluating theory is critical reflection. This evaluation allows a critique of the application of theory in practice. Leininger’s transcultural nursing theory has been around for many decades proving it’s benefits to the nursing field. Chinn and Kramer’s (2010) evaluation method offers five focuses to assist in a critical reflection of a theory.
Clarity and Simplicity
	Madeline Leininger appears to have taken her time in forming TCN. She wrote several documents on the continued clarity and application of TCN throughout the many decades it has been around. Clarity is made in the application of improving upon patient outcomes through improving upon caring. Leininger quotes many times, “There can be no curing without caring, but caring can exist without curing” (Leininger, 1996). Leininger simplifies TCN from the beginning with an explanation to her theoretical beliefs (Leininger, 1999). The sunrise model was formed as a simple guide in helping nurses work through the application of TCN (Leininger, 1999). The Ethnonursing method assists in breaking down the needs to align culture and care.
Generalizability
	Although formed to improve patient outcomes using culture in care, Leininger’s TCN theory applies to several other fields of patient care. TCN is used in education, research, policies, and nursing care plans (Leininger, 1999). Leininger formed the theory to be able to be used in any culture around the world (Leininger, 1999). 
Accessibility
	Transcultural nursing theory has been made readily available around the world. The focus of TCN is to bring the cultures home. The function of the Ethnonursing method in research has increased the application and accessibility of both theory and method worldwide (Leininger, 1999). The simplicity of the sunrise model increases the accessibility of TCN by offering a simplified guide to the foundation of the theory. 
Importance to Nursing
	Leininger saw the need to improve the care she offered her patients. Leininger believed cultural factors and humanistic care in nursing would improve upon patient outcomes (Leininger, 1999). Through her belief that curing cannot happen without caring, Leininger formed TCN to educate the nursing field in the holistic needs of patients (Leininger, 1999). As the world of nursing continues to grow, the nurse must be more aware of the cultural needs of their clients. From basic bedside cares, to implementing policies and procedures, cultural sensitive care will improve quality.
Conclusion
Early nursing care had less benefits of culture sensitive care that it does today. Madeleine Leininger’s theory on transcultural nursing was ahead of the times in the 1950’s. Modern nursing has evolved into a melting pot of culture. Starting with education, using TCN to educate the new nurse in the needs of cultural focused care will improve upon the inexperienced services they offer. As a nurse progresses into the level of expert nurse, the intuitive application of cultural needs will increase patient outcomes. TCN has been around and utilized for over 60 years, guiding improvement to the care of clients and improving research opportunities. Leininger formulated a well thought out theory that has shown its true colors with benefits seen around the world in many fields of study.
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References
Leininger, M. (1996). Culture care theory, research, and practice. Nursing Science Quarterly, 9(2), 71-78.
Leininger, M. M. (1999). What is transcultural nursing and culturally competent care. Journal of Transcultural Nursing, 10(1), 9.
Leininger, M. (2002). Culture care theory: A major contribution to advance transcultural nursing knowledge and practices. Journal of Transcultural Nursing, 13(3), 189-192. doi:10.1177/10459602013003005