N 491 Leininger’s Theory of Culture Care Diversity and Universality Case Study Assignment

Theories and concepts guide nurses to deliver care that meets patient needs and preferences. Cultural competency nursing implores nurses to develop patient care plans that meet their cultural needs and practices in diverse settings. Nurse theorists like Madeleine Leininger (1925-2012) and Jean Watson developed nursing theories to help guide interventions by nurses to improve the quality of care and patient outcomes (Smith, 2019). The purpose of this paper is to discuss, based on two case studies, the application of Leininger’s culture care model and Watson’s transpersonal caring theory.

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Using Leininger’s Culture Care Model: Case Study of Franklin-Jones

Leininger’s culture care theory entails knowing and understanding different cultures and their impact on nursing practices, beliefs, and values with the focus of offering better nursing care. The theory advances that various cultures have different approaches to care (Ares, 2021). The culture care theory focuses on the provision of culturally congruent nursing care by leveraging cognitively founded assistive, supportive, facilitative, and enabling actions and decisions that are customized to align with individual, group’s, and institutional or health population’s cultural values, beliefs, and ways of life.

1. i) Factors for Nurse to Consider When Planning for Franklin-White’s Discharge

The case study of Franklin-White shows a host of cultural issues that nurse Hernandez should consider while developing the discharge plan for the patient. These factors are essential and enhance the delivery of a culturally sensitive discharge care plan. They include the importance of taking medications as prescribed, the need to adhere to the appropriate diet, taking sufficient rest, and raising concern or caution over the consumption of herbal tea as a supplement. Nurse Hernandez should ensure that Mrs. Franklin-White adheres to effective medication as prescribed. The nurse must educate the patient about the need to take medications to attain the therapeutic levels in her system.

The nurse should also consider the Jamaican heritage of the patient and the cooking style as stressed, the family history, the strain associated with multiple jobs and being a single income earner as well as compounding educational barriers. The beliefs that Franklin-White possesses are also a concern for the nurse since they affect her adherence to medication taking. She also forgets to take medications due to these aspects. For example, she believes that bad pressure killed her mother and that the demands of multiple jobs may be a source of fatigue and loss of memory. The nurse should also consider the cultural practices associated with her cooing that she acquired in Jamaica (McFarland & Wehbe-Alamah, 2019). The nurse should consider these factors to ascertain if the patient is fit for discharge and develop an effective care plan.

1. ii) Significance of Using Leininger’s Culture Care Model for Patients

The main goal of care based on this theory is to fit or offer beneficial meaning and health outcomes for individuals with diverse or similar cultural backgrounds. Through this theory, nurses can work with patients and their families to offer healthcare that aligns with their customs, values, beliefs, and cultural practices (Ares, 2021). The theory allows nurses to make better decisions and create care plan designs that are culturally-sensitive hence providing holistic satisfaction to the patient without any biases or discrimination.

Leininger’s model stresses the importance of nurses understanding both the patient and her cultural values to help enhance the development of better care plans for effective recovery. Through the identification of cultural values and beliefs, the nurse can develop good rapport and create better patient-nurse relationships (McFarland & Wehbe-Alamah, 2019). The theory is also essential in ensuring that nurses offer care that is culturally-sensitive as they come to understand and appreciate the cultural beliefs, values, and practices of their patients. The theory also makes nurses accept diversity as a core component of patient-centered care delivery.

Leininger’s theory stresses the important role of cultural assessment that entails aspects like observation with nurses’ lenses, listening and being attentive, appreciation of generic folk practices as demonstrated by Mrs. Franklin-White who longs to have Jamaican cooking style and herbal tea, as well as the synthesis of themes and patterns to develop a plan of care collaboratively with the patient. The implication is that this theoretical perspective is categorical that nurses should develop effective plans of care to meet diverse patient needs and concerns.

iii) Plan of Care for Mrs. Franklin-White

The main aspect of this plan of care is to individualize or customize nursing care to meet the patient’s cultural aspects as captured in her explanation, especially her Jamaican culture and her diagnosis of acute myocardial infarction (McFarland & Wehbe-Alamah, 2019). The plan also entails working together with her to develop an appropriate dietary plan so that she does not have to learn new cooking styles. The plan should also focus on improving her memory so that she can take her medications. Therefore, as a nurse, Hernandez should have a conversation with the patient and her family, especially Tomas, to discuss these aspects of care. Through this approach, the nurse will have a comprehensive understanding of the cultural variables, health practices as well as patient beliefs.

The care plan should strive to preserve and maintain positive Jamaican cultural practices that can help her attain quality living. The core of this approach is to ascertain that she takes more of the traditional foods to deal with her diagnosis. The second aspect is to preserve aspects related to the preservation and preparation of foods and thirdly, talking to her about ways that she can integrate physical activity and exercises into her daily routine (Jeffreys & Zoucha, 2018). The last aspect is to re-pattern her way of life, especially if she can find a job that allows her to have sufficient time and rest while meeting her financial obligations.

1. iv) Strengths and Limitations of Leininger’s Theory

The theory is effective since it shows the relationship between universality and cultural care diversity among patients and nurses. Imperatively, nurses and other healthcare practitioners leverage this model to offer culturally-appropriate care based on a patient belief and value system. Additionally, the theory is flexible in such a manner that it applies to diverse situations and care diagnoses, especially in attaining the goals of culturally-sensitive care (Wehbe-Alamah, 2018). The theory is generalized and considers core aspects of cultural practices that nurses can leverage to offer patient-centered care (Ares, 2021). However, Leininger’s model requires nurses to have cultural competencies and understand its key terms. Furthermore, it can be difficult for nurses to develop culturally-appropriate interventions based on patients with multiple cultural backgrounds or diversity.

Case Study #2: Application of Transpersonal Caring Theory by Jean Watson

i). Jean Watson’s Caring Theory and Its Assumptions

Jean Watson’s theory of transpersonal or human caring incorporates ten carative factors that define the caring process. Based on these factors, Jean asserts that nursing is about health promotion, preventive approaches, caring for patients or the sick, and the restoration of health. The main concepts of this model include human beings, health, and nursing as well as the environmental factors that influence the caring process. The ten carative factors like the formation of a humanistic-altruistic value system, instilling faith-hope and cultivation of sensitivity to self and others, as well as the development of helping-trusting relationships form the core assumptions of this theory (Gunawan et al., 2022). The model also advances the expression of feelings, creative problem-solving caring process, transpersonal teaching and learning, having a supportive, protective, and corrective holistic environment, the gratification of human needs, and enabling existential-phenomenological-spiritual forces are critical to healthcare delivery.

The theory makes the assumption that nurses should demonstrate caring at an interpersonal level. The second assumption is that the carative factors are the primary considerations to satisfy certain human needs. The third assumption is that effective caring promotes the health of an individual or family. Additionally, the theory assumes that caring needs nurses to accept both the present and future health situations of their patients (Morrow & Watson, 2022). The fifth assumption is that having a friendly environment leads to a positive caring process. The theory also assumes that the science of caring complements the science of curing and this makes the caring practice a core component and part of the nursing process and practice.

1. ii) Role of Nursing Based on Caring Theory

The caring theory identifies the different roles of nursing in the process of delivering care to patients. The first role is an assessment where nurses observe, identify and review the problem that the patient presents while the second role is planning where they create an effective care model based on patient needs and preferences as well as their diagnosis. The third role of nursing care is to develop an appropriate intervention based on the care plan and the collected information. The theory also demonstrates the need for nurses to evaluate patients through the analysis and interpretation of their data and outcomes. The role of nurses in the case study of Mr. Jean-Baptiste is essential in aiding his outcomes (Morrow & Watson, 2022). The environment is appropriate based on the welcoming signage on the wall.

 The case shows that the nursing process and environment are important and align with Jean Watson’s carative factors. For instance, the nurses encourage him to bring food and spiritual resources as well as share the warmth of his culture with the staff. The center also has a translator who enables effective communication during conversations between the nurse and the patient, Jean-Baptiste. Through this friendly interaction and environment, the nurse can collect vital data and information to evaluate the patient’s overall recovery process.

iii). Meaning of the Concept of Love & Creation of a Healing Environment

Watson deliberately integrated the concept of love into the theory by evolving the carative factors into the Caritas process. Caritas is Latin for love and charity. The case study demonstrates the concept of love as the nurses are welcoming and warm to the patient. The patient can also incorporate his cultural care aspects and share the warmth of the culture with the nursing staff to aid his recovery. These actions depict the transpersonal relationship progresses.

Showing kindness and extending grace as well as a genuine interest in a patient’s true well-being leads to a healing environment for a patient as illustrated in Jean-Baptiste’s case. The development of trust with the patient by identifying the best way to interact with him and allowing him to share the warmth of his culture shows a healing environment (Gunawan et al., 2022). Teaching the patient self-care shows love and leads to the development of a healing environment.

1. iv) Strengths and Weaknesses of the Caring Theory

The theory’s strengths include being easy to understand and can be applied in guiding and improving nursing care. The second strength is its carative factors that form the foundation of the model and providers a supportive framework. The theory’s scope is large and promotes health, healing, and the development of a positive environment. However, a core limitation of the theory is its focus on patients and not nurses or healthcare providers. Again, the theory ignores the physical nature of illness and the needs that align with these characteristics or features. Despite these limitations, the caring theory remains one of the most effective nursing models in the promotion of a healing environment.

Conclusion

The two theories of cultural care and caring by Leininger and Watson are critical in nursing practice and allow nurses to develop better interventions to offer quality care. Watson’s model focuses on the care and associated interactions that help patients attain better outcomes. However, Leininger’s model is concerned with the cultural aspects of care and their effects on patient outcomes. While these theories have their shortcomings, they remain a vital part of positive care delivery and are used by nurses in diverse settings.

References

Ares, T. L. (2021). American Roma: A Cultural Care Case Study. Journal of Transcultural

            Nursing, 32(2), 111-118. DOI: 10.1177/1043659619899995.

Gunawan, J., Aungsuroch, Y., Watson, J., & Marzilli, C. (2022). Nursing Administration:

            Watson’s Theory of Human Caring. Nursing Science Quarterly, 35(2), 235-243.

 DOI: 10.1177/08943184211070582.

Jeffreys, M. R., & Zoucha, R. (2018). Cultural Congruence in the Workplace, Health Care, and

Academic Setting for Multiracial and Multiheritage Individuals. Journal of Cultural

Diversity, 25(4), 113–126. https://doi:10.1891/0739-6686.37.1.43

McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s theory of culture care diversity

and universality: An overview with a historical retrospective and a view toward the future. Journal of Transcultural Nursing, 30(6), 540-557. https://doi.org/10.1177/104365961986713

Morrow, M. R., & Watson, J. (2022). Nursing is the light in institutional darkness: A dialogue

            with Dr. Jean Watson. Nursing Science Quarterly, 35(1), 35-40.

DOI: 10.1177/08943184211051349.

Smith, M. C. (2019). Nursing theories and nursing practice. FA Davis.

Wehbe-Alamah, H. B. (2018). Leininger’s culture care diversity and universality theory: Classic

            and new contributions. Annual Review of Nursing Research, 37(1), 1-23.

DOI: 10.1891/0739-6686.37.1.1.

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Assignment Description:
Leininger and Watson

Write a 1500-1750 word APA paper addressing each of the following points. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least two (2) sources and the textbook using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.

Case study #1

Mrs. Franklin-Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction. She has recovered as expected and is moving to the cardiac step down unit today. She is talking with Nurse Julie Hernandez, as she gets settled in her new room, “I was really surprised when I got that bad pain in my chest! I knew I had high pressure but I just didn’t think it was that bad. I try to take my medicine like they told me to in the clinic but sometimes I forget. I guess that I need to study those papers they gave me about what foods I should eat and not eat. I better take care of myself! Momma had bad pressure and it killed her! Who knows—I may even have to learn to cook different than I was taught in Jamaica! I may have to let Tomas do the cooking. He’s got more time at home now than I do since he lost his job. There isn’t too much time between my shifts at the school cafeteria and my new housecleaning job. You know my sister is coming up from Jamaica to see me. I think she is bringing me some bush tea. That’ll set me right!”

Using Leininger’s Culture Care Model, what factors in the story shared by Mrs. Franklin-Jones should be considered by Nurse Hernandez when planning for the patient’s discharge?
Why is the theory of Culture Care Diversity important in the delivery of nursing care for all patients?
Using Leininger’s Theory of Culture Care Diversity and Universality, develop a plan of care for Mrs. Franklin-Jones.
Discuss the strengths and limits to Leininger’s Theory.

Case Study #2

Claude Jean-Baptiste is recovering from post-hip replacement surgery and has been transferred to the Rehabilitation Institute adjacent to the hospital. When he enters the unit, he sees welcoming signs written in several languages including his own, Creole. Since there are no nurses on that shift that speak Creole, they use a language line to ask for translation services. During this initial nursing assessment, the translator informs Mr. Jean-Baptiste that the nurses invite him to have a relative at his side so that they can be sure to understand and meet his needs. He is asked about Haitian customs and beliefs that they might honor. Mr. Jean-Baptiste is encouraged to bring food and spiritual care items, and to share the warmth of his culture with the nursing staff.

Discuss assumptions of the Transpersonal Caring relationship. What is the nurse’s role?
How is love, as defined by Watson, evident in this caring moment?
How can the nurse creatively use self to create a healing environment?
Discuss the strengths and limits to Watson’s Theory.

The following specifications are required for this assignment:
Length: 1500 – 1750 words; answers must thoroughly address the questions in a clear, concise manner.
Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment.
References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least two (2) scholarly sources to support your claims.
Format: Save your assignment as a Microsoft Word document (.doc or .docx).