Nursing Theory Critique Paper Example


One of the most widely recognized nursing theories is the Transcultural Nursing Care Theory. The researcher, who coined the idea, is believed to be the draftswoman of nursing cultural theory. Since she began her writings in the 1960’s, Madeleine has become one of the influential researchers in the field of transcultural nursing. The theory attempts to provide culturally compatible nursing care, while using acts that are supportive and facilitative. Moreover, it suggests tailor-made decisions that fit within institutional, group or individuals’ lifeways, cultural values and beliefs. The main purpose of Leininger’s care is to have beneficial institutional results and also present positive health outcomes to people with similar or different cultural backgrounds (Leininger, 2008). In order to understand the theory, a critique of its ideologies and concepts is important.


Leininger’s theory is based on several terms that are addressed in the framework. The major ideas include care, caring, culture, culture care, and health concepts among others. Care has the aim of improving human condition based on their real or perceived needs. Caring is the activity or actions that are focused towards care providence. Culture defines the values, norms and beliefs that are either transmitted or shared among individuals or groups, which guide their way of living, actions and decisions. Culture care includes multiple cultural aspects that influence behavior of individuals or groups when encountering death, illness or human health conditions. In the theory, culture care diversity is defined as the acceptable differences in values and perceptions among different groups of people. The term cultural care universality is identified as the similar meanings or common care features that are present in different cultures. Leininger presents nursing as the learned profession that is oriented towards care phenomenon. Finally, health is the state of well-being that is valued and demarcated by a selected culture (Leininger & McFarland, 1993).

Apart from the defined concepts, Leininger’s theory is based on several assumptions that are related to the defined concepts. Firstly, care is assumed to be the essence of nursing, which is also dominant and distinct with a fusing focus. The second assumption is that caring is necessary for health, healing, well-being or when facing death. The statement is different from the first claim, as it sees culture care as the wide field and also the rounded mean. It requires a nurse to perceive, explain, predict and understand nursing care with the purpose of directing care practices. In fact, the researcher assumes that caring is crucial to healing and curing with to the degree that curing cannot exist without caring. The third assumption is that nursing is humanistic, scientific and transcultural care profession and discipline that has a central purpose to serve human beings around the world. However, culture care concepts, expressions and meanings are similar and at the same time different for the world cultures (Leininger & McFarland, 1993).

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The fourth assumption of a theory is that every human culture has its own practices and knowledge of care, and some of them vary between cultures. Thus, the theory assumes that cultural beliefs, practices and values are based on the context of a certain culture. In addition, the perceptions are rooted on kinship, spirituality, language, economics, politics, environment as well as technology. The theory also assumes that culturally-based care that is satisfying, healthy and beneficial contributes not only to individuals’ welfare, but also to that of families and communities in the environmental context. Culturally competent care is only possible with proper knowledge of community, family and the patient’s values and expressions. Therefore, the differences and parallels in care are present in the human culture all over the world. In addition, lack of proper culturally congruent nursing approach results in such things as non-compliance, cultural conflicts, stress and other moral and ethical concerns. The last assumption is that qualitative paradigm presents new ways of understanding differences that can be used to discover ontological and epistemic dimensions of the human race (Leininger & McFarland, 1993).

The assumptions and the concepts show similarity. One of the major notable relationships between the concepts is the emphasis of culture, which is used to understand behavior. In addition, differences in culture and the influences on people’s lives are crucial for the theory. Moreover, the cultural competence is a necessary skill in successful nursing care. Furthermore, the theory emphasizes the importance of the insider’s and the outsider’s knowledge of culture; and how the latter ought to understand the former. Care is also seen as a crucial factor in the nursing practice especially when combined with understanding of culture. Care tends to have a certain power over nursing practice based on its emphasis all through the assumptions and the concepts (Leininger, 2008).

Origins of the Theory

In order to further understand the theory, it is also important to look at its starting point and the inspirations of the theorist. The knowledge and experience of Leininger proves her competence in the area of nursing. Despite being born in a small town, Leininger’s background pushed her through the achievements, which contributed to her success in the career. She earned various honors and degrees including BS, BSN, MSN and PhD in nursing at different institutions in the US. During her career, Leininger developed an understanding of the importance of human care in nursing. She worked with patients from diverse cultural background, which influenced her perception of the differences that existed among patients based on their individual and cultural perceptions. Through constant observations and questioning of human care concepts, Leininger was able to establish the theory of cultural care.

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The approach employed in the theory development is the sunrise model, which maps and presents the facts, components, dimensions and major theory’s concepts in order to have an integrated view of the different factors. The theory also uses the erthnonursing method, which qualitatively focuses on health, care and illness (Leininger & McFarland, 1993). The main theme, as observed earlier, is care and culture care, which is regarded as the core nursing principle.

Usefulness of the Theory

Leininger’s theory is not only useful, but is also very popular in the nursing practice. Currently, nursing curricula accepts the theory and emphasizes on transcultural care and nursing. In addition, various researchers are regularly testing the theory, despite earlier beliefs that the theory was complex and hard for experimentation. The theory is applied to discover unknown care phenomena in various cultures. For example, the theory can be used to understand the type of care needed for a certain culture group (Fawcett & Desanto-Madeya, 2012).


An evaluation of Leininger’s theory to determine for testability shows that its lack of simplicity impairs the probability of testing. In fact, the theory is highly complex and takes a holistic perspective. The research methods are more qualitatively-oriented, and the scope is worldwide. Despite the difficulties with testing, Leininger’s theory has motivated various researches in the area. For example, the author also conducted a study on the Gadsup people in New Guniea using the ethnonursing framework. The research helped in identifying various values and beliefs specific to the people in regard to nursing. Moreover, the theory’s model was used by Wenger in 1991 to study the Old Order Amish. The research used the two models of Leininger’s theory discussed earlier and found that generic care, inclusive of anticipatory care is important in a community context (Leininger 2008).

Overall Evaluation of the Theory

An evaluation of Leininiger’s theory shows that the results are comprehensive, which has always hindered testability. However, the theory has led to other researches that utilized the models specific to Transcultural Nursing Care Theory. Despite the numerous benefits, Leininger’s theory has its weaknesses mostly because it emphasizes on culture and its comprehensive nature. In conclusion, its strengths include the aid for nurses on cultural competitiveness, focus on people, their environment, health and nursing care for different people. The abovementioned facts make the theory highly recognized in the industry. However, the theory fails to focus on symptoms and disease, which are largely important in nursing. The framework of the theory is static, which makes it fail to recognize the structural context, within which some health care issues stem (Fawcett, 2000).

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