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Embracing Cultural Diversity in Nursing: An Analysis of Leininger’s Culture Care Theory

Embracing Cultural Diversity in Nursing: An Analysis of Leininger's Culture Care Theory

Culture Care Diversity and Universality Theory

The culture care diversity and universality theory are concerned with comprehending various cultural backgrounds concerning caring practices in nursing, health conditions, views, and values. The theory aims at providing significant and effective nursing care to individuals according to their beliefs, values, culture and health status. It emphasizes that cultural practices have different caring models, health issues, beliefs, and behavior patterns. This paper holds that culturally-based care is the largest and most significant mechanism to study, enlighten and predict nursing knowledge and care practices. Therefore, the study of the cultural care diversity and universality theory is necessary to guarantee the provision of care practices that correspond to patients’ cultural needs.


This theory aims to determine, document, understand and explain mutual reliance on care, cultural practices, and differences and similarities between cultures. This knowledge is crucial to the present and future nursing care practice. Professionals have envisioned research-based culture care skills as a means to practice nursing and offer care services. These skills change nursing and benefit individuals from the same and diverse cultural backgrounds.


Through the development of the theory, the theorist wanted to employ culture care research results to offer culture-specific care that would correspond to patients’ cultural practices and benefit individuals of a similar and different culture. This theory was developed to ensure that care focused on individuals’ health and well-being and to help them face disabilities and death. The cultural care theory uses a qualitative methodology, which makes it complete in scope and applicable to almost every healthcare setting.


Leininger, a mental health specialist, faced significant challenges and noncaring practices for children in the 1950s. She realized that nursing professionals needed to recognize the significance of culture in healing, caring and treatment practices. At that moment, Leininger realized that understanding and responding therapeutically to patients from diverse cultural backgrounds is essential, which requires theoretical explanation. Therefore, Leininger formulated the culture care diversity and universality theory by integrating culture and care to form a conceptual and theoretical association. It demonstrated the significance of considering the effect of culture on health and healing. Leininger aimed to find a new care mechanism for patients that incorporates their cultural backgrounds.


The culture care diversity and universality theory contain several major concepts. They include transcultural nursing, ethno-nursing, culturally congruent care, professional nursing care, environmental context, language, health, worldview and human beings. Transcultural nursing is concerned with studying and analyzing culture concerning patients’ beliefs, values, nursing, and health conditions. Ethnonursing focuses on nursing care beliefs, practices and values as perceived by a particular culture through experience. Environmental context refers to the entirety of a situation, event or experience that defines the human expression of social relations in the given ecological, physical, or socio-political setting.


This theory conceptualizes four major proportions (objects of belief):

  • Although cultural care expressions, practices, trends and implications are diverse, they have some similarities and universal attributes.
  • Environmental context, language, ethnohistory and professional nursing care influence cultural care, well-being, and how individuals face disabilities and death, healing and infection.
  • Folk and professional health factors influence infection and health outcomes.
  • The theory makes decisions based on analyzing the mentioned factors to find mechanisms that provide meaningful, secure and culturally congruent healthcare.


Several assumptions underlie the culture care diversity and universality theory. The theory holds that care is the dominant, distinctive and uniting focus of nursing. Scientific and humanistic care is critical to human growth, survival, health, and attitude to disabilities and death. Since curing is impossible without caring, the theory suggests that care is significant to healing or curing. In addition, therapeutic and culturally congruent care can only occur if the patients’ trends, beliefs, expressions and values are well-known.

The Context of the Theory

The culture care diversity and universality theory recognize and appreciates the significant role of culture in the process of treatment, caring and healing. Culture and care are the main dimensions that need to be integrated into past nursing and healthcare practices. This theory contextualizes professional nursing care concerning diverse cultural practices to enhance the care provided to patients from different cultures. It brought knowledge concerning health, care practices and culture into nursing as the foundation for transcultural nursing. As a result, this theory is important, given that people from different cultures have diverse care needs.

Theory Analysis: Concept and Statement Definitions

  • The cultural care worldview.
  • Relates to knowledge about families, individuals, society, groups and organizations in healthcare systems. Such knowledge gives exact meanings related to culture in the context of care and health. The theory describes several systems: generic, nursing care, professional care, and folk systems. Knowledge gained from these systems helps to explain specific care characteristics. Such information enables a recognition of cultural differences and similarities or universality and diversity. The delivery of nursing care relies on care decisions and actions, which encompass cultural care maintenance, accommodation and restructuring. These practices conform to transcultural nursing, which aims at providing culturally-specific care with cultural practices, values and views.

  • Cultural care maintenance.
  • This concept is also called cultural care preservation. It relates to all the activities and decisions that enable practitioners to help individuals from a given cultural background to preserve their values. For example, such actions and decisions may help patients recover from medical conditions or retain their well-being. They also assist them in facing disabilities and death.

  • Culture care restructuring.
  • This concept includes all the actions and decisions to ensure that patients restructure, vary or adjust their lifestyles to correspond to care trends or patterns that benefit their life. Cultural care restructuring is meant to occur when the patient’s cultural values and beliefs are observed. The goal is to see clients adopt a better lifestyle with significant health benefits compared to the way of life they used to have.

  • Cultural care accommodation.
  • Cultural care accommodation involves making decisions that assist individuals from a particular cultural background in discussing significant and fulfilling health outcomes with care providers. The aim is to facilitate care reorganization, guaranteeing a better lifestyle and significant health benefits.

Specific Examples in the Context of the Concepts

The complexity of cultural diversity poses significant challenges to providing all-inclusive care practices. For instance, a nursing model that eliminates symptoms and infections must be more comprehensive and effective for the functional caring discipline. As a result, the theory introduced a comprehensive worldview that observes the sacredness and distinctiveness of human beings and their cultural beliefs, values and patterns. Abandoned cultures can, therefore, be served through transcultural nursing.


In transcultural nursing, the extent to which caring practices satisfy patients’ needs is linked to how nursing care satisfies the anticipations of the ethnic group from which a patient comes. The standard of such anticipations is always culturally determined. In this case, cultural congruency depends on the caregiver (nurse) knowing cultural matters. Effective transcultural care is related to user research that employs an ethnoscientific method, sophisticated valuation, and the ability to execute culturally sensitive arrangements. The culture care diversity and universality theory draws a relation (linkages) to Purnell’s model. Purnell’s model enables care providers to understand concepts and characteristics of the patient’s culture.


This theory is illustrated in the Sunrise Model, which defines a framework that facilitates mapping and comprehending a culture. It demonstrates the theory’s domains and facilitates innovation of transcultural knowledge through recognition and investigation of cultural universality. Given the theory’s main concepts, the model outlines cultural values, lifeways, views and social structural factors and specializes in institutions, groups and individuals in different health contexts.

Consistency and Predictability

The theory’s consistency is evident since it continues to develop the capacity of caregivers to offer secure and efficacious healthcare to patients of diverse cultural backgrounds. The theory’s consistency is connected to culturally specific attributes such as cultural consciousness, knowledge, skills and cultural sensitivity. The consistency has also enhanced its predictability, given that nurses can apply the model to their daily care practices, particularly when preparing a nursing plan with foreseeable outcomes.

Theory Evaluation: Congruence with Nursing Standards and Interventions

The theory introduced a humanistic approach to the profession that centers on holistic skills, cultural care and expertise. These skills help people maintain their well-being in a manner that is congruent with communities’ lifestyles, values and beliefs. The theory has enhanced culturally congruent healthcare that involves tailored interventions related to the modes of available care, such as the patient’s nutrition plan.

Testability, Usability, and Relevance

Testability relates to the confirmation of the theory’s hypothesis. Thus, when repeated experiments reveal that the hypothesis is correct, a theory passes the test of falsifiability and testability. In the case of the culture care diversity and universality theory, the theoretical nursing care practices espoused by Leininger have proved very practical and useful. The theory’s broad, holistic and culture-specific emphasis that discovers significant care in many cultures has produced quality health outcomes. Regarding its usability, the theory is widely used worldwide, given that nurses must remain sensitive to their patient’s culture when constructing their nursing plans. This fact demonstrates the application and use of the theory in the healthcare setting. As a consequence, the theory remains relevant to modern care practices. The rising emphasis on culturally specific healthcare treatments increases the relevance of this theory in the future.

Contribution to Nursing and Implications for Implementation

The theory has significantly strengthened nurses’ commitment to nursing based on their client relationships. Introducing and using culturally-based knowledge to treat various ailments have significantly transformed care practices. The implication of this theory in the nursing profession includes the fact that nurses can investigate the relationship between clients’ cultural background and their medical problems. They can then apply this knowledge to construct a treatment plan that would enable patients’ recovery while respecting their culture.


In conclusion, diversity is becoming evident for varying demographics in care practices. As a result, Leininger’s principles formulated in the cultural care diversity and universality theory are increasingly defining the roles nurses play in culturally-based care practices. Cultural knowledge plays an integral role in nursing care delivery. By applying the theory, caregivers can study clients’ cultures to their pathological conditions. This theory has facilitated the realization of the aim of transcultural nursing, which is to offer healthcare treatment congruent with cultural values and beliefs.

📎 References

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