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CCT-TFN *Naka tabs ang other theorist ha ngitaa niyo -​ First woman to serve as a Deputy lang!! Surgeon General TFN REVIEWER CLIENT -CENTERED NURSING THEORIES AND THEIR THEORISTS VIRGINIA AVENEL HENDERSON...

CCT-TFN *Naka tabs ang other theorist ha ngitaa niyo -​ First woman to serve as a Deputy lang!! Surgeon General TFN REVIEWER CLIENT -CENTERED NURSING THEORIES AND THEIR THEORISTS VIRGINIA AVENEL HENDERSON (November 30, 1897- March 19, 1996) “DEFINITION OF NURSING, 1955” -​ A nurse, theorist, & author -​ Also known as “ First Lady of Nursing”, “Nightingale of Modern Nursing”, “Modern- Day Mother of Nursing” & “20th Century Florence DOROTHEA OREM Nightingale (June 15, 1914 – June 22, 2007) -​ Known for her “NEED THEORY” “THEORY OF SELF-CARE DEFICIT” defined nursing as: “The unique function of the nurse is to assist the -​ Born and brought up in Baltimore, individual, sick or well, in the Maryland performance of those activities -​ Attended Seton High School in contributing to health or its recovery Baltimore & graduated in 1931 (or to peaceful death) that he would -​ In 1971, she published Nursing perform unaided if he had the Concepts of Practice, which she necessary strength, will or outlines her theory of nursing, the knowledge.” self-care deficit theory of nursing; which she established as the leading theorist of nursing practice & education. -​ Served as CHAIRPERSON of the nursing development conference group. -​ In 1973, edited that group’s work in the -​ book Concept formalization in Nursing. -​ Authored many other papers during FAYE GLENN ABDELLAH 1970’s & 1980’s (March 13, 1919- present) -​ spoke at numerous conferences and “PATIENT- CENTERED APPROACHES, 1960” workshops around the world. -​ received accolades for her -​ Pioneer in nursing research contributions to the field of nursing, -​ Developed the “21 Nursing Problems” including honorary degrees from -​ Her model of nursing was progressive Georgetown University, Incarnate for the time in that it refers to a nursing Word College, Illinois Wesleyan diagnosis in which nurses were taught University, and the University of that diagnoses were not part of their Missouri-Columbia role. -​ She was inducted into the American -​ First nurse officer to earn the ranking Academy of Nursing, and received of a Two-Star Rear Admiral awards from the National League for  Nursing and the Sigma Theta Tau -​ Died on 1996. Nursing Honor Society. -​ The International Orem Society was “Levine’s Conservation Model” founded to foster research and the continued development of Orem's -​ Focus in promoting adaptation & theories of nursing. maintaining wholeness using the principles of conservation -​ The model guides the nurse to focus on the influences & responses at the organismic level. -​ The nurse shall accomplishes the goals of the model through the conservation of energy, structure, and personal and social integrity. -​ She discussed 2 other important concepts critical to the use of her model-adaptation(how the need of patients adjust) and wholeness (the importance of viewing patients as whole MYRA ESTRINE LEVINE beings, recognizing their unique (December 12, 1920- 1996) experiences and needs, and promoting “Conservation Principles A model for health, overall well-being rather than just 1969” focusing on specific health issues.) -​ Born in Chicago, Illinois. -​ Oldest of 3 children SISTER CALLISTA ROY -​ Had 1 sister & 1 brother -​ Developed interest in Nursing ( October 14, 1939- October 13, 2023) because her father (had “Adaptation Model, 1977” or “Roy gastrointestinal problems) was Adaptation Model” frequently ill & required nursing care in many occasions -​ Contains the key concepts -​ Graduated from the COOK COUNTRY -​ The person is adapting in a SCHOOL OF NURSING, in 1944. stable interaction with the -​ Obtained her BS nursing from the environment either internal or UNIVERSITY OF CHICAGO in 1949. external. -​ Worked as a PRIVATE DUTY NURSE, -​ The environment serves as the CIVILIAN NURSE for the US ARMY, as source of a range of stimuli that a SURGICAL NURSING SUPERVISOR, will either threaten or promote and in NURSING ADMINISTRATION. person’s unique wholeness. -​ Earned an MS in Nursing at WAYNE -​ Person’s major task is to STATE UNIVERSITY in 1962. maintain integrity in face of -​ Taught nursing at many different these stimuli. institutions such as University of -​ Roy and Andrews (1999) defined Illinois at Chicago and Tel Aviv integrity as the degree of wholeness University in Israel. achieved by adapting to changes in -​ Authored 77 published articles which needs. included “AN INTRODUCTION TO -​ Stimuli: FOCAL, CONTEXTUAL, or CLINICAL NURSING” with multiple RESIDUAL publication years on 1969,1973, & 1989. -​ Also received an Honorary Doctorate from Loyola University in 1992.  HEALTH -​ Originally. Roy wrote that health and illness are on a continuum with many different states or degrees possible. -​ More recently, she states that health is the process of being and becoming an integrated and whole person. -​ Adaptation is defined as the process and outcome whereby awareness and choice to create human and environmental integration. -​ NURSING PERSON -​ Nursing is the science and practice -​ Roy's models view the person as that expands adaptive abilities and biopsychosocial being in constant enhances person and environment interaction with a changing transformation. environment -​ Roy's goal of nursing is the -​ The person is an open, adaptive promotion of adaptation in each of the system who uses coping skills to deal four modes, thereby contributing to with stressors. It includes people as the person's health, quality of life and individuals or in groups (families, dying with dignity. organizations, communities, nations, -​ Nursing is about the decrease, and society as a whole). enhancement, modification and -​ An adaptive system has cognator alteration of the stimulus to achieve and regulator subsystems which act adaptation. to maintain adaptation in the four adaptive modes: physiologic- physical, self-concept-group identity, role function, and interdependence, LYDIA HALL ENVIRONMENT ( September 21, 1906 - 1969) -​ Roy viewed environment as “CORE, CARE, CURE, 1964” also known as conditions, circumstances and “THREE C’S OF LYDIA HALL” influences that surround and affect the development and behavior of the -​ born on September 21, 1906 in New person. York City. -​ She described stressors as stimuli -​ In 1927, she earned her nursing and uses the term residual stimuli to diploma describe those stressors whose -​ Went on to complete a Bachelor of influence on the person are not clear. Science in Public Health Nursing in -​ Three kinds of stimuli are the focal, 1937. contextual, and residual. -​ Earned a Master’s degree to teach -​ Significant stimuli in all human natural sciences in 1942. adaptation include stages of -​ Worked as the first director of the Loeb development, family, and culture. Center for Nursing. -​ Nursing Experience was in Clinical Nursing, Nursing Education research, and in a Supervisory Role. -​ Developed the care, cure, core theory of nursing in late 1960’s; as a result of her work in psychiatry -​ Promoted involvement of community members in healthcare issues -​ The theory puts emphasis on the importance of the total patient rather than looking at one part or aspect. There is also emphasis put on all three aspects of the theory (care, cure, and core circles) functioning together JEAN WATSON  -​ In 2008, Created a non-profit foundation: Watson Caring Science JEAN WATSON Institute (June 10, 1940- Present) “THEORY OF HUMAN CARING” CENTER FOR HUMAN CARING -​ Established in 1980’s by Watson & Personal Life Colleagues, at the University of -​ Born in Welch, West Virginia, USA in Colorado–the nation’s first the Appalachian Mountains. interdisciplinary center committed to -​ Youngest of 8 Children using human caring knowledge for -​ Attended highschool in West Virginia clinical practice,scholarship, -​ Attended the Lewis Gale School of administration,leadership. Nursing in Roanoke Virginia -​ sponsor clinical, educational, and -​ In 1961, after she graduated she community scholarship activities and married her husband, Douglas human caring projects which involve -​ Moved west to his native state of national & international scholars in Colorado residence & international connections -​ She has 2 daughters, in 1963– with colleagues around the world Jennifer & 1967– Julie -​ Activities such as these continue at the -​ In 1997, she had an accident & lost her University of Colorado’s International left eye Certificate Program in Caring Healing, -​ Left with 2 daughters and 5 where Watson offers her theory Grandchildren courses for doctoral students Educational Background PHILOSOPHY & SCIENCE OF CARING -​ In 1964, she earned a baccalaureate -​ Concerned with how nurses express degree in Nursing (BSN) at the care to their patients. Boulder Campus. -​ In 1966, master of science in WATSON’S THEORY psychiatric and mental health nursing -​ Stresses the humanistic aspects of at the Health Sciences Campus nursing as they intertwine with -​ In 1973, Ph.D. in educational scientific knowledge & nursing psychology and counseling at the practice. Graduate school, Boulder Campus -​ Caring is central to nursing practice & promotes health better than a simple medical cure CAREER AND APPOINTMENTS -​ Believes that a holistic approach to -​ Joined the School of Nursing Faculty, healthcare is central to the practice of as the faculty & administrative caring in nursing positions, in the University of Colorado Health Sciences Center, in NURSING MODEL Denver -​ Stresses the humanistic aspects of -​ In 1981 & 1982, she pursued nursing as they intertwine with international sabbatical studies in, scientific knowledge & nursing New Zealand, Australia, India, practice. Thailand and Taiwan. -​ In 2005, she took sabbatical for a walking pilgrimage in the Spanish el Camino  HUMAN HEIRARCHY OF NEEDS -​ A valued person in & off themselves to SURVIVAL NEEDS be cared for, respected, nurtured, -​ Food, fluid, elimination & ventilation understood, & assisted -​ A fully functional integrated self FUNCTIONAL NEEDS -​ Viewed as greater than & different -​ Activity, inactivity, and sexuality from the sum of his or her parts. INTEGRATIVE NEEDS HEALTH -​ Achievement and affiliation -​ The absence of Illness -​ The presence of efforts leading to GROWTH SEEKING NEEDS absence of Illness. -​ Self actualization -​ A high level of overall physical, mental, & social functioning NURSING PROCESS -​ A general adaptive-maintenance level ASSESSMENT of daily functioning. -​ Observation, identification & review of the problem & the formation of NURSING hypothesis -​ A Science of persons & health-illness experience mediated by professional, PLANNING personal, scientific, & ethical care -​ Creating a care plan interactions. INTERVENTION ENVIRONMENT -​ Implementation of the care plan -​ She does not define the fourth metaparadigm concept of EVALUATION environment. -​ Analyzes the data, interprets the results 10 CARATIVE FACTORS THEORY OF CARING -​ Concerns how nurses care for their patients -​ How that caring progresses into better plans to promote health and wellness -​ Prevent illness and restore health -​ Needs of the person attached to the machine -​ The disease might be cured, but the illness would remain -​ Without caring, health is not attained -​ The essence of nursing and connotes responsiveness between the nurse and the person -​ The nurse co-participates with the person -​ Contends that caring can help the person; gain control, knowledgeable, promote healthy changes 10 CARATIVE FACTORS & CARITAS PROCESS HILDEGARD PEPLAU  -​ 1950 & 1960 HILDEGARD ELIZABETH -​ Summer workshops (State PEPLAU Psychiatric Hospitals) -​ Interpersonal Concepts (September 1, 1909- March 17, 1999) (Individual, Family, Group “INTERPERSONAL RELATIONS THEORY” Therapy) -​ Advisor (WHO) -​ Visiting Professor (Africa, Latin Personal Life America, Belgium, USA) -​ “First nursing theorist since Florence Nightingale” -​ “Mother of Psychiatric Nursing” -​ “Nurse of the Century” CAREER -​ Born on September 1,1909 -​ Staff nurse – New York City -​ A german descent -​ School nurse - Bennington College, -​ Raised in Reading, Pennsylvania Vermont -​ 2nd daughter of Gustav & Otyllie -​ Army Nurse Corps – 312th Field Peplau Station Hospital in England (1943 – -​ Father- Illiterate but persevering 1945) -​ Mother- perfectionist and oppressive -​ American School of Military -​ At Young Age, grow beyond Psychiatry was located traditional women’s role -​ Nursing– one of the few career choices for women during her time. CAREER AFTER WAR -​ Mental Health– worked to reshape the mental health in the US DATES TO REMEMBER -​ 1946— NATIONAL MENTAL HEALTH -​ In 1900, Schools were handled by the LAW hospitals. Formal “book learning” was -​ 20TH CENTURY– nursing ade a great put down process, from occupation to a -​ In 1918, she witnessed the devastating professional FLU EPIDEMIC that greatly influenced her understanding of the impact of illness & death on families -​ In 1931, graduated in Pennsylvania ACHIEVEMENTS School of Nursing -​ PSYCHOANALYSIS -​ In 1943, earned a bachelor’s degree in -​ Certified by the William Interpersonal Psychology at Alanson White Institution of Bennington college in Vermont. New York City -​ In 1947, earned a Master’s & Doctoral -​ 1st graduate level program degrees from Teachers College, -​ Prepare clinical specialist in Columbia University psychiatric nursing -​ In 1950— taught 1st class in -​ Prolific Writer psychiatric nursing students at -​ Presentations, speeches, & Teachers College clinical training workshops -​ 1950–1970— she worked as Clinical -​ US SURGEON GENERAL (US Specialist in Psychiatric Nursing AIRFORCE) -​ In 1954–1974— Member of the College of Nursing at Rutgers University  STRONG ADVOCATE 4 COMPONENTS OF THE THEORY -​ Graduate education PERSON -​ Research -​ Developing organism that tries to reduce anxiety caused by needs HEALTH -​ A word symbol that implies a forward ANA movement of personality -​ Only nurse who served as executive ENVIRONMENT director and president -​ Existing forces outside the person NURSING -​ A significant therapeutic interpersonal ICN process -​ Served two terms as Board of International Council of Nurses 7 NURSING ROLES 50 year career -​ Founder of modern psychiatric nursing -​ Innovative educator -​ Advocate for mentally ill INTERPERSONAL RELATIONS THEORY -​ 1952 Mainly influenced by: -​ 1.Henry Stack Sullivan -​ 2. Percival Symonds -​ 3. Abraham Maslow -​ 4. Neal Elgar Miller NURSING  INTERPERSONAL RELATIONS THEORY ORIENTATION PHASE Problem defining phase -​ ORIENTATION PHASE Client meets nurse as a stranger -​ WORKING PHASE/ IDENTIFICATION Defining the problem SUBPHASE Deciding the service needed -​ WORKING PHASE/ EXPLOITATION Client asks assistance SUBPHASE conveys needs -​ TERMINATION PHASE Asks questions Shares preconceptions PEPLAU’S STAGES & TASKS OF Expectations of past experiences RELATIONSHIPS Nurse ORIENTATION Responds Explains roles to the client Identifies problems Uses available resources and services IDENTIFICATION PHASE Clients works interdependently with the IDENTIFICATION nurse Expresses feelings Begins to feel stronger Selection of appropriate professional Assistance EXPLOITATION Patients Begin to have a feeling of belonging Capability of dealing with the problem Decreases the feeling of Helplessness RESOLUTION Hopelessness EXPLOITATION PHASE Clients Makes full use of the services offered Use of professional assistance for problem solving alternatives Feels like an integral part of the helping environment Make minor requests or attention-getting techniques May fluctuate on independence Nurse Must be aware of the various phases of communication Aids the patient in exploiting all avenues of help  Progress is made towards the final phase RESOLUTION PHASE Client no longer needs professional services Gives up dependent behavior relationship ends sometimes may be difficult for both as psychological dependence persists 4 LEVELS OF ANXIETY MILD -​ Positive state of heightened awareness -​ Person can take in stimuli MODERATE -​ Decreased in perceptual Field -​ Focus on immediate task only SEVERE -​ Feelings of dread & terror -​ Has physiologic symptoms PANIC -​ Loss of rational thought -​ Delusions -​ Hallucinations -​ Complete physical immobility muteness DOROTHY JOHNSON  -​ Each subsystem, has 3 functional requirements which include; DOROTHY E. JOHNSON -​ Protection from noxious (August 21, 1919- February 1999) influences “BEHAVIORAL SYSTEM MODEL” -​ Provision for a nurturing environment -​ Developed the behavioral system -​ Stimulation for growth model -​ An imbalance in each system results -​ “an external regulatory force which in disequilibrium. The nurse’s role is acts to preserve the organization and to help the patient to maintain his or integration of the patient's behaviors her equilibrium at an optimum level under those -​ Dorothy Johnson’s theory defined conditions in which the behavior Nursing as “an external regulatory constitutes a threat to the physical or force which acts to preserve the social health, or in which illness is organization and integration of the found.” patient’s behaviors at an optimum -​ Nursing career began in 1942; she level under those conditions in which graduated from Vanderbilt University the behavior constitutes a threat to School of Nursing in Nashville, the physical or social health, or in Tennessee which illness is found.” -​ Top student in her class -​ It also states that “each individual has -​ Receive the prestigious Vanderbilt patterned, purposeful, repetitive ways Founder’s Medal of acting that comprises a behavioral -​ In 1948, she received her Masters in system specific to that individual.” public health from HARVARD university in Boston, Massachusetts GOALS -​ began her work on the model with the BEHAVIOR SYSTEM MODEL OF premise that nursing was a profession NURSING that made a distinctive contribution to the welfare of society. -​ 1st Proposed in 1968 -​ nursing had an explicit goal of action -​ States that, “each individual has in patient welfare. patterned, purposeful, repetitive ways -​ (1) To assist the patient whose of acting that comprises a behavioral behavior is proportional to social system specific to that individual.” demands. -​ advocates the fostering of efficient -​ (2) To assist the patient who is able to and effective behavioral functioning in modify his behavior in ways that it the patient to prevent illness. supports biological imperatives. -​ The patient is defined as a behavioral -​ (3) To assist the patient who is able to system composed of seven benefit to the fullest extent during behavioral subsystems: illness from the physician’s -​ Affiliative knowledge and skill. -​ dependency -​ (4) To assist the patient whose -​ ingestive behavior does not give evidence of -​ Eliminative unnecessary trauma as a -​ sexual consequence of illness. -​ Aggressive -​ achievement.  HUMAN BEINGS ATTACHMENT OR AFFILIATIVE -​ Has two major systems: SUBSYSTEM -​ the biological system and the behavioral system. -​ Attachment or affiliative -​ It is the role of medicine to subsystem is the “social focus on the biological system, inclusion intimacy and the whereas nursing’s focus is the formation and attachment of a behavioral system. strong social bond.” -​ The concept of human being was -​ It is probably the most critical defined as a behavioral system that because it forms the basis for strives to make continual adjustments all social organization. to achieve, maintain, or regain -​ On a general level, it provides balance to the steady-state that is survival and security. adaptation. -​ Its consequences are social inclusion, intimacy, and the formation and maintenance of ENVIRONMENT a strong social bond -​ it is implied to include all elements of the surroundings of the human DEPENDENCY SUBSYSTEM -​ Dependency subsystem is the system and includes interior “approval, attention or stressors. recognition and physical assistance.” HEALTH -​ In the broadest sense, it -​ the opposite of illness, and Johnson promotes helping behavior that defines it as “some degree of calls for a nurturing response. regularity and constancy in behavior, -​ Its consequences are the behavioral system reflects approval, attention or adjustments and adaptations that are recognition, and physical successful in some way and to some assistance. degree… adaptation is functionally -​ Developmentally, dependency efficient and effective.” behavior evolves from almost total dependence on others to a greater degree of NURSING dependence on self. -​ seen as “an external regulatory force -​ A certain amount of which acts to preserve the interdependence is essential organization and integration of the for the survival of social patient’s behavior at an optimal level groups. under those conditions in which the behavior constitutes a threat to INGESTIVE SUBSYSTEM physical or social health, or in which -​ Ingestive subsystem is the illness is found.” “emphasis on the meaning and structures of the social events surrounding the occasion when the food is eaten.”  -​ should not be seen as the input defense response when there is a and output mechanisms of the threat to life or territory system -Its function is protection and -​ All subsystems are distinct preservation. subsystems with their own -Society demands that limits be input and output mechanisms placed on modes of self-protection -​ The ingestive subsystem “has and that people and their property be to do with when, how, what, respected and protected. how much, and under what conditions we eat.” ACHIEVEMENT SUBSYSTEM -​ Achievement subsystem ELIMINATIVE SUBSYSTEM provokes behavior that tries to -​ Eliminative subsystem states control the environment that “human cultures have -​ It attempts to manipulate the defined different socially environment acceptable behaviors for -​ Its function is control or excretion of waste, but the mastery of an aspect of self or existence of such a pattern environment to some standard remains different from culture of excellence to culture. -​ Areas of achievement behavior -​ addresses “when, how, and include intellectual, physical, under what conditions we creative, mechanical, and eliminate.” social skills. -​ As with the ingestive subsystem, the social and psychological factors are viewed as influencing the biological aspects of this subsystem and may be, at times, in conflict with the eliminative subsystem. SEXUAL SUBSYSTEM -Sexual subsystem is both a biological and social factor that affects behavior has the dual functions of procreation and gratification Including, but not limited to, courting and mating this response system begins with the development of gender role identity and includes the broad range of sex-role behaviors. AGGRESSIVE SUBSYSTEM -Aggressive subsystem relates to the behaviors concerning protection and self-preservation, generating a MADELEINE LEININGER  -​ Her Culture Care Diversity & Universality theory was one of the MADELEINE LEININGER earliest nursing theories and it remains the only theory focused specifically on (July 13, 1925 – August 10, 2012) transcultural nursing with a culture care “CULTURE CARE THEORY ” focus. Her theory is used worldwide. -​ -​ Founder of transcultural nursing Culture Care Diversity & Universality -​ Initiated this field of nursing in mid-1950’s -​ Dr. Leininger established the first Caring -​ Born in Sutton, Nebraska, Lived on a Research Conference in 1978. She farm with 2 brothers & sisters developed the theory of Culture Care -​ Attended Sutton High School, with the ethnonursing method. Scholastica College, the Catholic -​ University of America in DC, & the -​ The ethnonursing method was the first University of Washington, Seattle nursing research method and has been -​ First professional nurse; with used for decades. graduate preparation to complete a -​ PhD in anthropology -​ She conducted the first transcultural -​ Brought nursing & anthropology nursing field study in early 1960s as she together coined the term, lived alone with the Gadsup of Eastern “transcultural nursing” as an Highlands of New Guinea. essential formal area of study & -​ practice Accomplishments of Dr. Leininger Culture Care Theory -​ Dr. Leininger wrote the first books on Madeliene Leininger- Culture Care Diversity transcultural nursing. & Universality -​ -​ Dr. Leininger is the founder of -​ She developed and launched the first transcultural nursing. undergraduate and graduate courses -​ Initiated this field of nursing in the and programs in transcultural nursing mid-1950s. beginning in the 1970s. -​ Born in Sutton, Nebraska, lived on a -​ farm with two brothers and sisters. -​ Introduced the idea of studying emic -​ Attended Sutton High School, generic (folk) and etic professional care Scholastica College, the Catholic differences and similarities to reduce the University of America iin DC, and the care gaps and conflict areas that can be University of Washington, Seattile non therapeutic to clients. -​ -​ -​ Madeleine Leininger, PhD, LHD, DS, -​ Conceived and saw the need to establish CTN, RN, FAAN, FRCNA the Transcultural Nursing Society as the -​ official organization of the new discipline -​ Dr. Leininger was the first professional in 1974. nurse with a graduate preparation to -​ complete a PhD in anthropology. Accomplishments (cont'd) -​ -​ She brought nursing and anthropology -​ Conceived and saw the need to establish together and coined the term the Transcultural Nursing Society as the transcultural nursing as an essential official organization of the new discipline formal area of study and practice. in 1974. -​ -​ -​ The TCN society today is the major includes care for families, groups, organization in this communities, cultures and institutions. -​ -​ discipline with theory and research to The Sunrise Enabler advance transcultural nursing science. Dr. Leininger established and was the -​ The theory includes an enabler (Dr. first editor of the Journal of Transcultural Leininger prefers it not be called a Nursing. model), serves as a conceptual guide or -​ Dr. Madeleine Leininger has received cognitive map to guide nurses in the many outstanding awards and honors systematic study of all dimensions of the and has been nominated for the Nobel theory. Prize for her significant and worldwide -​ breakthrough encouraging health -​ This map or guide is called the Sunrise disciplines to study and practice Enabler. transcultural health care. -​ The Theory -​ The Culture Care Diversity and Universality theory, according to Dr. Leininger, focuses on describing, explaining and predicting nursing similarities and differences focused primarily on human care and caring in human cultures. -​ -​ The Culture Care Diversity & Universality theory does not focus on medical symptoms, disease entities or -​ treatments. -​ -​ Application of the theory -​ It is instead focused on those methods of approach to care that means something -​ Key elements of a method of application to the people to whom the care is given. in Practice Methodology have been -​ identified by Dr. Leininger and they are Development of the theory (1) goals of nursing which address practices, clients (2) cultural assessment -​ Developed in the mid-1950s and early (using the Sunrise Enabler) and (3) 1960s. nursing judgments, decisions and -​ actions. -​ Developed particularly to discover the -​ meanings and ways to give care to -​ Research findings are used to develop people who have different values and protocols for cultural-congruent care that lifeways. blends with the particular cultural values, beliefs and lifeways of the client -​ Designed to guide nurses to provide -​ nursing care that fits with those that are Four metaparadigm concepts being cared for. -​ -​ Leininger criticizes the four nursing -​ Culture Care theory not only focuses on metaparadigm concepts of person, nurse-client interaction but the focus also environment, health, and nursing. -​ -​ Furthermore, she defines these -​ Nurse obtains knowledge about the concepts in her theory dynamic cultural and social structural -​ dimensions influencing health. Metaparadigm concepts defined -​ -​ -​ Nursing: care has the greatest meaning Leininger's Assessment Process which explains nursing -​ -​ -​ Nurse invites an individual, family, or -​ Person: should refer to families, groups, community to describe their own and communities experience about health and caring -​ -​ -​ Health: not distinct to nursing as many -​ Nurse documents the description of an disciplines use this term individual's, family's, or community's -​ Environment: included events with cultural and social structure that meanings and interpretations given to influence health patterns and concern them in particular physical, ecological, -​ sociopolitical or cultural setting. Conclusion -​ -​ Application of Theory -​ We live in a city that is rich in diversity. -​ How, then, should we treat one another? -​ Care always occurs in a cultural context We should value diversity. We have the Culture is viewed as framework people capacity to perform a cultural self- use to solve human problems assessment. We should be conscious of -​ the dynamics inherent when cultures -​ Culture is "the lifeways of an individual or interact and we should exercise cultural a group with reference to values, beliefs, awareness. Being culturally competent is norms, patterns, and practices" essential to being an efficient nurse. (Leininger, 1997, p. 38) -​ -​ -​ -​ Assessment of Client -​ -​ Information on culture is essential for holistic assessment of an individual, family, or community -​ -​ The assessment process must be comprehensive, accurate, and systemic -​ -​ Individual's, family's, or community's perspective of their culture is needed for an accurate assessment. -​ Leininger's Assessment Process -​ -​ Nurse approaches an individual, family, or community with the intent to gain understanding of the expressions, patterns of health, and care -​