TFN

Madeleine Leininger

Madeleine Leininger

Culture Care Theory of Diversity and Universality

Madeleine Leininger first term used

1. transcultural nursing

2. ethnonursing

3. cross-cultural nursing

Care

The conceptual phenomena related to helping, supporting or empowering experiences or behaviors toward others with evident or anticipated needs to improve human condition

Caring

Behavior directed toward assisting another individual or group with evident or anticipated needs to improve the human condition either to recover or to face death.

Culture

The studies, shared, and handed values, beliefs, norms, and lifeways of a certain group that directs their thinking, decision and actions in certain ways.

Culture Care

The subjectively and objectively obtained values, beliefs, and outlines of the lifeways that assist, enable, support facilitate or empower another individual or group to maintain well-being, health, and deal with illness, handicaps or death

Transcultural Nursing

Studied scientific and humanistic profession and discipline that centers on human care activities that assist support, facilitate or enable individuals or groups to maintain or regain their well-being (or health) in culturally meaningful and beneficial ways or to help people face handicaps or death.

Cultural Care Diversity

The changeable differences in meanings, patterns, values, lifeways, or symbols of care within concepts that are related in supporting human care.

Cultural Care Universality

The common, general definitions of care with its patterns, values, and symbols that is observed among many cultures and reflect assistive ways to help people

Worldview

The method people seem to look out on the world and or universe to form a picture of value perception about their life or world around them

Cultural and Social Structure Dimensions

The changing patterns related to the arrangement / organizational factors of a particular culture (subculture or society), which includes religious, kinship (social), political (and legal), economic, educational, technological, and cultural values and ethnohistorical factors

Environmental Context

The summation of an event, situation or particular experience that gives meaning to human expressions, particularly physical, ecological, sociopolitical, and/or cultural situations.

Ethnohistory

Past facts, events, and experiences of individuals, groups and various cultures and institutions that are mainly people-centered (ethnic) and that explains and interprets human lifeways within particular cultural trends.

Emic

Local, indigenous or the insider’s views and values about a certain phenomenon

Etic

Outsider’s or more universal views and values about a certain phenomenon

Professional Care System

• Formally educated, and instructed professional care, health, illness, wellness and related knowledge and practice skills that exist in professional institutions usually with multidisciplinary personnel to give service to clients

Generic (Folk or Lay) Care System

Culturally studied and given, indigenous (or traditional) folk (community and home-based) knowledge and skills used to provide assistive supportive enabling or facilitative acts towards or for another individual, groups or institution with evident or anticipated needs to ameliorate or improve a human lifeway or health condition (or wellbeing) or to deal with handicaps and death situations.

Health (Culture Care Theory of Diversity and Universality)

The state of well-being that defined through cultures valued and practiced, and reflects the ability of individuals to perform their daily role activities in culturally expressed, beneficial and patterned styles

Cultural Care Preservation or Maintenance

Caring skilled actions and decisions that people of a certain culture retain important care values so that they can keep up their well-being, recover from illness, or face handicaps or deaths.

Cultural Care Accommodation or Negotiation

The supporting, facilitative or enabling specialized actions and decisions that help people of designated culture to adapt to others for a beneficiary or satisfying health outcome with professional care providers

Cultural Care Repatterning or Restructuring

The assistive, sustaining, facilitative or enabling professional actions and decisions that helps clients greatly change their lifeways for new, different and beneficial healthcare patterns while regarding the client’s cultural values and beliefs and still giving a beneficial or healthier lifeway before the changes were laid out with the clients

Culturally Competent Nursing Care

The cognitively-based assistive caring facilitative or empowering acts or decisions that are made to fit with individual group or institutional cultural values, beliefs, and lifeways to offer or carry

Madeleine Leininger

• Creator of Transcultural Subfield of Nursing

• Nursing at St. Anthony School of Nursing, Denver, Colorado

• Conferred an LhD (Doctor of Humane Letters)

Margaret Newman

Theory of Health as Expanding Consciousness

Margaret Newman

• Born on October 10, 1933 in Memphis Tennessee

• Medical-surgical Nursing

Health (Theory of Health as Expanding Consciousness)

is the “pattern of the whole” of a person and includes disease as a manifestation of the pattern of the whole, based on the premise that life is an ongoing process of expanding consciousness.

Pattern

is information that depicts the whole understanding of the meaning of all of the relationship at once.

Explicit manifestations of the pattern are the:

1. Genetic Pattern

2. Voice Pattern

3. Movement Pattern

Consciousness

Is both the informational capacity of the system and the ability of the system to interact with its environment.

Newman identified three correlates of consciousness:

1. Time

2. Movement

3. Space

Movement

Is a means whereby space and time become a reality

The concept of time is seen as a function of ______

Rosemarie Rizzo Parse

Theory of Human Becoming

Rosemarie Rizzo Parse

Dr. Parse is a graduate of Duquesne University in Pittsburgh

She is also founder of the Institute of Human becoming, and a fellow in the American Academy of Nursing.

Nine assumptions of Theory of Human becoming

1. The human is coexisting while co-constituting rhythmical patterns with the universe.

2. The human is open, freely choosing meaning in situation, bearing responsibility for decisions.

3. The human is unitary, continuously co-constituting patterns of relating

4. The human is transcending multidimensionally with the possibles.

5. Becoming is unitary human-living-health.

6. Becoming is rhythmically co-constituting human-universe process.

7. Becoming in the human's patterns of relating value priorities.

8. Becoming is an intersubjective process of transcending with the possible.

9. Becoming is unitary human's emerging.

Principle One (Theory of Human Becoming)

Structuring meaning multidimensionally is cocreating reality through the language of valuing and imaging"

Meaning is the central theme of this principle. Structuring meaning multidimensionally is what humans do; every person constructs a unique view of the world that evolves at both explicit and tacit levels in the process of living and relating with others

Confirming-nonconforming (Valuing)

is an important paradoxical process in light of the concept of valuing.

Imaging (One of the Principle One concepts)

Is persons' explicit-tacit knowing of their personal realities. It is a process of knowing and of coming to know as persons accept and reject ideas, values, beliefs, and practices consistent with their worldview.

_____ is the creating of reality, and one's reality reflects who one is as a unitary person

Valuing (One of the Principle One concepts)

a process of choosing and embracing what is important.

____ reflect choices and help shape patterns of uniqueness.

Valuing (One of the Principle One concepts)

a process of choosing and embracing what is important.

____ reflect choices and help shape patterns of uniqueness.

Confirming-nonconforming (Valuing)

is an important paradoxical process in light of the concept of valuing.

Non-confirming (Valuing)

is the opposite of confirming in that people, ideas, and projects maybe denied, rejected, and ignored.

Confirming (Valuing)

is about embracing accepting, and cherishing people, ideas and projects that are most important.

Non-confirming (Valuing)

is the opposite of confirming in that people, ideas, and projects maybe denied, rejected, and ignored.

Languaging (One of the Principle One concepts)

It is about the ways persons are with the world and in relationships with others and self.

Principle Two (Theory of Human Becoming)

"Co-creating rhythmical patterns of relating is living the paradoxical unity of revealing-concealing and enabling-limiting while connecting-separating

The theme of this principle is rhythmicity, and it focuses on the paradoxical rhythms that constitutes patterns of becoming.

Revealing-concealing (Paradoxical Unities 2nd Principle)

Concerns the ways persons disclose and do not disclose meanings, thoughts, feelings, values, concerns, and hope. Human beings reveal and conceal all at once through their choices, actions, and words

Enabling-limiting (Paradoxical Unities 2nd Principle)

Concerns the choices persons make moment to moment and the inherent opportunities and limitations that accompany those personal choices. The concept is linked to doors opening and closing as people make choices and move on in life.

Connecting-seperating (Paradoxical Unities 2nd Principle)

Concerns the ways persons can be with others while at the same time being separate from them or how persons can be together without being in the same location

Principle Three (Theory of Human Becoming)

"Co-transcending with the possible is powering unique ways of originating in the process of transforming"

This principle brings forth ideas about change, struggle and transcendence. It focuses on how human beings create themselves while moving with their hopes and dreams.

Powering (One of the Principle Three concepts)

is the pushing-resisting process that propels people in life. It involves the way persons consider the possibilities that lie ahead and how they choose to go on and find a way to be with situations.

Originating (One of the Principle Three concepts)

Is about human uniqueness and the ways persons create their e becoming as they choose from all the possibilities that could be. The paradox of conformity-nonconformity surrounds the concept originating.

Transforming (One of the Principle Three concepts)

This represents a process of deliberately shifting one's patterns of health. The shift may be a choice to change one's attitude about a certain situation, or the shift may be a change in how one lives day-today routines or habits.

Katherine Kolcaba

Theory of Comfort

Katherine Kolcaba

• Was born on December 1944 in Cleveland Ohio

• Medical-surgical nursing

• Graduated RN to MSN class at Case Western Reserve University France Payne Bolton School of Nursing

• Specialty - Gerontology

Health Care Needs

These are comfort needs arising from stressful health care situations that cannot be met by recipients’ traditional support systems. These comfort needs may be in: Physical, Psychospiritual, environmental, sociocultural.

Comforting Interventions

These are intentional nursing actions and referrals designed to address specific comfort needs or recipients. These include physiological, social, cultural, financial, psychological, spiritual, environmental, and physical needs.

Intervening Variables

These are interacting forces that influence recipients’ perceptions of total comfort. These affect the planning and success of patient care interventions.

Comfort

This is the state experienced by recipients of comfort interventions. This is the immediate, holistic experience of being strengthened when one’s needs are addressed.

Relief (types of comfort)

state of a patient who has had a specific need met

Calm (types of comfort)

the state of calm or contentment

Transcendence (types of comfort)

state where patients rise above one’s problem or pain

Physical (content in which comfort occurs)

bodily sensations, homeostatic mechanisms

Psychospiritual (content in which comfort occurs)

internal awareness of self

Environmental (content in which comfort occurs)

external background of human experience

Socio-cultural (content in which comfort occurs)

interpersonal, family, and social relationships

Health Seeking Behaviors

This composes a broad category of outcomes related to the pursuit of health as defined by the recipient(s) in consultation with the nurse.

Internal Behaviors (Health Seeking Behaviors categories)

those we cannot see

External Behaviors or Peaceful Death (Health Seeking Behaviors categories)

are those we can see directly

Institutional Integrity

Corporations, communities, schools, hospitals, regions, states and countries that possess the qualities of being complete, whole, sound, upright, appealing, ethical, and sincere possess institutional integrity. When an institution displays this type of integrity, it produces evidence for best practices and best policies.

Best Practices

The use of health care interventions based on evidence to produce the best possible patient and family outcomes

Best Policies

Institutional or regional policies ranging from protocols for procedures and medical conditions to access and delivery of healthcare

Ramona Mercer

Maternal Role Attainment – Become a mother

Ramona Mercer

• Began nursing career in 1950

• She was an instructor in the areas of pediatrics, obstetrics, and contagious diseases

• Maternity nursing

• Her first book, Nursing care for Parents at Risk, received an American Journal of Nursing Book of the Year award.

Maternal Role Attainment

an interactional and developmental process occurring over a period of time, during which the mother becomes attached to her infant, acquires competence in the care-taking tasks involved in the role, and expresses pleasure and gratification in the role

Maternal Identity

having an internalized view of the self as a mother.

Perception of Birth Experience

a woman’s perception of her performance during labor and birth

Self-Esteem

an individual’s perception of how others view oneself and self-acceptance of the perception

Self-Concept (Self-Regard)

The overall perception of self that includes self satisfaction, self-acceptance, self-esteem, and congruence of discrepancy between self and ideal self.

Flexibility

Roles are not rigidly fixed. Therefore, who fills the roles is not important. “_____ of childrearing attitudes increases with increased development. older mothers have the potential to respond less rigidly to their infants and to view each situation in respect to the unique nuances.

Childrearing Attitudes

maternal attitudes or beliefs about childrearing

Health Status

“The mother’s and father’s perception of their prior health, current health, health outlook, resistance- susceptibility to illness, health worry concern, sickness orientation and rejection of the sick role.”

Anxiety

a trait in which there is specific proneness to perceive stressful situations as dangerous or threatening, and as situation- specific state.

Depression

“Having a group of depressive symptoms, and in particular, the affective component of the depressed mood.”

Role Strain

the conflict and difficulty felt by the women in fulfilling the maternal role obligation

Gratification

the satisfaction, enjoyment, reward, pleasure that a woman experiences in interacting with her infant, and in fulfilling the usual tasks inherent in mothering

Attachment

a component of the parental role and identity. It is viewed as a process in which an enduring affectional and emotional commitment to an individual is formed

Infant Temperament

an easy versus a difficult temperament, it is related to whether the infant sends hard-to-read cues, leading to feelings of incompetence and frustration in the mother

Infant Health Status

Illness causing maternal-infant separation, interfering with the attachment process

Infant Characteristics

temperament, appearance, and health status of infants

Infant Cues

are infant behaviors that elicit a response from the mother.

Family

a dynamic system which includes subsystems individuals (mother, father, fetus/infant) and dyads (mother-father, mother-fetus/infant, and fatherfetus/ infant) within the overall family system.

Family Functioning

the individual’s view of the activities relationships between the family and subsystems and broader social units.

Stress

positively and negatively perceived life events and environmental variables

Social Support

is the amount of help actually received, satisfaction with that help, and the persons (network) providing that help.

Emotional Support (Areas of social support)

feeling loved, cared for, trusted, and understood

Informational Support (Areas of social support)

helping the individual help herself by providing information that is useful in dealing with the problem and/or situation.

Physical Support (Areas of social support)

a direct kind of help

Appraisal Support (Areas of social support)

a support that tells the role taker how she is performing in the role; it enables the individual to evaluate herself in relationship to others’ performance in the role

Mother-father relationship

perception of the mate relationship that includes intended and actual values, goals, and agreements between the two.

Abraham Harold Maslow

Human Needs Theory (Non-Nursing)