Nursing: Cultural Theories and Conceptual Frameworks

Encouraging a customer-oriented approach in nursing typically implies creating a sustainable framework for meeting diverse patients’ needs. The described characteristic of contemporary nursing goals is linked to the process of globalization and the increasing rates of diversity within communities all over the world (Ray, 2016). Promoting cultural awareness has become not only an innovative tool for improving care but also an indispensable element of a nursing strategy (Prosen, 2015).

By introducing the principles of diversity into the nursing setting, one will set the environment for promoting cultural awareness and, thus address the needs of communities populated by people from a wide range of cultural backgrounds.

For this purpose, Leininger’s Theory of Nursing along with the model known as “The Process of Cultural Competence in the Delivery of Healthcare Services” (Campinha-Bacote, 2002) (PCCDHS) will have to be introduced. By incorporating the proposed theoretical frameworks into the nursing setting, one will improve the dialogue between a nurse and a patient, simultaneously encouraging a nurse to learn to address the culture-specific needs of patients.

The suggested theories are likely to provide equally plentiful opportunities for enhancing the efficacy of nursing care. However, each of the proposed tools has a unique set of characteristics that will shape a nursing approach and encourage a nurse to learn about culture-specific needs of patients. For instance, Leininger’s Theory of Nursing should be seen as the paradigm for approaching the situations that involve previously unknown specifics of patients’ culture (Hendson, Reis, & Nicholas, 2015).

Therefore, the selected framework should be applied to the scenarios that involve the first encounter and cross-cultural exchange between a nurse and a patient. The observed detail stands in slight contrast to the PCCDHS theory, which enables nurses to educate themselves continuously and, thus building their knowledge based on a previously acquired system of knowledge. Although it could be argued that Leininger’s model also implies selecting approaches for managing patients’ health issues based on the existing experience, it does not have the sense of continuity that the PCCDHS framework suggests.

The constituents of each theory are very different from each other, yet their sum amounts of the same notion of learning and communication as the crucial tool for promoting public health in diverse communities. For example, the concepts of cultural awareness, skill, desire, encounters, knowledge, and, ultimately, competence can be seen as the steps toward understanding how a nurse can improve the levels of public health and the well-being of a particular community.

The PCCDHS approach, in turn, embraces the multiple aspects of the notion of cultural care, such as its maintenance, accommodation, and restructuring (Campinha-Bacote, 2002). Each set of steps described above seems very different from the other, yet both approaches ultimately amount to the increase in the quality of the cross-cultural dialogue between a nurse and the target community. Moreover, both nursing theories reinforce the significance of continuous education as a tool for nurses to manage health concerns.

Both theories are the same in their initial premise of people’s health being the ultimate goal and the most valuable notion that these theories are built to sustain. The interpretation of health as the desirable and attainable state of being that should be pursued and promoted actively lies at the core of both theoretical frameworks, thus uniting them. The interpretation of health described above is what allows the theories to constitute a single theoretical entity that can be utilized to promote health on a larger level, particularly, on the global scale, and embrace the needs of the world community.

Moreover, what Leininger (1988) defines as the “culture care” and an important premise of her theory makes the very essence of the PCCDHS approach, with the notion of cross-cultural communication permeating every facet of its framework, from information management to the design of an intervention. Therefore, both theories support the idea of a nurse-patient conversation being the key to the management of public and community health concerns.

The focus on structuring patient-nurse relationships and making them interchangeable is another feature that both approaches share, even though there are minor discrepancies in the application of the specified principle. Both Leininger’s model and the PCCDHS framework ultimately serve to improve the dialogue between a nurse and a patient (Campinha-Bacote, 2002). It could be argued that, in Leininger’s model, the focus on the communication between the care provider and its recipient is more pronounced. Indeed, the author specifies that the enhancement of cultural competence should occur through the cultural exchange taking place between a nurse and a patient.

The final difference between the two strategies for improving care concerns the time period at which they were created. Although one may claim that a proper nursing framework that allows taking patients’ needs into account can be regarded as timeless, it is important to understand the cultural context in which it originates. Being a product of the 90ies nursing system, Leininger’s theory should be viewed as the predecessor of the PCCDHS approach and, possibly, its direct inspiration (Campinha-Bacote, 2002).

Indeed, with a sharp focus on cultural competence, the PCCDHS tool incorporates a plethora of elements that Leininger’s framework provides, thus creating the sense of continuity between them.

Although the PCCDHS tool is admittedly more advanced and elaborate in its focus on transcultural issues and the understanding of the effects that the globalization process has had on the world community, Leininger’s tool also warrants its use in the nursing setting. Specifically, the approach should be seen as a means of exploring the significance of communication between patients and nurses, as well as engaging patients’ families into the process of care (Campinha-Bacote, 2002). Therefore, it would be reasonable to perceive the theories through the prism of continuity in nursing. Leininger’s approach has provided the platform for incorporating innovative tools into the management of diverse patients’ needs and extending the patient-nurse dialogue across the global community, which makes both models equally important.

By integrating the principles of Leininger’s Theory and the PCCDHS framework into the context of modern nursing, one will create the nursing strategy that will allow encompassing the problems of contemporary healthcare.

The proposed technique will help to drive the process of health management toward addressing the needs of vulnerable groups (Campinha-Bacote, 2002). Furthermore, the selected frameworks will be used to enhance education among nurses and encourage them to develop the skills such as cultural competence and empathy. The resulting increase in the quality of healthcare and the effects of nursing will prove that the specified theoretical frameworks should be included into the modern nursing setting. Thus, the quality of a nurse-patient dialogue will increase, and the overall efficacy of nursing strategies will rise.


Campinha-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 13(3), 181-184.

Hendson, L., Reis, M. D., & Nicholas, D. B. (2015). Health care providers’ perspectives of providing culturally competent care in the NICU. Journal of Obstetric, Gynecologic & Neonatal Nursing, 44(1), 17-27.

Leininger, M. M. (1988). Leininger’s theory of nursing: Cultural care diversity and universality. Nursing Science Quarterly, 1(4), 152-160.

Prosen, M. (2015). Introducing transcultural nursing education: Implementation of transcultural nursing in the postgraduate nursing curriculum. Procedia-Social and Behavioral Sciences, 174, 149-155.

Ray, M. A. (2016). Transcultural caring dynamics in nursing and health care (2nd ed.). Philadelphia, PA: F.A. Davis.

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