Leiningers Theory of Culture Care Diversity

1
Leiningers Theory of Culture Care Diversity
UniversalityVs Levines Conservation Model

• Leanne McFarland, Lara Kim, Astrid Anderson

2
Madeleine Leininger

• Theory of Culture Care Diversity Universality

3
Leiningers Theory

• Caring is the essence of nursing and is unique to
  nursing
• Does not rely upon the four nursing paradigms of
  person, environment, health, and nursing
• Too restrictive for open discovery about culture
  and care

4
Leiningers Theory

• Care culture are inextricably linked
• Leininger recognized the importance of an
  understanding of culture - both the nurses and
  the clients - to effective nursing practice.
• All cultures have practices related to caring.
• Practices common across cultures are culture care
  universalities
• Practices specific to a given culture are culture
  care diversities
• Research findings indicate there is more
  diversity than universality.

5
Leiningers Theory

• To practice from a cultural perspective
• Respect the culture
• Recognize the importance of the culture to
  nursing care
• If not practiced
• Patient can show signs of cultural conflict,
  noncompliance, stress, and ethical or moral
  concern

6
Leiningers Sunrise EnablerA conceptual model
to guide nursing judgments and activities to
provide culturally congruent care
(See Chitty Black, 2007, pg. 343)
7
How does Leiningers theory inform our practice?

• Remember.culturally congruent care is care that
  is beneficial and meaningful to the people being
  served (Andrews Boyle, 2003, p. 6)
• Culture should determine the way that individuals
  receive care, based on the different ways their
  cultures meet their basic needs.
• By 2050, white native-born Americans are
  estimated to represent less than 50 of the
  population. To care for this increasingly
  diversified nation, nurses must embrace the
  concept of culturally congruent care!

8
Leininger in Practice Cont

• Leiningers theory does not focus on medical
  symptoms, disease, or treatment, it focuses on
  the nurses approach to care (this is truly a
  holistic nursing idea!)
• Tailor your nursing care to your patients with
  the goal of improving their comfort and response
  to care
• Utilize this theory for holistic assessments of
  the patient

9
Leininger in Practice Cont

• Spend time researching culture and asking
  questions
• Get patient feedback
• Dont assume
• Remember to ask what the patient considers good
  care
• Ask patients to describe their own experiences
  with health care
• Finding out about their culture helps identify
  the influencing factors related to their health
  practices and concerns

10
Leininger In Practice Cont

• Leiningers Theory is flexible and widely useful
• it can be utilized with individuals, families,
  groups, communities and institution in diverse
  health systems (Andrews Boyle, 2003, p. 6).
• No matter what type or setting of nursing you
  pursue, there is always a model to guide your
  care with concern to culture!

11
Key Points to Remember..

• CULTURE
• E
• I
• N
• GUIDES
• N
• G
• E
• CARE

12
Levines Conservation Model

• Four Guiding Principles
• of the
• Art of Nursing
• (1973)

13
Primary Focus Conservation of the Individual

• Adaptation to changes in health and disease so as
  to preserve individual integrity
• Individuals require nursing care when they are
  unable to adapt and retain wholeness themselves.
• Conservation aims to maintain an equilibrium
  conducive to health accordingly, many nursing
  interventions use conservation principles to
  maintain patient wholeness (Leach, 2006).

14
A Conceptual Model to Guide Nursing Interventions

• Conservation of
• Energy
• Structural Integrity
• Personal Integrity
• Social Integrity
• Nursing Interventions focus on promotion and
  support of adaptation to preserve the four
  principles

15
Conservation of Energy

• Promote the bodys energy balance when faced with
  changes in psychological or physiological
  processes so as to sustain life
• Energy conservation is based on the following
  ideas
• Patient activity is dependent on energy balance
• Illness increases energy demand
• Increased energy demand can be measured by the
  level of fatigue (Leach, 2006)

16
Conservation of Structural Integrity

• Age and illness can produce structural changes
  which require adaptation
• Through conservation of structural integrity,
  patients will feel intact and whole and
  subsequently manifest improvements in
  self-identity (Leach, 2006)

17
Conservation of Personal Integrity

• The conservation of personal integrity aims to
  protect personal identity, an intrinsic factor to
  wholeness of the individual
• Conserving personal integrity is based on the
  following ideas
• Individuals require privacy and are responsible
  for their own decisions
• Illness and hospitalization compromise personal
  integrity, self-identity, and self-respect
  (Leach, 2006).

18
Conservation of Social Integrity

• Social interaction and relationship of self to
  others is key to unity of the individual
• Conserving social integrity is based on the
  following principles
• Individual life has meaning only in the context
  of social life
• Individual behavior is influenced by the ability
  to relate to various social groups
• Families often are affected by an individuals
  illness
• Hospitalization results in social isolation
  (Leach, 2006)

19
Example of Levines Conservation Model
www.ids-healthcare.com
20
How does Levines Model inform our practice?

• RememberLevines Conservation Model is used to
  guide nursing interventions with the goal of
  conserving integrity of the individual through
  adaptation to physical and psychological changes.
• Nursing actions and interventions should
• aim to conserve 4 areas of integrity
• Energy
• Physical Integrity
• Personal Integrity
• Social Integrity

21
Nursing Interventions for Conservation of Energy

• The nurse will foster balance between energy
  output and input to avoid excessive fatigue
• Support adjustment to changes in living
• situations (i.e. SNF)
• Improve nutritional status
• Control pain and anxiety
• Reduce patient activity when appropriate
• Promote exercise and
• rehabilitation within the
• patients abilities, limitations
• and comfort

22
Nursing Interventions for Conservation of
Structural Integrity

• The nurse will help maintain or restore the
  patients body structure by preventing physical
  breakdown and promoting healing
• Precautions in infection and injury prevention
• Promote mobility
• Early ambulation to prevent complications of bed
  rest
• Assist in adaptation to decreased mobility
• Maintain musculoskeletal integrity through ROM
  exercises
• Maintain venous integrity through use of
  compression therapy and/or TED hose
• Maintain skin integrity (early detection and
• management of disease processes conserve
• structural integrity)
• Positioning

23
Nursing Interventions for Conservation of
Personal Integrity

• The nurse will help maintain or restore the
  patients sense of identity and self-worth,
  acknowledging uniqueness of the patient
• Respect ones privacy and property
• Support personal choice
• Enhance self-esteem through good hygiene and
  dress
• Foster independence
• Loss of independence negatively affects pride and
  self-identity
• Provide knowledge and support, but encourage
  patient to maintain independence
• Promote appropriate coping mechanisms
• Exercise

24
Nursing Interventions for Conservation of Social
Integrity

• The nurse will foster awareness that the patient
  is a social being who interacts with others in
  their social environment.
• Promote meaningful social activities and outings
• Encourage family support education
• Promote family participation in care
• Foster patient interaction with others
• Promote healing to restore the
• patients mobility
• Promote exercise to increase
• the patients ability to socialize

25
Key Points to Remember.

• Levines Model focuses on conserving the
  patients wholeness by regaining or maintaining
  their
• Energy
• Structural Integrity
• Personal Integrity
• Social Integrity

26
References

• Andrews, M.M. Boyle, J.S. (2003). Transcultural
  concepts in nursing care (4th ed.). Lippincott
  Philadelphia.
• Chitty, K.K. Black, B.P. (2007) Professional
  nursing concepts and challenges (5th ed.).
  Suanders Elsevier St. Louis.
• Cox, R.A. (2003). Using NANDA, NIC, and NOC With
  Levine's Conservation Principles in a Nursing
  Home. International Journal of Nursing
  Terminologies and Classifications, Oct-Dec.
• Leach, M.J. (2006, August 1). Wound management
  using Levines conservation model to guide
  practice. Ostomy Wound Management, 52 (8).
  Retrieved October 17, 2008, from
  http//www.o-wm.com/article/6024
• Mock V., St. Ours C., Hall S., Bositis A. ,
  Tillery M. , Belcher A., Krumm S. McCorkle R.
  (2007) Using a conceptual model in nursing
  research - mitigating fatigue in cancer patients.
  Journal of Advanced Nursing 58(5), 503512.
• Schaefer, K., Potylycki, M.J. (1993). Fatigue
  associated with congestive heart failure use of
  Levine's Conservation Model. Journal of Advanced
  Nursing, 18, 260-268.
• www.madeleine-leininger.com