Leininger developed new terms for the basic tenets of her theory. These definitions and the tenets are important to understand. Understanding such key terms is crucial to understanding the theory. Below is a basic summary of the tenets that are essential to understand with Leininger’s theory ;

• Care is to assist others with real or anticipated needs in an effort to improve a human condition of concern or to face death.

• Caring is an action or activity directed towards providing care

• Culture refers to learned, shared, and transmitted values, beliefs, norms, and lifeways of a specific individual or group that guide their thinking, decisions, actions, and patterned ways of living.

• Cultural care refers to multiple aspects of culture that influence and enable a person or group to improve their human condition or to deal with illness or death.

• Cultural care diversity refers to the differences in meanings, values, or acceptable modes of care within or between different groups of people.

• Cultural care universality refers to common care or similar meanings that are evident among many cultures.

• Nursing is a learned profession with a disciplined focused on care phenomena.

• Worldview refers to the way people tend to look at the world or universe in creating a personal view of what life is about.

• Cultural and social structure dimensions include factors related to religion, social structure, political/legal concerns, economics, educational patterns, the use of technologies, cultural values, and ethnohistory that influence cultural responses of human beings within a cultural context.

• Health refers to a state of well-being that is culturally defined and valued by a designated culture.

• Cultural care preservation or maintenance refers to nursing care activities that help people of particular cultures to retain and use core cultural care values related to healthcare concerns or conditions.

• Cultural care accommodation or negotiation refers to creative nursing actions

that help people of a particular culture adapt to or negotiate with others in the healthcare community in an effort to attain the shared goal of an optimal health outcome for client(s) of a designated culture.

• Cultural care repatterning or restructuring refers to therapeutic actions taken

by culturally competent nurse(s) or family. These actions enable or assist a client to modify personal health behaviors towards beneficial outcomes while respecting the client’s cultural values.

There are several specific assumptions inherent in this theory that support the theory premises and Leininger’s use of the terms described above. These assumptions are the philosophical basis of Culture Care: Diversity and Universality theory. They add meaning, depth, and clarity to the overall focus to arrive at culturally competent nursing care. The following are distilled from Leininger‘s work and preceeded other nurses’ use in recent years who are now valuing and using these ideas and the theory. These statements are derived from Leininger’s key sources (Leininger 1976, 1981, 1991, 1995, 2002, but most

specifically, 2001, pp. 44–45):

• Care is the essence and central focus of nursing.

• Caring is essential for health and well-being, healing, growth, survival, and also for facing illness or death.

• Culture care is a broad wholistic perspective to guide nursing care practices.

• Nursing’s central purpose is to serve human beings in health, illness, and if dying.

• There can be no curing without the giving and receiving of care.

• Culture care concepts have both different and similar aspects among all cultures of the world.

• Every human culture has folk remedies, professional knowledge, and professional care practices that vary. The nurse must identify and address these factors consciously with each client in order to provide wholistic and culturally congruent care.

• Cultural care values, beliefs, and practices are influenced by worldview and language, as well as religious, spiritual, social, political, educational, economic, technological, ethnohistorical, and environmental factors.

• Beneficial, healthy, satisfying culturally based nursing care enhances the well-being of clients.

• Culturally beneficial nursing care can only occur when cultural care values, expressions, or patterns are known and used appropriately and knowingly by the nurse providing care.

• Clients who experience nursing care that fails to be reasonably congruent with the client’s cultural beliefs and values will show signs of stress, cultural conflict, noncompliance, and ethical moral concerns.

In synthesizing the information contained in the defining terms and assumptions just presented, a broad definition emerges of a culturally competent nurse who:

• Consciously addresses the fact that culture affects nurse–client exchanges

• With compassion and clarity, asks each client what their cultural practices and preferences are

• Incorporates the client’s personal, social, environmental, and cultural needs/beliefs into the plan of care wherever possible

• Respects and appreciates cultural diversity, and strives to increase knowledge and sensitivity associated with this essential nursing concern.