Nursing practice and theory are characteristically interrelated where the latter is used to analyze, develop, distribute, and apply real-time expertise in the profession and offer a paradigm for healthcare providers to systematize their undertakings. Leininger's model provides care standards that are in harmony with patient's or group's cultural practices and values. The model mainly guides nurses to offer optimal holistic, culture-founded care and exercise personal attention to patients within a familiar, caring, and relevant cultural context. Commitment to learning and practicing culture-capable care provides much satisfaction and numerous other benefits to those who can offer holistic, supportive care to all individuals irrespective of other factors.
Understanding culture is essential in addressing healthcare inequality since culture is the widest-ranging, comprehensive, and global aspect of people where care is embedded. The structure of the theory is based on the Sunrise Model, incorporating technological, kinship, social, religious, philosophical, and cultural aspects (Sagar, 2012). It also incorporates critical analysis in elucidating the role played by the theory in solving the problem of health and healthcare inequality. As such, the following paper presents a critique of an available nursing theory founded by a nursing theorist Madeleine Leininger. The analysis is based on the issues mostly experienced by nurses in healthcare centers and the application of the theory in solving the problem of health inequalities in healthcare.
The first section of the paper presents the description of the heath and healthcare inequality concern by stating its importance to the nursing profession, providing evidence from nursing literature, and identifying affected people. The next section is dedicated to the application of Leininger’s theory to solve the concern and the identification of a specific useful strategy. Lastly, the conclusion provides a summary of the key points of the paper.
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Health and Healthcare Inequality Concern in Healthcare and Nursing Practice
Health and healthcare inequality concern is a serious factor in healthcare and nursing practice. In various countries, affected people experience inequalities in access and utilization of proper healthcare, as they receive less assistance and attention as compared to the general population. Furthermore, healthcare and health inequalities or biases represent global concerns in healthcare that have persisted for years and continue to exist in the twenty-first century. For the affected persons, the stated health-affiliated inequalities are grave concerns. Moreover, the accompanying fiscal and social stress created for the country is another adverse consequence.
There exist distinct issues regarding health and healthcare inequality. It should be mentioned that the minorities, including ethnic and racial groups, are the most affected people. For instance, according to the U.S. Department of Health and Human Services [USDHHS] (2014), Blacks and Hispanics have worse access to care and receive worse care as compared to Whites. They also have lower rates of insurance (USDHHS, 2014). One can also observe the biased proportion in the provision of medication for pain, especially among the Hispanic population (USDHHS, 2014). As such, white individuals are in a position to acquire improved health and healthcare services compared to those who are not. Thus, health-affiliated biases for ethnic and racial minorities are undeniable.
The issue raises a big concern since there is a small improvement made in eradicating the disparities in the healthcare context. Therefore, health-related inequalities become the primary concern that can be addressed by Leininger’s theory, as they are becoming problematic. There is a need for the nursing profession to care about the issue in question since, in the United States, the number of people from different racial and ethnic backgrounds increases regularly. There also exists the probability that the number of health-associated inequalities will continue to worsen.
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The nursing fraternity and non-white clients are the most affected by the issue. There also exist other groups that may face bias in health and healthcare provisions, including individuals classified by gender, sexual orientation, literacy status, below-average socioeconomic status, age, residence location, and disability status (USDHHS, 2014). Health determinants are typically clustered into four classes, namely the social, behavioral, environmental, and biological. The social determinants entail but are not limited to healthcare access and quality, race, gender, education, income, and nutrition security status.
The behavioral factors affecting health include the consumption of alcohol, drug abuse, and obesity. Drug and substance abuse may result in unpremeditated deaths or chronic ailments. The environmental factors entail polluted workplace, poor living conditions, or security factors. Finally, biological factors include inherited conditions and health issues. Therefore, it becomes apparent that there is a need to institute and implement policies based on the above aspects to facilitate the reduction of health and healthcare inequalities (USDHHS, 2014).
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Use of Leininger’s Theory in Addressing Health and Healthcare Inequalities
Owing to the intricacy of health-associated inequalities, it becomes evident that no single approach may solve the issue. Nonetheless, compound goals have been classified through the analysis and the collaboration with communities, state agencies, and other affected groups with the intention of solving the issue. A summary of important goals may entail obliging the healthcare system to guarantee quality and accessibility, improving understanding of health inequalities, and conducting research.
Cultural competence in the healthcare context is regarded as a vital aim to eradicate health-associated biases by the public and private sectors, communities, and affected individuals. Irrespective of the distinct group experiencing inequalities in health and healthcare, cultural competence is an essential step in the pursuit of lessening and eradicating healthcare biases.
Leininger's theory defines how a nurse can effectively address the needs of patients from various cultures since the population is composed of a mixed proportion. Inequality in health and healthcare can be reduced and even eradicated if Leininger's theory is fully implemented. The theory is instrumental in tackling the challenges because it is the only method in the nursing practice to offer a paradigm of culture and care.
The fundamental aspect of eradicating the stated inequalities and improving minorities ’ health and access to healthcare is managing it from a cultural perspective. Leininger’s theory of cultural competence combines a group of congruent traits with attitudes and awareness that helps a person to function efficiently in diverse cultural settings. According to Betancourt (2015), Leininger's theory enables individuals to analyze the expectations of the nurse-client relationship effectively, which results in a better provision of care.
Usually, cultural competence in healthcare helps healthcare institutions and experts to comprehend and respect cultural differences and provide assistance and care that will result in desirable patient outcomes. The cultural competence of the healthcare professional is essential in complementing social capability in the healthcare model. However, accomplishing such a result proves problematic and challenging. Usually, the healthcare provider is bound by the necessary structural, institutional, and state standards, guidelines, and regulations to achieve a cultural capability.
Cultural competency advocated by Leininger's theory is particularly relevant to the nursing career as nurses devote most of their time to providing patient care as compared to other experts. The nursing practice is patient-focused, making it essential to offer culturally adequate nursing care. Nurses providing culturally competent nurture care possess the capability to devote the necessary attention to patients, resulting in their satisfaction and desirable health outcome for culturally diverse groups.
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In the context of nursing, culture can be defined as an essential element that affects the provision of health services and may take an adverse or a positive dimension depending on the behavior of the practitioner (Weiner, Mcconnell, Latella, & Ludi, 2012). The primary concept behind Leininger’s theory is determining and understanding the cultural forces that shape the nurse-customer relationship. The theory addresses health and healthcare disparities through the delivery of culturally congruent care.
Through discovering, documenting, interpreting, and explaining various factors influencing and defining care from a holistic cultural viewpoint, the theory manages inequities in the nursing context. Understanding equitable health and healthcare would require a better understanding of the kingships, technology, economics, social and religious values, norms, customs, beliefs, and practices that are enshrined in the theory.
Leininger’s theory can best be understood through the Sunrise Model that was developed to present the associated dimensions of Leininger’s model of culture care. The method addresses health and healthcare inequality issues through identifying, explaining, and shaping the nursing profession. The theory uses culture to understand behavior (Sagar, 2012). Typically, nursing awareness becomes an essential factor for sustaining and solidifying the connection between nursing theory and practice. With the theory, a framework to create new and validate existing knowledge is instituted. The theory enables nurses to communicate more efficiently with customers from varied cultural and linguistic backgrounds and help those with psychological concerns irrespective of race.
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In determining health disparities, precise and persistent measurement and reporting are crucial. It is also essential to note that inadequate data have been associated with inconsistent or lack of information regarding other health determinants that affect the health of minorities in many circumstances (Truman et al., 2011). The issue of health-associated inequalities creates a great necessity to close the gap and realize national health equities. Therefore, lessening or eradicating health and healthcare inequalities will contribute to the wellness of all individuals in the nation.
There exists a strategy that can be applied to resolve the problem of inequality in health and healthcare and that is usually associated with Leininger's theory. The transcultural nursing educational plan is an essential new resource that can be used to assist nurse educators and practicing nurses in their objectives to offer culturally congruent care. When implemented appropriately, the strategy can reduce the effects of biases on care provision since care providers will be in a position to provide high-quality care for all patients (Sagar, 2014). The effective implementation of the strategy can be accomplished by applying the Sunrise Model to ensure they practicing nurses are fully equipped to function efficiently in the care environment.
For desired results, the theory can be best implemented through advanced research in nursing institutions. In further research, there is a need to identify strategies that enhance the cultural competence of health workers within the healthcare facilities, taking into consideration the differences in culture and language of various populations, as well as the provision of care in different settings. As such, medical organizations should invest in research and the development of initiatives improving the collection of information about their patients and developing new models of provision of care to minorities and immigrants. These strategies should be evaluated to define whether they are relevant and effective.
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The inequality problem in health and healthcare provision partly arises due to the deficiency in acquiring original, analytical, and precise information regarding patients’ cultures and their understanding of care, expressions, and desirable results. Leininger's theory guides nurses in differentiating care and culture and, therefore, puts them in a better position to deal with the concern. The central concept behind the method is determining and understanding the cultural forces that shape the nurse-patient relationship. Through culture care preservation and maintenance, the theory utilizes helpful, supportive, and enabling expertise decisions that assist in retaining, preserving, or upholding beneficial care dogmas and values. The decisions guide the nurses in alleviating disparities in health and healthcare providers and ensure equal healthcare for all.
From the research, I learned that biases in offering quality care are partly fueled by actions or decisions that fail to take into consideration the peculiarities of different cultures. Consequently, I will implement the Leininger’s theory in my practice because it ensures that care and culture are bridged for the betterment of service delivery, thus assisting in delivering quality care. Owing to research, I also understood that proper care can be provided if healthcare professionals receive proper training.