Madeleine Leininger: Sunrise Model

In the mid 1940s, working with med-surg patients, Madeleine Leininger began to notice
behavioural differences in the patients and questioned the cultural aspects of these
differences in relation to care. This led her to develop the theory of culture care and
transcultural nursing (Cameron, 2005). From this theory the Sunrise Model was
developed. It is a model to demonstrate inter-relationships of the concepts in her theory
of Culture Care Diversity and Universality. Culture care diversity is referred to as
differences in meanings, patterns, values, life ways, or symbols of care within or between
collectives that are related to assistive, supportive, or enabling human care expressions.
Cultural Care Universality is defined as the common, similar, or dominant uniform care
meanings, pattern, values, lifeways or symbols that are manifest among many cultures
and reflect assistive, supportive, facilitative, or enabling ways to help people. (Sager
2012).
Leininger developed three modes of nursing care decisions and actions as nursing
interventions does not demonstrate the ideas of cultural interference and imposition. The
first includes: cultural care preservation or maintenance. It entails making professional
decisions on the part of the nurse that helps the people of a culture to retain care values to
maintain their well-being, recover from illness, or face handicaps or death.
The next mode of decision- making continues from preservation to understanding or
negotiation. The nurse will enable professional decisions that help the people of that
culture to adapt or reach a compromise for a beneficial outcome between health care
professionals and patients. This is a balance between emic and etic (Tomey, 2001).
The last mode if nursing care decision is Cultural care restructuring. This includes
restructuring the cultural beliefs of the patient so that they will receive optimum health
care while still having their beliefs respected. This is the final outcome between the
balance of emic and etic. All these modalities acknowledged reduce culture shock or /
and cultural imposition to produce culturally competent nurses (Sager, 2012).
To carry out these modalities a few assumptions were made:
Different cultures perceive, know, and practice care in different ways, yet there
are some commonalities about care among all cultures of the world.

Values, beliefs, and practices for culturally related care are shaped by, and often
embedded in, the worldview, language, religious (or spiritual), kinship (social),
political (or legal), educational, economic, technological, ethno-historical, and
environmental context of the culture.

While human care is universal across cultures, caring may be demonstrated
through diverse expressions, actions, patterns, lifestyles, and meanings.

Cultural care is the broadest holistic means to know, explain, interpret, and
predict nursing care phenomena to guide nursing care practices.

All cultures have generic or folk health care practices, that professional practices
vary across cultures, and that in any culture there will be cultural similarities and
differences between the care-receivers (generic) and the professional care-givers.

Care is distinct, dominant, unifying and central focus of nursing, and, while
curing and healing cannot occur effectively without care, care may occur without
cure.

Care and caring are essential for the survival of humans, as well as for their
growth, health, well-being, healing, and ability to deal with handicaps and death.

Nursing, as a transcultural care discipline and profession, has a central purpose to
serve human beings in all areas of the world; that when culturally based nursing
care is beneficial and healthy it contributes to the well-being of the client(s)
whether individuals, groups, families, communities, or institutions as they
function within the context of their environments

Nursing care will be culturally congruent or beneficial only when the clients are
known by the nurse and the clients patterns, expressions, and cultural values are
used in appropriate and meaningful ways by the nurse with the clients.

If clients receive nursing care that is not at least reasonably culturally congruent
(that is, compatible with and respectful of the clients life ways, belief, and
values), the client will demonstrate signs of stress, noncompliance, cultural
conflicts, and/or ethical or moral concerns.

(Gonzalo, 2011)

The nurse will help the patient move towards health improvements or try as changing or
altering cultural values will be hard for the health care provider. Leininger formulated a
theory, however, that specified a multicultural aspect of care. This theory is
commendable and very valid but critics, however, argued that the theorist did not state
how to assist, support or enable the patient to attuning them to an improved lifestyle.
















Reference:
Cameron, C., & Luna, L. (2005). Conceptual models of nursing: Analysis and
application. Upper Saddle River, NJ: Pearson Prentice Hall.

Gonzalo, A. (2011). Culture Care Diversity and Universality. Retrieved September 30,
2014, from http://nursingtheories.weebly.com/madeleine-m-leininger.html

Sager, P. L. (2012). Transcultural nursing theory & models: Application in nursing
education, practice & application. New York , NY: Springer Publishing Company.

Tomey & Alligood (2001). Understanding the Work of Nurse Theorists. Retrieved from
http://nursing.jpub.com/sitzman/ch15pdf.pdf.