Analysis and critique of Madeleine Leininger

Analysis and critique of Madeleine Leininger Introduction This paper is an analysis and critique of a published nursing philosophy and theory by the nurse theorist Madeleine Leininger. The analysis is based on Leiningers publications about her theory starting in the mid-1950s with her major contribution stemming from her second book, Transcultural Nursing: Concepts, Theories, Research, and Practice in 1978. The model used to analyze this theory is the Chinn and Kramer model. This model was developed by Peggy Chinn and Maenoa Kramer in 1983. The model utilizes a two-step process to evaluate theories called theory description and critical reflection. Theory description consists of purpose, concepts, definitions, relationships, structure, and assumptions. Critical reflection analyzes the purpose of the theory utilizing a series of questions. (McEwen Willis, 2010, p. 95) This model will be used to critique one of the oldest theories in nursing. Purpose Transcultural Nursing Theory discovers and explains the culturally based care factors that influence health, well-being, illness, and death of each individual or community. The purpose and goal of the transcultural nursing theory is to provide culturally congruent, safe, and meaningful care to clients of diverse or similar cultures. (Leininger, 2002, p. 190) Leininger has established a theory that studies cultures to understand their differences and similarities. Cultural competence is important within the nursing profession due to the differences in each individuals perception of illness and wellness. Congruency between culture and health care is essential to the well-being of each individual and community. An individuals health beliefs and practices are linked by his/her culture. The culture care theory focuses on cultural beliefs and practices when determining a plan of care. It continues with the belief that nurses need to consider that not all cultures are similar, and there are variations within each culture. Each individual or community should be treated differently from the rest and that personal uniqueness should always be considered. This belief stems from Leiningers personal belief in Gods creative and caring ways. (Leininger, 2002, p. 190) Concepts Definitions Transcultural theory uses the concepts of culture, race, and ethnicity to understand human behavior. When providing culturally competent care nurses should understand the meaning of these terms. Leininger also focuses on a few other concepts such as cultural competence, cultural awareness, and acculturation. Leiningers theory focuses on numerous concepts, but these were selected based on the importance of nurses integrating the most basic concepts of transcultural nursing into their well-established knowledge base. Culture influences all spheres of human life. It defines health, illness, and the search for relief from disease or distress. With increased mobilization of people across geographical and national borders, multicultural trends are emerging in many countries. (Ayonrinde, 2003, p. 233) Culture is defined as a set of beliefs, values, and assumptions about life that are widely held among a group of people and that are transmitted across generations. (Leininger McFarland, 2002 , p. 47) Burchum (2002) defines culture as a learned world viewà ¢Ã¢â€š ¬Ã‚ ¦shared by a population or group and transmitted socially that influences values, beliefs, customs, and behaviors, and is reflected in the language, dress, food, materials, and social institutions of a group (Burchum, 2002, p. 7) All cultures are not alike, and all individuals within a culture are not alike. Each person should be viewed as a unique human being with differences that are respected. Individuals may be of the same race, but of different cultures. Race is defined as a social classification that relies on physical markers such as skin color to identify group membership. (Leininger McFarland, 2002, p. 75) Many nurses overlook cultural differences of individuals due to their similar racial characteristics. Race is considered one of the identifying characteristics of a culture, and this identifying characteristic represents an ethnicity. Ethnicity is defined as a cultural membership that is based on individuals sharing similar cultural patterns that, over time, create a common history that is resistant to change. (Leininger McFarland, 2002, p. 75) Cultural competence is an important factor in nursing. Culturally competent care is provided not only to individuals of racial or ethnic minority groups, but also to groups that vary by age, religion, socioeconomic status or sexual orientation. Cultural competence is defined as a combination of culturally congruent behaviors, practice attitudes, and policies that allow nurses to work effectively in cross cultural situations. (Leininger McFarland, 2002, p. 78) Religious and cultural knowledge is important in the healthcare profession. It is also important that health care professionals assess their own beliefs and ask themselves how those beliefs may affect the care given to clients. The awareness of your own beliefs is called, cultural awareness, and is defined as self-awareness of ones own cultural background, biases, and differences. (Burchum, 2002) Not only must nurses be aware of their own beliefs, but also must be willing to learn and understand an individuals beliefs. The proc ess of learning a new culture is acculturation. Adapting to a new culture requires changes in each nurses practices. Relationships Structure The relationship and structure between the concepts in the culture care theory is presented in Leiningers sunrise model. (Figure 1) This model is viewed as rising sun and should be utilized as an available tool for nurses to use when conducting cultural assessments. This model interconnects Leiningers concepts and forms a structure that is usable in practice. This model provides a systematic way to identify the beliefs, values, meanings, and behaviors of people. The dimensions of the model include technological, religious, philosophic, kinship, social, values and lifeway, political, legal, economic, and educational factors. These factors influence the environment and language, which affects the overall health of the individual. Individuals who may not feel understood may delay seeking care or may withhold key information. Environment and language affect the overall health system which consists of the folk and professional health system. The folk health system consists of the traditio nal beliefs, while the professional health system consists of our learned knowledge such as organized school and evidenced-based practice. The combination of these systems creates the nursing profession which allows us to meet the cultural, spiritual, and physical needs of each individual. These factors help nurses understand the client and recognize what is unique about the client. This model helps each nurse avoid stereotyping an individual into a culture based on the minimal factors of race or ethnicity. (Leininger, 2002, p. 191) The last dimension of the model helps nurses establish culturally congruent care through the utilization of three concepts: culture care preservation/maintenance, culture care accommodation/negotiation, or culture care repatterning/restructuring. Cultural preservation means that the nurse supports and facilitates cultural interventions. (Burchum, 2002) Cultural interventions may include the use of acupuncture or acupressure for relief before utilizing standard practices/interventions. Cultural accommodation requires the nurse to support and facilitate cultural practices, such as the burial of placentas, as long as these practices are found not to be harmful to individuals or the surrounding community. (Burchum, 2002) Cultural repatterning requires the nurse to work one-on-one with an individual or community to the help them restructure, change, or modify their cultural practice. (Burchum, 2002) Cultural repatterning should only be used when the practice is found to harmful to an indi vidual or community. All of these factors and concepts guide the nurse towards their ultimate goal of providing culturally competent care. These factors and goals allow the nurse to fulfill the individuals need of having holistic and comprehensive culturally based care. Assumptions There are a number of theoretical premises for the cultural care theory. Leininger (2002) highlighted five important assumptions. The first is Care is the essence of nursing and a distinct, dominant, central, and unifying focus. (Leininger, 2002, p. 192) Nurses provide care with sensitivity and compassion. Cultural care theory requires nurses to provide that same care, but based on the cultural uniqueness of each individual. The second is Culturally based care (caring) is essential for well-being health, growth, survival, and in facing handicaps or death. (Leininger, 2002, p. 192) Non-culturally competent care may increase the cost of health care and decrease the opportunity for positive health outcomes. The third is Culturally based care is the most comprehensive, holistic, and particularistic means to know, explain, interpret, and predict beneficial congruent care practices. (Leininger, 2002, p. 192) Culturally competent nursing care is designed for a specific client, reflects the individuals beliefs and values, and is provided with sensitivity. The fourth is Culturally based caring is essential to curing and healing, as there can be no curing without caring, although caring can occur without curing. (Leininger, 2002, p. 192) Therefore, there is an increased need to recognize the impact of culture on health care and to learn about the culture of the individuals to whom your provide care. The last assumption is Culture care concepts, meanings, expressions, patterns, processes, an d structural forms vary transculturally, with diversities (differences) and some universalities (commonalities). (Leininger, 2002, p. 192) Nurses should be aware of cultural beliefs, cultural behaviors, and cultural differences and should avoid the temptation of premature generalizations. Following these assumptions of the cultural care theory allows nurses to be less judgmental and more accepting of cultures which promote holistic care for all cultures. Critical Reflection Culture Care Theory has played a significant role in nursing practice. The theory is highlights numerous concepts in which Leininger clearly defines and consistently utilizes in numerous publishings. The concepts in Leiningers theory are the gold standard for transcultural nursing and are mentioned in the majority of literature regarding culturally based care. The theory is complex with a number of concepts and interrelationships. The complexity is important as it develops a meaningful and comprehensive view of cultural and holistic based care. Leiningers theory has a high level of generality due to its ability broad to be applied to all cultures, ethnicities, and races. The key to Leiningers theory is communication, and even crosses languages and establishes how to eliminate language barriers, through the use of interpreters. The theory consistently approaches culturally based care by requiring the nurse to use cultural knowledge as well as specific skills when deciding nursing inte rventions and practices. The theory continues to be consistent in requiring the same approach by requiring the nurse to perform a cultural assessment. The assessment provides an understanding of an individual health perception which guides culturally appropriate interventions. Culture care theory is widely accessible as it is the major and most significant contributor to transcultural nursing. (Ayonrinde, 2003) Cultural care theory played and will continue to play a significant role in nursing practice, research and education. Healthy People 2020 goal is to eliminate health disparities among different populations based upon numerous factors. Nurses are the key in moving forward with eliminating these disparities. Todays environment is multicultural and the emphasis on providing culturally competent care has increased. The Culture Care theory is well established and it has been the most significant breakthrough in nursing and the health fields in the 20th century and will be in great er demand in the 21st century. (Leininger, 2002, p. 190)

Childcare Level 2 Unit 1 Assignment

CACHE Level 2 Award/Certificate/Diploma in Child Care and Education Question 1 D1: An example of a statutory provision for children under 5 years is a nursery. A nursery helps children learn to communicate, reach a certain level of independency and helps the children understand the stuff e. g. numbers, colours, fruits, animals etc. It also allows children to learn new things in a fun environment and at their own pace. A nursery helps to get children into a routine of a classroom.Nurseries often have designated times for different activities and helps the children learn the patience for sitting still and listening in a group. An example of a statutory provision for children of 5-7 years would be a GP. A GP does regular checks to ensure the child is well and healthy. When visiting the GP the doctor would examine the child to make sure everything is how it should be, such as: the child’s weight, height, whether the child is feeding properly, ensure the child is making positive pr ogress etc. D2: A private provision for children under 5 years would be a playgroup.A playgroup is quite different to a nursery but they still have their similarities. A nursery has to educate whereas a playgroup provides a social group, doesn’t have a strict structure and also doesn’t have a curriculum to follow. A private provision for children aged 5-7 years would be after school clubs. The children can benefit from after school clubs because of the range of activities/services they can provide such as; many sporting activities, a safe environment, a chance to learn about their own interests and also to build on their social skills.Question 2: D3: A midwife is a highly skilled, trained professional who provides advice and care for expectant mothers. A midwife organises and carries out tests and scans during the pregnancy to check mother and baby are healthy. She offers advice and support for the mother – to both her body and her feelings. From the onset of la bour the midwife is present to assist and advise the course of the birth itself, from helping the mother through her contractions to delivering the baby.Once the baby has been born, the midwife will help the new mother to adjust. The midwife can advise and assist with her experiences of knowledge. Further support and guidance is provided for the mother by the midwife while she recovers from birth. Question 3: D4: There are many ways on how to keep information safe. The two most effective ways are; to use a filing system if any information is only on paper. The papers should be stored in a locked filing cabinet or cupboard with a key that only the staff can use.If any information is stored electronically then it should always be password protected with a high security password and which will only be known by authorised personal. The most basic way is for staff and families to not gossip outside the setting about anything from their own information or information about the setting. D7 : Every child has different needs whether it’s a disability or a medical issue there is always that chance of a child being slightly different in a way that they may need more help or assistance. For example; if a child is HIV positive no body needs to know this information.If they need medical help the first aider must always wear gloves regardless of what has happened. If the staff, children or family knew a child was HIV positive they may act different towards that child which is extremely unfair. Every one should be treated the same no matter what their condition may be. C1: There are many examples of when you should refer information about children and families to a professional in your setting. Two examples of common scenarios are; †¢If you notice an unusual mark on a child’s body or if they ention something on their own accord. In many cases, any unusual mark has a reasonable explanation such as; the child was running around their home, fell and bumped thei r head on the floor or a hard object. But any mark that didn’t happen in you setting should be reported because children are extremely vulnerable and easily manipulated. Sometimes the family/carer of the child may be hurting them so its important to report any signs as early as possible so that the case can be looked further into without the possible abuse escalating. If a child is extremely disobedient, rude majority of the time, uncontrollable on a daily basis or maybe if the child isn’t developing properly it should be reported because the child may have a certain medical condition such as; autism or ADHD. The first signs of this usually show in young children and it is important to know exactly what’s going on so you don’t address the child in the wrong way or jeopardise the child’s learning. A1: It is extremely important to ensure confidentiality so that no staff, child or family member gets excluded in any situation.In a nursery everyone is w orking in best interest of every child, if a child has a certain disability or medical condition that everybody found out about, that child has a high chance of being treated differently and very unfairly. There are many examples of personal records which must be kept confidential such as; registration and admission forms, signed consents, information concerning the child and/or family, reports from meetings concerning the child from other agencies, observations from the staff on any confidential matter involving the child e. g. development concerns or child protection matters, incident and accident logs. If a family member finds out that something has been said about their personal life or has overheard something about their own child all trust from the family and the nursery will be broken, the information could be a small part or a very important note, regardless, nurseries have policies that state; nothing about a staff member, child or family should be mentioned unless its some one of higher importance, unless someone has concern about a particular child and on a ‘need to know basis’.In a nursery setting it is a professional responsibility to keep all information confidential. If a member of staff were to expose any confidential information it could result in them losing their job and in some cases, banned from having the same job. As a student going into a nursery for your course placement setting you must sign a Data Protection form. If you fail to keep any information confidential and decide to gossip outside of the nursery it could result in you losing your college place and not being allowed to study childcare. In most settings the policy is simply that no one other than the parents, manager or supervisor and any other authorised person is able to view the children’s records† Tassoni. P (2005) (page 74) Question 4: D5: When preparing for placement you should ensure you are fully aware of your setting; B1: In your setting, the first impressions you make are always extremely important. On your first day in the setting you walk in looking a mess, come in late, walk around with an attitude your supervisor will think that you don’t want to be there and he/she will speak to your college tutor and that means your college placement may be jeopardised.If you walk in to your setting on time, dressed suitably, have a hard working attitude and have everything organised your supervisor will realise that you want this opportunity and try help you as much as they can which isn’t a requirement from them. If you do everything in your power especially on your first day you will learn a lot, get on with everyone and get the best out of the course you possibly can. You never get a second chance to make a first impression so what you do when it comes down to meeting anyone is important and in your placement if arents see you not acting like you want this chance they wont want you around their child, they wonâ €™t be polite they will just act how you did. The best way in a nursery to make everyone know that the course is exactly what you want is to get in to the placement 15 or 20 minutes early, sit down talk to your supervisor so that when the parents come you are ready to stand there with a smile and greet them. B2: Showing a positive attitude when working in a childcare setting is important because it shows the staff and families of the children that you are committed and that you know what is expected of you.There are many ways to show this such as; †¢Be responsible and reliable †¢Team work †¢Good communication †¢Non-judgmental †¢Avoiding negative attitudes †¢Being appreciative †¢Enthusiasm †¢Look for opportunities to have fun without over exciting the children †¢Resist sarcasm Showing staff and families you have a positive attitude towards helping, teaching and also learning allows them to trust you and they still feel safe leaving the ir children with you.If you don’t have a positive attitude while being in your placement and the parents aren’t happy they may wish to take their child out of the nursery and put somewhere else which wouldn’t look good for you. Whether you have issues at home, relationship issues or you are stressed out from college you should never under any circumstances take that into your placement. Your supervisor may not know you have personal problems and you may take something out of context.When entering your placement you should be mature and responsible enough to realise it’s not the placements fault, it’s not the children’s fault so the best thing to do is smile and enjoy your day. Question 5 D6: Every child is different, whether it be religious beliefs, gender, race etc but there are many ways you can teach a child that everybody is different but we all are the same (D7). Teaching children about different countries and languages is a good way to get them to accept other individuals.Personally, the easiest way for me is to teach them about different religious holidays such as Lent or Eid. It shows the children that everybody has different beliefs, that everybody does different things but at the same time everybody is the same. D7: Every individual is a unique person but in life this isn’t always accepted by everyone. A nursery for instance has a very diverse and inclusive environment; they accept all children regardless of their gender, race, background, physical abilities and religious beliefs which is extremely beneficial in this day and age.Adults are trying to teach children that no matter how different an individual looks or acts, everybody is equal and everybody should be accepted, everyday people learn to be inclusive and accept any individual. Question 6 A*: I am a visual learner and my learning style is most enjoyable when it comes to being in my placement setting because I can watch the children play whilst learning at the same time. There are many different examples of what I can do to learn my own way such as; †¢Mind-mapping and brainstorming †¢Collages, posters and cartoon drawings Using different coloured pens and highlighters to highlight key points in study notes †¢Using symbols to help me remember things †¢Videos and CD ROMs †¢Use flow charts to see the sequence of things I find it hard to learn by sitting in a classroom and getting spoken to which is why I highly enjoy placement because no matter how busy my day is I will always learn as I go along and I will always remember everything that happened in that day whereas when I’m sitting in a classroom I lose focus easily, I am easily distracted and I don’t take note of what’s being said by my teachers.I have always enjoyed learning visually; it’s a fun and very effective way to learn. My study strategies are quick and simple. All I have to do is highlight important informatio n which I know I will need to remember or put symbols in my margin so I know what bit to start from. Even when it comes down to planning activities I find it easy to mind map anything that needs to be done. D8: Tassoni, P (2007) CACHE Level 2 Childcare and Education (4th edition) Heinmann Tassoni. P (2005) (page 74)

William Shakespeare s Sonnet 138 - 863 Words

Trials and Tribulations Everyone has been in a relationship before where you know your partner may not be faithful or trustworthy. Unfortunatley, this comes as a very common feeling in most relationships. Sometimes it is just easier to ignore the obvious rather than accepting the facts. Sadly this is exactly how this poem seems to plays out. Sonnet 138 is one of William Shakespeare most famous sonnets. The poem emphasizes the effects of age on the relationship, the mutual decision of dishonesty, and the mysterious and infamous ‘Dark Lady’. Subsequently, in the sonnet Shakespeare references a lot to his numerical number in life. The line â€Å"that she might think me some untutored youth† points out that the speaker is self-conscious about his age. He stresses his awareness that his best days are behind him; a truth that his lover knows but ignores. The narrator expresses that his mistress declares him youthful, even though they both know he is not. He understands that the two of them are lying to each other for the sake of their relationship to live. Mindful that the mistress has vowed to make him happy, he knows the reality that he is in fact older and wiser. â€Å"She fantasies about him being young, and hopes he hasn’t been through too many experiences† (Fresques). When the mistress speaks to him and confesses her love, she knows its not to be true. However, Shakespeare seems to be grateful for the company she provides him, the love she professes, and the unspoken trust aShow MoreRelated Midlife Crisis in William Shakespeares Sonnet 138 Essay1954 Words   |  8 PagesMidlife Crisis in William Shakespeares Sonnet 138 William Shakespeare’s â€Å"Sonnet 138† presents an aging man’s rationalization for deceit in an affair with a younger woman. The speaker of the sonnet realizes his mistress lies to him about being faithful. He in turn, portrays himself as younger than he actually is: â€Å"When my love swears that she is made of truth / I do believe her though I know she lies, / That she might think me some untutored youth†¦Ã¢â‚¬  (1-3). â€Å"Sonnet 138† allows the reader aRead MoreSonnet 144 By William Shakespeare1464 Words   |  6 Pagesall time, Sonnet 144 is among one of William Shakespeare s most popular poems. To understand the meaning of this poem it is important to read the complete sequence of Shakespeare s sonnets. Sonnets 1-126 are addressed to Shakespeare s admired friend, a young man superior in social station and sonnets 127-152 are about his mistress, a dark lady, who charms the young man into an affair (POWERPOINT). 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Essay on Police Pursuits of Criminals - 1114 Words

Police Pursuits of Criminals There has been a heated debate over the last few years whether police chases are worth the risk of public safety to catch a fleeing criminal. Each year these hot pursuits end in the arrest of thousands of criminals wanted for a wide array of crimes. At the same time it can cause injury and some times even death. There is a huge misconception that police are out chasing the red-light violator or the burned-out tail light criminal. This is not the case at all. They are protecting the community and chasing serious felons. That is why most cops defend their right to engage in these high-risk pursuits. No police officer wants to try to stop somebody that they believe is good for a crime just to†¦show more content†¦This is gut wrenching to police officers every time they are confronted with a chase and it is a big decision for them to make. The majority of the people who want to see the pursuits come to an end are the ones who have lost a loved one in an accident. When cars are flying through residential neighborhoods where our family and children are, the odds go up that they could be killed or injured. It isn’t limited to around our homes that these accidents can kill our family, but out in the town or on the highway as well. Your husband or wife could be heading home from work and before you know it they are killed and taken away from you because someone was afraid of getting a speeding ticket. Then you might feel that the officer could have just gotten the license plate number and picked the suspect up at a later time. This is all true, but the officer has no way of knowing this at the time. The person might be running because he just robbed a convenience store or kidnapped a child from their home. We just don’t know. That’s why police go off statistics. Even though statistics show that pursuits end up with good arrests, many critics say that when a police officer is full of adrenaline he is not going to make as good of a choice when the chase should be called off. This is why more police officers are being held accountable for their actions more than ever before. Most departments have a policy to protect the officer where their supervisor has the responsibility toShow MoreRelated Police Pursuits Essay1455 Words   |  6 Pagesare virtually an unlimited amount of aspects about police work that places them in harm’s way every day. Some of which officers are trained to mitigate and exercise some form of control over while others are mostly out of police control. Vehicle pursuit is one instance where police have little control over and thus must adopt a mostly reactionary response rather than a proactive approach. 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It has been a very boring day for you, since you have only been called on your radio once, and it was for an accident (fender bender). Almost at the end of your shift, a blue car drives by going ninety miles an hour, but you kn ow theRead MoreInvestigation Of Search And Seizure1025 Words   |  5 Pageslegal systems whereby police or other authorities and their agents, who suspect that a crime has been committed, do a search of a person s property and impound any related evidence to the offence. In other words, it is a pursuit by law enforcement officials for possessions or communications alleged to be evidence of the crime, and the act of taking possession of this assets. The law of search and seizures is very essential in helping fight the current pursuit of criminals. 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