Madeleine Leininger, Nurse Anthropologist

Profiles in Nursing

Madeleine Leininger, Nurse Anthropologist

Making a world of difference

By Elizabeth Hanink, RN, BSN, PHN
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With the modern emphasis on evidence-based practice, it’s easy to imagine nursing as a universal discipline that can be applied in the same ways to any group of patients. Madeleine Leininger, RN, Ph.D., FAAN knew better. As the founder of transcultural nursing, she recognized early in her career that patients’ cultural background can have a profound effect on the way they describe symptoms, respond to pain and understand diagnoses. This in turn requires nurses to reconsider how they provide care and what “care” even means.

Nebraska Farm Girl
Although she is best known today for what she called the theory of culture care, diversity and universality, Madeleine Leininger’s early life was far from cosmopolitan. Born in Nebraska, she grew up on a homestead farm and attended small rural schools. She entered nursing school in Denver through the U.S. Cadet Nurse Corps, receiving her diploma in 1948.

While working as a nurse, she continued her education, earning her master’s degree in psychiatric nursing from the Catholic University of America in 1954 and becoming an associate professor of nursing at the University of Cincinnati. During this period, she was responsible for developing one of the nation’s first graduate child-psychiatric nursing programs after realizing that there was a general lack of understanding among nurses of the connections between cultural factors and behavior.

Next Stop: New Guinea
Around this time, Leininger became friends with well-known anthropologist Margaret Mead, who inspired Leininger to study cultural and psychological anthropology at the graduate level. In 1966, Leininger became the first nurse to complete a Ph.D. in that field. Her field work involved three years of study in two Gadsup villages in Papua, New Guinea.

That experience helped to codify Leininger’s basic philosophy: that beneficial nursing care could only occur when the nurse understood and related appropriately to the patient’s cultural values and expressions. Nurses who did not, Leininger argued, would find their patients noncompliant and their care ineffectual.

As a teacher and academician, Leininger worked to develop models for formally instructing nurses in understanding and interacting with patients from different cultural perspectives, the basis for what today are called culturally competent care practices.

“Culturally Meaningful” Care
Over the next decade, Leininger served as the director of the nurse-scientist Ph.D. program at the University of Colorado and then as dean of nursing at the University of Washington. In 1970, she published Nursing and Anthropology: Two Worlds to Blend, the first book to elucidate her concepts of transcultural nursing. Four years later, she founded the Transcultural Nursing Society and the Journal of Transcultural Nursing. She also played a key role in establishing transcultural nursing programs at several universities.

In 1978, while serving as the dean of nursing at the University of Utah, Leininger published the first textbook on transcultural nursing and care, Transcultural Nursing: Concepts, Theories, and Practices. In that book’s second edition in 1995, she described the goal of transcultural nursing as “providing culture-specific and universal nursing care practices in promoting health or well-being or to help people to face unfavorable human conditions, illness or death in culturally meaningful ways.”

World Traveler
Leininger spent much of her later career as a professor at Wayne State University and later at the University of Nebraska, but her consulting work took her around the world, working with nursing schools throughout the Caribbean, Europe, Africa, Russia and Australia. More than 70 colleges and universities hosted her at one time or another.

Leininger’s work on “ethnonursing” and her theory of culture care, diversity and universality earned her many awards, including three honorary doctorates. The American Academy of Nursing, designated her a “Living Legend” in 1998. She died at her home in Omaha, Neb., in August 2012.  

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