nursing takes place within a culture. This culture is the pattern of individual attitudes and orientations among the members of both the nursing profession and the larger society of which the profession is a part. It is the subjective realm that underlies and gives meaning to nursing actions. The components include cognitive orientations, affective orientations and evaluative orientations, or, in other words, judgments and opinions about factors involved in the process of nursing.
Caring is defined in terms of nurturant and skillful activities, processes, decisions to assist people on their own terms, and the philosophic, theoretical, and applied aspects of the phenomenon (Leininger & Reynolds (1993, pp. 33-54). Diversity in cultural values, thus, is of particular significance to nursing (Leininger, 1991, p. 55). Cultural values affect health beliefs, attitudes, and behaviors of both care givers and patients (Friedman, 1991, p. 169). The phenomenon of caring is comprised of both scientific and ethical dimensions. An ethical decision is one made on the basis of ethical or moral (normative) principles, rather than on the basis of medical, practical, financial, religious, or legal criteria (Fowler, 1989, pp. 955-965). The culture care model recognizes the incorporation of the ethical values of a culture into nursing. According to Leininger (1988b, p. 22), American nurses have become dependent on modern technology and find it difficult to function in cultures with limited technology.
The culture care theory is significant to the practice because application of the theory may lead to improved clinical decision-making. Clinical decision-making refers to the cognitive processes involved in the formulation of a patient diagnosis by a decision-maker, and to the selection by the decision-maker of appropriate intervention(s) to correct the patient's problems (Bunting & Webb, 1988, p. 30). The primary sources of error in clinical...