Leininger’s Theory of Cultural Competence

Subject: Nursing
Pages: 3
Words: 580
Reading time:
3 min
Study level: College


Leininger’s Theory of Cultural Competence seeks to bridge the gap in providing care for patients from different cultural backgrounds. In her professional practice, Madeleine Leininger witnessed a chronic lack of cultural understanding that can negatively influence the quality of patient care (Busher Betancourt, 2016). The theorist described cultural competence as missing from nursing education and practice elements, able to significantly change a patient’s experience.


The theory is based on several beliefs that are crucial for its basic understanding. The first theoretical tenet states that “care diversities and universalities exist… among and between cultures in the world” (McFarland & Wehbe-Alamah, 2019, p. 6). The second tenet emphasizes the significance of social structure elements, environment, and worldview in predicting health outcomes and a patient’s views on illness and death (McFarland & Wehbe Alamah, 2019). In the third theoretical tenet, Leininger presents generic and professional factors as the principal contributors to health status (McFarland & Wehbe-Alamah, 2019). The last tenet serves as a conceptualization of the previous ones and outlines harmonious with a patient’s cultural background care planning (McFarland & Wehbe-Alamah, 2019). Therefore, the theory’s tenets prepare the ground for its practical implementation.


The Theory of Cultural Competence is grounded in several concepts that are addressed throughout Leininger’s theoretical work. Culturally Congruent Care is one of the most fundamental concepts that may be viewed as implementing nursing practices accommodated to the cultural peculiarities of a patient. Transcultural nursing is identified in theory as a subfield aiming to determine the influence of cultural differences on illness outcomes. Ethnonursing in Leininger’s theory is a method that serves to investigate nursing practices in the framework of one culture.

Central theoretical tenets:

  • diversity and universality in patients’ cultural backgrounds;
  • the importance of social elements in predicting health outcomes;
  • presents generic and professional factors as the principal contributors to health status;
  • harmonious with a patient’s cultural background care planning.
  • principal concepts:
  • culturally congruent care;
  • transcultural nursing;
  • ethnonursing.


The theory has found full application in various domains of nursing. It can be used as guidance in nursing research, policy-creating, administrative activities, and education in general. Leininger’s Theory of Cultural Competence has been critical in nursing practice since the results of its application were documented and measured to create scientific support and justify its usage. For instance, the theory has been implemented in Alzheimer’s disease daily care, bringing positive results (Barbosa et al., 2020). The notion of culturally aware nurses is advocated so that the theory becomes increasingly renowned in medical education.

The Impact on Evidence-Based Practice

The evidence in support of Feininger’s theory has also been incorporated into nursing practice. Wehbe-Alama and McFarland state apropos of the theory that it “may facilitate the application of evidence-based ethnonursing research findings in clinical practice, academia, administration, policy development, consultation, and research, thus advancing nursing science” (p.12 ). Leininger’s Theory of Cultural Competence has the potential to be used extensively in nursing practice, alleviating the state of patients with different cultural backgrounds.

Overall, the nursing theory managed to bring attention to the fact that a patient’s system of beliefs is integral for high‑quality patient care. Healthcare inequality associated with a cultural background is an issue that the theory developed by Leininger indicated decades ago; nevertheless, the problem persists. As the approach becomes more acknowledged, its broader application may help solve some aspects of culture-related inequality in healthcare. Spheres of application:

  • nursing research;
  • policy-creating;
  • administrative activities;
  • and education.

The main consequence – cultural considerations in nursing practices.


Barbosa, M. E. M., Corso, E. R., Scolari, Giovana. A. S., & Carreira, L. (2020). The interdisciplinarity of care to the elderly with Alzheimer’s disease: Reflection to the light of the theories of Leininger and Heller. Escola Anna Nery, 24(1), 1‑15.

Busher Betancourt, D. A.(2016). Madeleine Leininger and the transcultural theory of nursing. The Downtown Review, 2(1), 1–18.

McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s theory of culture care diversity and universality: An overview with a historical retrospective and a view toward the future. Journal of Transcultural Nursing, 30(6), 1–18.

Wehbe-Alamah, H., & McFarland, M. (2020). Leininger’s ethnonursing research method: Historical retrospective and overview. Journal of Transcultural Nursing, 1-13.