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Running Head: RELATIVISM AND HISTORICISM IN NURSING

Relativist and Historicist Perspectives in Nursing Science


Joshua Capps, BSN, RN, PhD Student
University of Louisville

RELATIVISM AND HISTORICISM IN NURSING

Introduction
Nursing scholarship and knowledge development are firmly rooted in a variety of
philosophical traditions. According to Polifroni and Welch, Philosophy of science in nursing
seeks to understand truth, to provide a description of nursing, to propose an understanding of
explanation, to examine prediction, causality and law, to critically relate theories, models and
scientific systems (1999, p. 5). Rodgers further asserts that Philosophy offers a wide array of
viewpoints and arguments from which nurses can re-evaluate the knowledge base of nursing and
perhaps construct even strong and more useful characterizations (2005, p. 13). Rodgers
contends that understanding knowledge development in nursing encourages discipline growth
and promotes a foundation of solid praxis (Rodgers, 2005). By examining these philosophical
underpinnings of nursing and their role in theory development for research and practice, nurses
stand to diversify their methods of inquiry and understanding of nursing.
Historically, nursing scholars have adopted a multitude of philosophical approaches to
nursing. Jean Watson (1995) detailed a post-modern paradigm of the nursing discipline,
advocating for a shift in knowledge and practice and reconstruction of the discipline. Similarly,
Laura Dzurec discussed a post-structural, multiparadigmatic approach to nursing, which goes
beyond the simple limits of inquiry to allow nurse researchers to focus on The metaphysical and
political assumptions that structure and limit the content of nursing (1989, p. 76). Few nurse
scholars have examined the discipline of nursing through a historicist or relativist lens.
Relativism is a belief that all knowledge, claims, and truths are products of differing
conventions and are dependent upon the context which gave rise to them (Baghramian & Carter,
2015). This assertion is corroborated from the historicist perspective, which stresses the
importance of understanding relative to a historical context, that knowledge claims are a

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reflection of local culture, and not representative of an independent reality (Matheson &
Dallmann, 2015; Reynolds, 1999). The purpose of this paper is to describe the philosophical
approaches of historicism and relativism, present three significant philosophers with similar
approaches, and discuss how these views are relevant to the theory of Culture Care Diversity and
Universality of Madeleine Leininger.
Historicism and Relativism
Historicism emphasizes a particular and contextual view over a universal truth (Reynolds,
1999). Two important tenets of historicism are To be understood properly things must be
considered within their historical contexts (Reynolds, 1999, p. 1) and Standards of rationality
are not fixed and eternal, but change over time (Reynolds, 1999, p. 2). These discussions first
arose from the works of Giambattista Vico and Johann Herder in the mid-1700s, as an opposition
to the Enlightenment ideal of an ahistorical and universal rationality (Reynolds, 1999). This
Enlightenment concept was built upon the assumption that a universal rationality can be applied
to all people and cultures and that human history is a linear process (Reynolds, 1999). This idea
was strongly refuted by Vico and Herder, who believed that each historical epoch and cultural
unit was unique (Reynolds, 1999).
Historicism was later revived by Georg Wilhelm Friedrich Hegel in the 1800s with his
discussions of the history of philosophy (Mastin, 2008). Later coined as Hegelian Historicism,
this school of thought contended that all societies and activities are defined by their history
(Mastin, 2008). Hegel further suggested that in order to understand a person, you must first
understand their society, and to fully understand their society, you must understand that society's
history (Mastin, 2008). Hegel posited significantly important attitudes towards rationality,
emphasizing the importance of a relativist approach to understand a person and their culture.

RELATIVISM AND HISTORICISM IN NURSING

Historicism upholds that societies and cultures are products of the historic succession of events
and local occurrences (Reynolds, 1999).
The later historicists, including Kuhn, Toulmin, Hanson, Lakatos, and Laudan, sought to
understand science in terms of broad, global units, such as research traditions, paradigms,
research programmes, and disciplines, in opposition to the adamant adherents of logical
positivism (Cull-Wilby & Pepin, 1987; Silva & Rothbart, 1984). Silva and Rothbart define the
historicist research tradition as A broadly based foundation of many theories and is an accepted
way of viewing the fundamental phenomena within a discipline (1984, p. 3). The historicists
saw science as A process of human behavior and thought exhibited by practicing scientists (p.
5), which was a stark contrast to the views of logical empiricists who evaluated science relative
to its product (Silva & Rothbart, 1984). Historicism permitted a sense of subjectivity in science,
positing a more holistic and humanistic approach to theory construction (Silva & Rothbart,
1984). Research traditions or disciplines are grounded in collaboration between scientists,
allowing for knowledge integration across disciplines (Silva & Rothbart, 1984). This integration,
as discerned by Larry Laudan, promotes a multidimensional approach to understanding
phenomena (Cull-Wilby & Pepin, 1987).
A similar epistemological approach, relativism, further emphasizes evaluating scientific
progress relative to a specific framework of assessment (Baghramian & Carter, 2015). This
framework may be constituted of a specific culture, social norms, or individual standards
(Baghramian & Carter, 2015). Relativism can be employed in a variety of settings, including
moral, cultural, and epistemic applications (Baghramian & Carter, 2015). An important aspect of
relativism is its covariance definition. This concept suggests that any object is dependent upon
and co-varies with its domain or frame of reference (Baghramian & Carter, 2015). As the

RELATIVISM AND HISTORICISM IN NURSING

approach of relativism can be broadly applied, defined, and used in a multitude of disciplines, it
will only be narrowly used in this paper for its covariance definition. In order to more broadly
understand these philosophical approaches, this paper will discuss three authors with similar
viewpoints
Philosophers
A multitude of philosophers and scholars have contributed to the epistemological
approaches of relativism and historicism. The following section will discuss Stephen Toulmin,
Imre Lakatos, and Larry Laudan, and their expansions to the historicist and relativist
perspectives.
Stephen Toulmin (1922-2009)
Stephen Toulmin, who earned a PhD in Ethics from the University of Cambridge in 1948,
was a seminal scholar in the field of bioethics (Johnson, 2009). Upon arriving in the United
States, Toulmin served as a faculty member at a plethora of top-tier academic institutions,
including Dartmouth, Columbia, Stanford, and the University of Chicago (Johnson, 2009).
Toulmin's historicist and relativist roots lie in his evolutionary views of scientific change and his
case-based approach to reasoning and rationality (Arras, 2010).
In the 1970s, Toulmin was selected to serve as the staff philosopher for the Belmont
Report, a government commission concerned with bioethical issues in medical research and
practice (Jonsen, 2010). While serving in this role, Toulmin developed strong interests in
casuistry, a method of moral reasoning originally used by the medieval Catholic Church
(Cavalier, 2002). Toulmin's casuistry applies a case-based approach to reasoning that is antitheoretical in nature and rejected the top-down approach to problem solving (Toulmin, 1967).

RELATIVISM AND HISTORICISM IN NURSING

Toulmin felt that all rationality and certitude in decision-making are contextual, and cannot be
solved with universal laws, thus his refutation of theoretical approaches (Toulmin, 1967). These
beliefs resonate with historicist and relativist views, as they iterate the importance of situationbased reasoning and the contextuality of understanding.
Toulmin further intimated his historicist views in his discussions of the evolutionary
account of scientific change (Toulmin, 1967). Toulmin, who preferred the term scientific
research discipline, felt that these disciplines should be viewed as A developing subject having
a continuity through time, and characterized as much by its process of growth as by the content
of anyone one historical cross-section (1967, p. 466). Toulmin asserted this evolutionary
transformation of scientific disciplines, as they transition from one historical cross-section to the
next (Toulmin, 1967). This idea is captivated by Toulmin's statement that Whenever one turns to
consider the development of science in any particular culture, nation, or epoch, one fruitful first
questions can be, 'On whose back was Science riding at this stage?' (1967, p. 461). This allows
for further appreciation of Toulmin's relativist views, as he continually asserts that scientific
progress Has always been contingent on other activities or institutions, whichinadvertently or
by design have provided occasions for men to pursue scientific investigations (1967, p. 461).
From Toulmin's discourse, the covariance definition of relativism and historicist implications for
scientific evaluation become much clearer. This critical evaluation of the societal, cultural, and
political influences on scientific activity provides a more concise, accurate portrayal of the
specific phenomena and its relevance to that time period.
Imre Lakatos (1922-1974)
Lakatos was born in Hungary to a prominent Jewish family (Godfrey-Smith, 2003). After
weathering the Nazi invasion and rise of Hitler, Lakatos studied mathematics, physics, and

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philosophy, eventually receiving a PhD in Philosophy from the University of Cambridge


(OConnor & Robertson, 2003). Once completing doctoral education, Lakatos would spend the
remainder of his unfortunately abbreviated life as a professor in the London School of
Economics (OConnor & Robertson, 2003).
A major portion of Lakatos's published discourse examined his idea of research
programmes and their role in knowledge development. Lakatos's description of these research
programmes is similar to Kuhn's discussions of research paradigms. Lakatos wrote According
to my methodology the great scientific achievements are research programmes which can be
evaluated in terms of progressive and degenerating problemshifts; and scientific revolutions
consist of one research programme superseding another (Lakatos, 1978, p. 110). In this
definition of scientific achievement, Lakatos alludes to a sense of historicism and relativism,
indicating an organic progression of problemshifts in science, which lead to newer research
programmes superseding older ones (Lakatos, 1978). Problemshifts occur and are based upon
theories building upon and superseding each other (Lakatos, 1978). This discussion was fully
presented in his 1978 book, the Methodology of Scientific Research Programmes. In this book,
Lakatos refuted Popper's falsificationism, stating that falsification should not lead to rejection,
rather these anomalies should be recorded and acknowledged, but not acted upon (Lakatos,
1978, p. 111). Research programmes, according to Lakatos, are comprised of two distinct units: a
hard core and a protective belt (Lakatos, 1978). Lakatos wrote that the protective belt of these
programmes is composed of auxiliary hypotheses which bear the brunt of tests (Lakatos, 1978,
p. 111). The theories within the protective belt are meant to explain the hard core, forming chains
of integration and progression based upon novel predictions (Lakatos, 1978). Posthumous essays
on Imre Lakatos further expound his focus on historical relativity and case law as major criteria

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for scientific judgment and incorporation into scientific programmes (Toulmin, 1976). These
later developments lend even greater credence to his assertions of historicism and relativism in
science.
Larry Laudan (1941-Present)
A final philosopher of great interest in the historicist and relativist perspective is Larry
Laudan. Laudan received his bachelors of arts in physics in 1962 and later obtained a PhD in
philosophy from Princeton University in 1965 (Shook, 2005). Laudan has assumed various
faculty positions in philosophical and legal sciences at Virginia Polytechnic University, the
University of Hawaii, and the University of Texas at Austin (Shook, 2005).
Similar to Lakatos's discussions of research programmes, Laudan elaborated on the
concept of research traditions. For Laudan, research traditions were defined as:
A set of beliefs about what sort of entities and process make the domain of inquiry
and a set of epistemic and methodological norms about how the domain is to be
investigated, how theories are to be tested, how data are to be collected and the like
(as cited in Gorenberg, 1983, p. 347).
Laudan saw research traditions as traversing an evolutionary process, in which traditions
continually modify themselves based on demands (Gorenberg, 1983). Furthermore Laudan spoke
of the intimate relationship between theories and research traditions, in which these traditions
exist to explain theories and facilitate solving problems which stem from them (Gorenberg,
1983). Research traditions are meant to be applied to their given historical period, in which they
serve the greatest utility. As the progression of time imposes new demands on the tradition, it
thus alters itself to better explain the questions of this new epoch's theories. This evolutionary

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account of scientific change does not assume cumulativity (Matheson & Dallmann, 2014).
Laudan rejected the notion that progress in science requires a fixed methodology, the
cumulativity of previous innovations, and the convergence on a universal truth (Shook, 2005).
Rather, Laudan advocated for evaluating knowledge claims relative to their research tradition
and shifted the lens of inquiry to problem-solving (Rodgers, 2005).
These ideas can be further understood by examining Laudan's 1981 writings of an
approach to evaluating scientific progress. In this discussion, Laudan frequently incorporates the
importance of relativity in knowledge evaluation. For example, Laudan states The views of
former scientists about how theories should be evaluated must enter into judgments about how
rational those scientists were in testing their theories in the ways that they did (Laudan, 1981, p.
148). In this statement we see Laudan's acknowledgment that scientific developments were
highly relative to their time period and the frameworks of the acting scientists.
Influence on Nursing Theory
Theoretical Assumptions
Leininger listed numerous theoretical assumptions in describing her viewpoint of culture
care. The first assumption is that Care is essential for human growth, wellbeing, and survival
and to face death or disability (Leininger, 1988, p. 155). Leininger, similar to Orem and Watson,
felt that caring and care are the central, crucial component which unifies all nursing. The second
assumption of her theory was that there are Diverse and universal forms, expressions, patterns,
and processes that exist transculturally (Leininger, 1988, p. 155). This assumptions lists the
terms diverse, universal, and transcultural, all of which were Leininger's buzzwords in her
discussion of culture care theory. Leininger frequently acknowledged that there are transcultural

RELATIVISM AND HISTORICISM IN NURSING

differences and similarities across groups, and it is important for the scholar to recognize these
diversities and universalities in their study of other cultural groups. Leininger further defined
cultural care diversity as The variability of meanings, patterns, values, or symbols of care that
are culturally derived by humans for their well-being or to improve a human condition and
lifeway or to face death (Leininger, 1988, p. 156). Equally important is the concept of cultural
care universality, which was defined as Common, similar, or uniform meanings, patterns,
values, or symbols of care that are culturally derived by humans for their well-being or to
improve a human condition and lifeway or to face death (Leininger, 1988, p. 156). Leininger
discussed each of these concepts with equal importance, acknowledging that cultural scholars
frequently use their own culture as a referent for other cultures of interest. In this juxtaposition of
cultures, the exploration of diversities and universalities facilitates teasing out critically
important constructs underlying a culture.
A third assumption of Leininger's theory was that Care is the essence of nursing and the
distinct, dominant, and unifying feature of nursing (1988, p. 155). From this statement,
Leininger's devout adherence to her belief of caring as the crux of nursing is evident, as many of
her theoretical foremothers would also state. A fourth assumption of the theory of Culture Care is
that Culture care is the broadest means to know, explain, account for and predict nursing care
phenomena and to guide nursing care practices (Leininger, 1988, p. 155). In this assumption
Leininger begins to provide greater clarity to the role of culture care and its purpose for nursing,
illuminating that cultural understanding is a crucial component to all nursing care provisions.
Another assumption provided by Leininger was that Knowledge of meanings and
practices derived from world views, social structure factors, cultural values, environmental
context, and language uses are essential to guide nursing decisions and actions in providing

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culturally congruent care (1988, p. 155). Leininger frequently referred to nursing care that is
culturally congruent. This notion of congruency implies a sense of mutual agreement and
consensus, which Leininger felt was crucial to nursing care. Culturally congruent care provides
nursing care that meets expectations and desires of the culture, rather than care that is predicated
on what the nurse believes is appropriate. For this same reason, Leininger rejected the use of the
term interventions in her theory, as she felt this term invoked a sense of patriarchy and onesided decision-making (Leininger & McFarland, 2002). Expounding further on this definition,
Leininger systematically defined world views, social structure, and environmental context. World
views refer to The way people tend to look upon the world or universe to form a picture or
value stance about their life and the world about them, (Leininger, 1988, p. 156). This relatively
simple concept is frequently discussed by Leininger, who felt that worldviews were greatly
dictated by cultural, social, and environmental contexts (Leininger & McFarland, 2002). Social
structure is The dynamic nature of interrelated structural or organizational factors of a particular
culture and how these factors function to give meaning and structural order, including religious,
kinship, political, economic, educational, technological, and cultural factors (Leininger, 1988, p.
156). This definition of social structure presents a complex concept that is significantly affected
by many other factors. Leininger frequently advocates for an intensive examination of social
structure when using the theory of Culture Care, as this will provide the scholar with a much
greater understanding of the studied culture (Leininger, 1988; Leininger & McFarland, 2002). A
final concept of interest for this assumption is environmental context. Leininger defines
environmental context as The totality of an event, situation, or particular experience that gives
meaning to human expressions, including social interactions and physical, ecological, emotional,
and cultural dimensions (Leininger, 1988, p. 156). The concept of environment is very broad in

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this manner and can refer to any number of factors impacting an individual, family, or cultural
group.
A sixth assumption of her theory was Cultures have folk and professional care values,
beliefs, and practices that influence cultural care practices in Western and non-Western cultures
(Leininger, 1988, p. 155). From this assumption, Leininger laid further theoretical groundwork
by acknowledging emic and etic health care practices that transcend all cultures. The folk health
system was defined by Leininger as Traditional or local indigenous health care or cure practices
that have special meanings and uses to heal or assist people, which are generally offered in
familiar home or community environmental contexts with their local practitioners (1988, p.
156). This type of health system is commonly known as local, traditional, or folk medicine.
Leininger contends throughout her theory that these traditional practices can be just as or more
important than professional practices in many cultures (Leininger, 1988). Etic practices involve
professional medicine practiced in Western cultures. The professional health system was defined
by Leininger as Professional care or cure services offered by diverse health personnel through
formal professional programs of study in special educational institutions (1988, p. 156). These
practices may not be present whatsoever in many remote cultures which entirely use emic, or
folk medicine (Leininger & McFarland, 2002).
The seventh assumption of this theory is Care is essential to curing; however, there can
be no curing without caring, but there can be caring without curing (Leininger, 1988, p. 155).
Again, Leininger returns to the importance of care in curative practices, though she
acknowledges that care does not always promote curing. This can be seen in nursing care
provided in times of disability and death, which she discussed in her first theoretical assumption.
This type of nursing process is not focused on curing, per se, but remains steadfast in adhering to

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Leininger's definition of care in nursing. A final assumption provided for the theory is that
Nursing is a transcultural phenomenon requiring knowledge of different cultures to provide care
that is congruent with the clients' lifeways, social structure, and environmental context
(Leininger, 1988, p. 156).
Theory Propositions
When using her theory of Culture Care Diversity and Universality, Leininger suggests
three different decision/action modalities for nurses (Leininger, 1988). According to Leininger,
culturally congruent care occurs in three distinct manners in the form of cultural preservation,
accommodation, or restructuring (Leininger & McFarland, 2002). It is helpful to think of these
modalities occurring across a spectrum, with preservation at one end, accommodation in the
middle, and restructuring at the other end. The progression from preservation to restructuring
involves increasing requirements for cultural compromise and adjustments of cultural beliefs and
values. Each of these sets of actions, or modalities, is guided by individual or group needs within
the culture and are each provided in order to promote beneficial and meaningful health outcomes
(Leininger & McFarland, 2002). Culture care preservation is defined as Assistive, supportive,
facilitative, or enabling professional actions and decisions that help people of a particular culture
to retain and/or maintain meaningful care values and lifeways for their well-being (Leininger &
McFarland, 2002, p. 84). In this modality, nursing actions are designed to maintain a culture's
values with regards to health, well-being, disabilities, or dying (Leininger & McFarland, 2002).
These nursing actions entirely retain the culture's values, without any imposition of subjective
values on behalf of the nurse or scientist. A second modality provided by Leininger was culture
care accommodation, defined as Professional actions and decisions that help people of a
designated culture to adapt to or to negotiate with others for meaningful, beneficial, and

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congruent health outcomes: (Leininger & McFarland, 2002, p. 84). This modality involves
negotiation, in which the nurse assists individuals to accommodate new values or beliefs, while
still maintaining their own cultural values and beliefs. The final, most extreme modality is
restructuring, defined as Professional actions and decisions that help clients reorder, change, or
modify their lifeways for new, different, and beneficial health care outcomes (Leininger &
McFarland, 2002, p. 84). In this modality, an individual or group will entirely redefine their
beliefs and values regarding health. The nurse scientists plays a pivotal role in this process, in
providing supportive and enabling actions to promote the client's adjustment to these changes.
Philosophical Underpinning of Theory
Throughout Leininger's publications and discussions of her theory of Culture Care
Diversity and Universality, she never specifically recognizes an epistemological standpoint
which served as the launching pad for her theory. Rather, Leininger contends that the main goal
of this theory was to Discover transcultural nursing knowledge to provide culturally congruent
and responsible care (Leininger & McFarland, 2002, p. 27). Although she does compliment
anthropology as her initial discipline, Leininger asserts that transcultural nursing is its own
discipline, distinctly separate from medical anthropology (Leininger & McFarland, 2002).
Leininger defined transcultural nursing as a discipline comprised of humanistic and scientific
knowledge which Focused on holistic culture care phenomena and competencies to assist
individuals or groups to maintain or regain health, deal with disabilities, dying, or other human
conditions in culturally congruent and beneficial ways (Leininger & McFarland, 2002, p. 84).
Leininger acknowledges that prior to development of her theory, nursing functioned within a
very narrow worldview, necessitating a shift into a much broader view and foundation (Leininger

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& McFarland, 2002). Her efforts to expand transcultural nursing were a pivotal shift in the
broadening of nursing's theoretical knowledge base and praxis.
Leininger's theory, with culture-care as the central construct, provides a humanistic,
holistic approach to understanding (Leininger & McFarland, 2002). At the time of its
development, the majority of nursing theories resided within the logical positivist domain (Silva
& Rothbart, 1984). Leininger's theory of Culture Care and her ethnonursing research methods
stressed the importance of understanding phenomena from the individual, family, or cultural
group's own perspective (Leininger & McFarland, 2002). According to Silva and Rothbart
(1984), This accommodation to subjectivism is more compatible with historicism than the
objectivism of logical empiricism (p. 8). Leininger's theory was an early shift to a perceived
view of understanding in nursing (Warelow, 2013). According to Meleis, The perceived view
bases the theoretical constructions of nursing around alternative methods, which accept values,
subjectivity, intuition, history, tradition and multiple realities although does retain some scientific
knowledge (2012, p. 137). This paradigmatic shift in nursing underpins Leininger's theory of
Culture Care and affords significant relevance to the historicist and relativist perspectives.
Leininger also detailed a comprehensive method of conducting transcultural nursing
research using her qualitative ethnonursing research method (Leininger, 1988). Leininger
described this research method as A qualitative nursing research method focused on naturalistic,
open discovery and largely inductive (emic) modes to document, describe, explain, and interpret
informants' worldview, meanings, symbols, and life experiences as they bear on actual or
potential nursing care phenomena (Leininger & McFarland, 2002, p. 85). This focus on emic
inquiry captivates the importance of the covariance definition in relativism. According to
Leininger's view of ethnonursing, emic inquiry examines objects pertaining to nursing and how

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they are dependent on and co-vary within the cultural framework of assessment (Leininger &
McFarland, 2002). Leininger also iterates the importance of cultural history, termed ethnohistory,
and how it shapes and affects cultural attitudes, values, and beliefs pertaining to care and caring
(Leininger & McFarland, 2002). This contingency on historical and cultural context, which
transcends Leininger's theory, is an example of historicist and relativist perspectives within
nursing science.
Historicism and relativism may also serve as robust frameworks in wholly evaluating
nursing theorists and their theories. According to Warelow, All people/nurses are embedded in,
and the subjects of, their own personal histories and the specific histories relating to the contexts
in which they work (2013, p. 39). Here the author acknowledges that nursing theorists and their
products are not independent of their historical epoch, but highly influenced by its political,
economic, and cultural climate (Warelow, 2013). Nursing theorists, themselves, are products of
their own time period, forged by the prevailing beliefs, values, and attitudes of that era.
Culturally Diverse Populations
The theory of Culture Care Diversity and Universality and its theoretical underpinnings
lend themselves well to a salient application in culturally diverse populations. Leininger's
primary purpose behind development of this theory was to accurately describe nursing
phenomena within a cultural context, and use these findings to provide nursing care that is
culturally congruent with the individual, family, or group's specific needs (Leininger &
McFarland, 2002). Leininger's theory, along with its Sunrise Model, provides a holistic,
comprehensive approach to examine the variety of factors influencing a culture's view of care
and caring and the implications for nursing practice. This is corroborated by the historicist and

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relativist perspectives, which purport that in order to understand a concept, person, or group, you
must understand the society and its history (Reynolds, 1999).
Emic inquiry and ethnonursing research methodologies are highly conducive to
examining nursing phenomena within a culturally diverse context (Leininger & McFarland,
2002). The methodology of ethnonursing research was specifically designed to ascertain
qualitative data regarding a specific culture's worldviews, values, beliefs, and their implications
to nursing phenomena (Leininger & McFarland, 2002). Currently, a substantial volume of
literature supports the use Leiningers theory and ethnonursing method in culturally diverse
populations. The theory has been successfully used to guide research and intervention
development for numerous culture groups, including rural Appalachian people (Mixer, Fornehed,
Varney, & Lindley, 2014), Palestinian cancer patients (Saca-Hazboun & Glennon, 2011), SyrianAmerican Muslims (Wehbe-Alamah, 2011), and Mexican Americans (Hernandez, 2013; Wagner,
2009).

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