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An historical overview of Leininger's Theory of Culture Care Diversity and Universality also known as the Culture Care Theory (CCT) and evolution of the Sunrise Enabler are presented along with descriptions of the theory purpose, goal, tenets, basic assumptions, major core constructs, and orientational definitions. Recent articles, books, and book chapters provide relevant exemplars to enhance scholarly understanding and application of theory constructs. Proposed future directions encompass using the CCT to guide research of discovery and translational research projects for evidenced-based nursing practice; develop nursing courses and curricula to prepare culturally competent nurses; guide future culturally competent administrative and leadership policies and procedures; inform public policy related to cultural diversity and underserved populations; promote grant writing initiatives to enhance cultural diversity in hiring nursing staff, supervisors, and faculty; and promote admission of nursing students from underserved and/or diverse backgrounds.

History brings together meanings related to earlier periods, being aware of the past as a panorama to reread the present. Madeleine Leininger presented in 1970 an implicit and respectful message to the Nursing Profession when introducing Nursing and Anthropology. Two Worlds to Blend. Implicitly: Nursing you disregard culture. This article shows the absence of the history of anthropology and of nursing within Transcultural Nursing and it includes how education has influenced theoretic, methodological, and comparative approaches giving researchers the responsibility to decide their fundamentals. Berthoud (2001) has inspired the anthropological and historic perspectives of the author, thus universalism, relativism, and comparison are presented.

A critical appraisal of the concept, quality of life, as used in nursing theories, is presented in a historically situated context. This approach to concept analysis was selected to illuminate the subjective, contextual, and fluid nature of the concept. Based on this review, quality of life is defined as an intangible, subjective perception of one's lived experience. From a review of Peplau's, Rogers', Leininger's, King's, and Parse's conceptualizations of quality of life, it is concluded that it may be viable to replace health with quality of life as a metaparadigm concept for nursing.

Nursing has a long history of focusing on the cultural dimension of care, dating back to Florence Nightingale and the early days of public health nursing. Nursing education studies advocated for including social science concepts in nursing curricula well before the founding of the first university school of nursing in the United States in 1910. A brief review of the highlights of major nursing curriculum, licensing, funding, accreditation studies, and initiatives reveals that culture competence in nursing education continues to receive increasing emphasis and support.

After establishing herself in her career as a perioperative nurse and ensuring her grown children were settled, this author pursued her dream of working abroad as a nurse. She chose to work in Pakistan, which is where her father was born. Her experiences there gave her a new appreciation for the help that perioperative nurses can offer to the citizens of developing countries.

Finnish nurses worked abroad already in the 19th century, before nurse education had started in Finland. Reasons for going abroad were the desire to help people, to acquire education, knowledge and experience, to look for a job or to seek adventures or love. In the course of time the reasons have remained nearly the same. Many of the first matrons got their education abroad. On the other hand, Finnish nurses have voluntarily joined the Red Cross ambulances abroad from the last century until today. Study trips were popular already in the beginning of this century, and nowadays a time abroad or at least congress visits are a part of everyday life. Many Finnish nurses have held prominent positions. The most remarkable among them is Sophie Mannerheim, who was President of the International Council of Nurses in 1922-1925. Missionary work in Africa and other developing countries has attracted believers, while others are employed by the World Health Organization.

This article reaffirms the relevance of the concept of culture for nursing and suggests the utility of recent developments in culture theory. Culture has long been considered to play an important role in the practice of nursing. The historical development of the concept of culture is reviewed with emphasis on nurse scholars and anthropologists who have addressed culture as an area of inquiry. The meaning-centered perspective of culture, to include embodiment, is reviewed and recommended as a means of addressing the current emphasis on cultural diversity in nursing. This perspective is seen as having broad implications for both advancing theoretical development in nursing and for nursing practice.

This essay examines the encounters between clients and public health nurses hired by the Office of Indian Affairs to work on American Indian reservations during the 1930s. It relies on two different types of sources. The first are the accounts of the nurses, including letters, memoirs, and above all their monthly and annual reports to Washington. The second are oral histories conducted by the authors with elderly residents of two Sioux reservations in South Dakota during August 1993. One of the key missions of the public health nurses was to inculcate Euro-American beliefs. They assumed that American Indians would follow a linear progression from understanding the 'rules of health' to the eradication of all traditional practices. That model left no room for ambiguity or syncretism. The Sioux viewed the nurses as resources to be used strategically and selectively. Those who accepted the nurses' services did so because the services addressed specific needs the Sioux themselves defined as important. Most disregarded the health education programme insofar as it assumed the superiority of Euro-American values.

Decisions about health promotion and illness prevention occur within a cultural context that is influenced by the contemporary context of community and family in addition to the ethnohistorical and language contexts, worldview and sociocultural factors of the particular culture and the available folk and professional health care resources. Using information about the health and care beliefs and values and health care decision making process in negotiating culturally congruent nursing and health care interventions is imperative, especially in a world with limited health care resources and an increasing demand for recognition of cultural diversity. This article uses data on health and health care decision-making from an ethnonursing study of the Old Order Amish to demonstrate the role of cultural context in health care practices and decision making. Leininger's cultural care theory and Hall's conceptualization of high context culture were used to investigate these phenomena. High context features of the Old Order Amish culture are used to explain how Amish are actively involved in decisions and actions taken to promote health and prevent and treat illness using a broad array of folk, alternative and professional services simultaneously. As nurses learn to involve clients in decisions and actions using the guiding principles of cultural care preservation, accommodation and repatterning they will provide culturally congruent care for Amish and other culture-specific groups.