A Conceptual Framework of Nursing in Native American Culture

Contributor: John Lowe
October 18, 202

Authors – John Lowe, RN, PhD and Roxanne Struthers, RN, PhD, CTN

Year published – 2001

Used by permission
Major Concepts
Model representing the circular, holistic worldview of Native American Culture
  • Caring
  • Traditions
  • Respect
  • Connection
  • Holism
  • Trust
  • Spirituality

Typology – Conceptual Framework


A Native American worldview is a holistic perspective that is experienced in a circular manner. The seven traits are intertwined, related and overlapping. The central symbol is of this worldview is the sunrise, representing new beginnings. Each of the seven dimensions of nursing in Native American culture embodies characteristics that reveal the holistic and intertwined nature of nursing in Native American culture.

  • The dimension of caring embodies characteristics of health, relationship, holism and knowledge.
  • The dimension of traditions contains characteristics of relationship, respect, wisdom and values.
  • The dimension of respect contains characteristics of relationship, honor, identity and strength.
  • The dimension of connection contains characteristics of relationship and foundation.
  • The dimension of holism contains components of balance, culture and relationship.
  • The dimension of trust contains components of relationship, presence and respect.
  • The dimension of spirituality contains components of relationship, unity, honor, balance and healing.

Primary Sources

Lowe, J., & Struthers, R. (2001). A conceptual framework of nursing in Native American culture. Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau, 33(3), 279–283. https://doi.org/10.1111/j.1547-5069.2001.00279.x

Lowe, J., & Crow, K. (2009). Utilization of a Native American Nursing Conceptual Framework to Transform Nursing Education. International Journal for Human Caring, 13(3), 56-64. https://connect.springerpub.com/content/sgrijhc/13/3/56

Lowe, John, & Nichols, Lee Anne. (2013). Utilisation of a Native American nursing conceptual framework: implications for practice and research. The Australian Journal of Advanced Nursing: A Quarterly Publication of the Royal Australian Nursing Federation, 31(2), 13–22. https://search.informit.org/doi/abs/10.3316/ielapa.285541468166522

Lowe, John. (2002). Balance and harmony through connectedness: the intentionality of Native American nurses. Holistic Nursing Practice, 16(4), 4–11. https://doi.org/10.1097/00004650-200207000-00004

Struthers, R., & Littlejohn, S. (1999). The essence of Native American nursing. Journal of Transcultural Nursing: Official Journal of the Transcultural Nursing Society / Transcultural Nursing Society, 10(2), 131–135. https://doi.org/10.1177/104365969901000206

About the Authors

John Lowe, RN, PhD, FAAN

Dr. Lowe is of Cherokee, Creek and Lenape heritage, and an enrolled Eastern Cherokee tribal member. He is the Joseph Blades Centennial Memorial Professor at The University of Texas at Austin School of Nursing, and an Indigenous adjunct scholar affiliate at the University of Southern Queensland in Australia. Previously he was founding director of the Center for Indigenous Nursing Research for Health Equity at Florida State University College of Nursing.

One of his foremost callings is to usher in the next generation of Indigenous nurses and health scientists. He is leading the effort to develop a center for Native American and Indigenous Health Research at The University of Texas at Austin, the purpose of which is to nurture Native American nurse scholars addressing health disparities and the need for health equity among Native American and Indigenous people around the world. (see https://emu.edu/now/news/2021/alumnus-of-the-year-award-john-lowe-81/)

Roxanne Struthers, PhD, RN, CTN – walked into the Spirit world on December 10, 2005 at the age of 53

Dr. Struthers was born on the White Earth Objibwe Indian Reservation in Minnesota. She earned her PhD in nursing from the University of Minnesota in 1999, one of only 14 Native Americans to hold a doctoral degree in nursing. Her research and scholarly work focused on Native American tobacco use, diabetes, traditional healing, and healers. She was known as a strong advocate for diversity; an enthusiastic supporter of traditional values; a leader in nursing research with frequent publications; and a respected, honored academician.