The Purnell Model For Cultural Competence Essay.

The Purnell Model For Cultural Competence Essay.

The Purnell Model for Cultural Competence

Please read chapter 2 of the class textbook and review the attached Power Point Presentation. Once done answer the following questions;The Purnell Model For Cultural Competence Essay.

1. In your own words discuss the empirical framework of the Purnell Model and what are the purposes of this model.

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2. Please mention and discuss the macro aspects of the model.

3. What is the role of the head of household and genders according to this model?

4. In your own words define the domain biocultural ecology and discuss one variation of this domain.

As indicated in the syllabus the assignment must be presented in an APA format, word document, Arial 12 font attached to the forum title "Week 2 discussion questions" in the discussion board. A minimum of 2 evidence based references besides the class textbook no older than 5 years are required. Assignment must contained a minimum of 500 words without counting the first and reference page.The Purnell Model For Cultural Competence Essay.

Discussion: The Purnell Model for Cultural Competence

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Purnell Model for Cultural Competence

Larry Purnell, PhD, RN, FAAN

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Purnell Model: Assumptions

All healthcare professions need much of the same information about cultural diversity and share the metaparadigm concepts of global society, community, family, person, and health.
One culture is not better than another culture; they are just different.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Purnell Model: Assumptions

There are core similarities shared by all cultures.
There are differences within, between, and among cultures.
Cultures change over time, but slowly.
Culture has powerful influences on one’s interpretations and responses to health care.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Purnell Model: Assumptions

If clients are co-participants in care and have a choice in health-related goals, plans, and interventions, health outcomes will be improved.
Variant cultural characteristics determine the degree to which people vary from their dominant culture beliefs, values, and practices.The Purnell Model For Cultural Competence Essay.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Purnell Model: Assumptions

Individuals and families belong to several cultural groups, usually known as subcultures.
Each individual has the right to be respected for his or her unique differences and cultural heritage.
Caregivers who can assess, plan, and intervene in a culturally competent manner will improve the care of clients for whom they care.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Purnell Model: Assumptions

Caregivers know themselves better by learning about their own cultures.
Professions, organizations, and associations have their own cultures.
Healthcare teams can benefit from a Model and Organizing Framework that is useable by all healthcare disciplines.

The Purnell Model For Cultural Competence Essay.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Variant Cultural Characteristics

Nationality
Race
Color
Gender
Age
Religious affiliation

Educational status
Socioeconomic status
Occupation
Military experience
Political beliefs
Urban versus rural residence

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Variant Cultural Characteristics

Marital status
Parental status
Physical characteristics
Sexual orientation
Gender issues

Length of time away from the home country
Reason for immigration—sojourner, immigrant, undocumented status

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Metaparadigm Concept: Global Society

Seeing the world as one large community of multicultural people
Evidence of global society
What happens in other parts of the world affects each community

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

ClickerCheck

What determines a person’s adherence with his/her dominant culture?

Metaparadigm concepts

Variant characteristics

Global society

Cultural worldview

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Correct Answer

Correct answer: B

Variant cultural characteristics determine the degree to which a person adheres to his/her dominant cultural beliefs and practices.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Metaparadigm concept: Community

A group or class of people having a common interest or identity living in a specified locality but can be an online community as well now
What happens in the community has an effect on the family.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Metaparadigm concept: Family

Two or more people who are emotionally involved with each other
They may, but not necessarily, live in close proximity to each other.
What affects the individual, affects the person.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Metaparadigm concept: Person

A human being, one who is constantly adapting to his or her environment biologically, physically, socially, or psychologically
Person is defined differently in other cultures.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Overview/Heritage

Origins
Residence
Topography
Economics
Politics
Education
Occupation

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Communication

Dominant language and dialects
Contextual use of the language
Paralanguage—volume and tone
Temporality—time—and spatial distancing
Use of touch
Eye contact and facial expressions
Greetings and name format

The Purnell Model For Cultural Competence Essay.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Family Organization

Head of household
Gender roles
Goals and priorities
Developmental tasks
Roles of the aged and extended family
Social status
Alternative lifestyles

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Workforce Issues

Acculturation
Autonomy
Language barriers

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Biocultural Ecology

Biological variations
Skin color
Heredity
Genetics
Endemics
Drug metabolism

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: High-Risk Behaviors

Tobacco
Alcohol
Recreational drugs
Physical activity
Safety
Sexual behavior

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Nutrition

Meaning of food
Common foods
Rituals
Deficiencies
Limitations
Health promotion

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Pregnancy and Childbearing

Fertility practices
Views toward pregnancy
Pregnancy beliefs
Birthing practices
Postpartum
Prescriptive, restrictive, and taboo practices

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Death and Dying

Death rituals during the dying process
Post mortem practices
Bereavement

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Spirituality

Religious practices
Use of prayer
Meaning of life
Individual strength
Spirituality and health

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

ClickerCheck

Contextual aspect of cultural communication includes

Dominant language

Dialects

Explicit versus implicit communication

Translation versus interpretation

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Correct Answer

Correct answer: C

Contextual use of a language is concerned with the number of words used to express a thought. High-contexted communication uses fewer words to express a thought.

Low-contexted communication uses a lot of words to express a thought

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Health-care Practices

Focus of health care
Traditional practices
Magicoreligious beliefs
Responsibility for health
Self-medication practices

The Purnell Model For Cultural Competence Essay.

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Health-care Practices

Responses to pain
Sick role
Mental health
Rehabilitation
Chronicity
Blood transfusion
Transplantation

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Domain: Health-care Practitioners

Perceptions of practitioners
Folk practitioners
Gender and health care
Status of healthcare providers

The Purnell Model For Cultural Competence Essay.

Purnell Model for Cultural Competence
The demographics of the American population are increasingly changing due to a growth in the proportion of persons collectively termed as ethnic minority. It is expected that by the year 2020, 35% of the American population will consist of ethnic minorities (Barrow, 2010). This increase in diversity is expected in the background of long-standing variations in the health status of persons from culturally diverse backgrounds (Barrow, 2010). These variations have been attributed to lack of cultural competence amongst healthcare professionals. Consequently, acquisition of cultural competence for health workers had been prioritized. A number of models for guiding cultural competency amongst multidisciplinary healthcare team members across a variety of settings have been proposed. Purnell’s model of cultural competence is one such model: it helps health professionals understand the concept of cultural competence and provides a process for achievement of this competence (Rose, 2013, p. 54).
Purnell’s model of cultural competence consists of a schematic combined with an organizing framework. It was first developed in 1991 as a clinical assessment tool. In 1992, the schematic, metaparadigm concepts, and scale for cultural competence were added. The model was conceptualized from multiple theories, a research base garnered from administrative, communication, family development and organizational theories as well as discipline knowledge in anthropology, nutrition, pharmacology, physiology, anatomy amongst others (Purnell, 2002). The model comprises of two sets of factors denoted as the macro and micro aspects. The macro aspects are the metaparadigm concepts that are universal to all cultures and healthcare professionals. These macro aspects are global society, community, family, and person. The micro aspects are the model’s 12 domains/ constructs. The theory also has explicit assumptions about healthcare providers and care recipients (Purnell, 2005).
Diagrammatically, Purnell’s model is organized into concentric circles. The macro aspects constitute the four outlying rims while the micro aspects constitute the inner circle. The four outermost concentric circles consist of the global society, community, family, and person moving inwards. The inner circle section is divided into 12 pie-shaped wedges. Each wedge represents a cultural domain and its related concepts. The 12 domains do not stand alone but are affected and related to each other. Each domain has a separate table called the organizing framework (Purnell, 2005). The tables contain a number of questions that healthcare providers can utilize to assess an individual or a group. The inner most circle of the schematic is empty. This section represents unknown aspects of a cultural group. Both the outer lying rims and inner circle form segments of a whole. At the bottom of the schematic is an erose. The erose represents the concept of cultural consciousness and relates to healthcare providers and organizations. Purnell conceptualized the process of gaining cultural competence as a non-linear process consisting of four levels: unconscious incompetence, conscious incompetence, conscious competence, and unconscious competence. Since the model is conceptualized from a broad perspective, it is applicable to all healthcare-related professions and across different care settings (Purnell, 2005).
The 12 domains of culture in Purnell’s model are overview/heritage, communication, family roles and organization, workforce issues, biocultural ecology, high-risk behaviors, nutrition, pregnancy and childbearing practices, death rituals, spirituality, healthcare practice, and healthcare practitioner. These domains influence healthcare diversity in a myriad of ways. The first domain, overview, influences issues such as conditions that patients in a certain cultural group are likely to be predisposed to on account of their country of origin and current residence. Communication, the second domain, influences the manner in which healthcare workers create rapport and disclose information to patients (Purnell, 2005).The Purnell Model For Cultural Competence Essay. For instance, the Pakistani community shields family members from bad news and thus do not inform terminally ill patients of their diagnosis. Family roles and organizations influence health-related issues such as decision making and child rearing practices. Workforce issues impact on individual and community healthcare practices. Biocultural ecology creates variances in terms of endemic, genetic, and hereditary conditions and drug metabolism. High-risk behaviors accepted in a culture influence the health risks members of a community are exposed to. Nutrition influences the prevalence of nutrient-related conditions in a community and use of foods to promote health and wellness. Pregnancy and child bearing practices influence birthing and family planning choices as well as pregnancy behaviors. Death rituals influence end-of-life decision making and manner of grieving. Spirituality influences individual and family coping mechanisms in diseases and illness. Healthcare practices influences individual responses to pain, adoption of the sick role, self-medication practices, and views towards illnesses. Healthcare practitioner status shapes individual and community views towards healthcare professionals, traditional healers, and gender of healthcare workers. In effect, they influence patient-health worker relationships (Purnell, 2005).The Purnell Model For Cultural Competence Essay.
In my practice, I will use Purnell’s model as a framework for providing culturally competent care to patients and clients. I will apply the model’s organizing framework in carrying out assessments and planning nursing interventions for patients drawn from different cultures. The domains of the model allow a more in-depth and focused analysis (Rose, 2013, p. 54). The model can thus provide useful insights into a patient’s cultural needs in every domain. In so doing, it will help me provide individualized care using approaches that respect the culture of clients/patients. The expected outcome is that my patients will participate in their own care.
In summary, an increase in the diversity of the American population has prompted health professionals to consider cultural variations in the provision of healthcare. This paper has described the theory and organizing framework of Purnell’s model of cultural competence. Further, it has discussed how the model’s 12 domains influence diversity in healthcare. Lastly, it has discussed how the model can be applied when working with different cultures.The Purnell Model For Cultural Competence Essay.

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