The need for understanding cultural competency has been developing over the recent past. This instance comes after the realization that cultural sensitivity increase healthcare outcomes and interactions in a multidisciplinary setting. The current healthcare setting has encouraged involvement from a diverse workforce with different racial and ethnic basis. In the same way, a precedent rise of a diverse population in the American society means that those in need of healthcare services also require healthcare practitioners to attend to their needs (Treas and Wilkinson, 2014). Given that culture is a complex and extremely demanding concept, the need for a conscious effort to understand the basis of this aspect among healthcare practitioners has been stressed and thus addressed in the Purnell Model.
In order to understand the Purnell Model, it is imperative to understand the meaning of culture. According to Rose (2013), culture is the social transmission of behavioral patterns, beliefs, art, customs, values, amongst other aspects considered to be characteristic of a human group and an outcome of their work and involvement that forms a basis of an individual’s worldview.
The Purnell Model was designed as an organizing framework that comprised of questions as well as the specific format that allowed for evaluating culture. This was done in recognition of the gap in health care in which case patients and practitioners alike did not implement cultural sensitivity, cultural awareness, and cultural competence in the course of practice (Purnell, 2014).
The 21st century has been associated with transcultural healthcare. As such, the importance of cultural competence has been stressed in an attempt to provide quality care to patients. Additionally, in terms of diversity in the healthcare setup, better outcomes are likely to be achieved through enhanced communication and teamwork, concepts retrieved from understanding the culture.
The Purnell Model takes the concept of a circle with different rings. According to Purnell (2013), the outward ring represents the global society. this part represents concepts such as natural disasters and famine, conflicts and warfare, global communication, and international commerce and business. The second ring is identified as a community. This aspect takes into consideration individuals with a common identity or interest and is living in a specific locality. The third ring is labeled as a family. This is defined as two or more individuals who share an emotional connection. The last ring is the person ring that explains an individualistic basis. As such, it takes into consideration the biopsychosociocultural aspect affecting an individual. It is in this ring that the 12 cultural domains are identified as explained further below (National Association of School Nurses, 2016):
Overview/Heritage
This aspect takes into consideration topography and localities such as one’s country of origin, current residence, as well as the effects of each as well as societal concepts such as education, economics, politics, and education. This concept is involved in a diversity of healthcare as it connects the environment and healthcare as well as its relevant impact from the relationship between the two concepts.
Communication
This concept takes into consideration verbal and nonverbal communication. As such, language, dialect, volume, and tone, amongst others, apply in the overall communication process between practitioners and patients. As such, the quality of healthcare is affected by the effectiveness of communication between the involved parties.
Family Roles and Organization
In this case, the connection to the household head as well as gender roles consideration is assessed with respect to health. As such, this aspect is important in healthcare as it provides an understanding of the decision-making ability of an individual, with regards to treatment of a family member.
Workforce Issues
This relates to aspects concerning gender, assimilation, communication, as well as a country’s healthcare practices. In this case, policy concepts can be formulated in relation t diversity in the workplace of concerned countries, in an effort to their effective implementation.
Biocultural Ecology
This concept refers to the differences in the ethnic and racial composition of a population. Given that this often comprises composition from diverse cultures, understanding healthcare treatment and policies aimed at individual groups will assist in determining vulnerabilities of the system and how they can be fixed effectively.
High-Risk Behavior
This encompasses behaviors such as excessive use of alcohol and tobacco, increased calorie consumption, as well as a lack of physical exercise. These habits directly affect an individual’s health state. As such, understanding trends and prevalence of such in communities assists healthcare practitioners and policymakers enact relevant legislation in an effort of advancing a healthy agenda among the population.
Nutrition
This entails the availability of adequate and healthy food for satisfying hunger, taboos, and beliefs and values about food. In this case, understanding the state of a population’s nutrition status and perspectives about food contributes to understanding various perspectives in regards to diverse groups in the society.
Pregnancy and Child-Bearing Practices
These include concepts such as birth control, fertility practices, and taboo beliefs related to pregnancy. As such, healthcare practitioners can implement relevant policies with regards to individual diversity considerations.
Death Rituals
This involves aspects such as death rituals, how various individuals and communities understand death and burial practices. In this regard, concepts such as end-of-life can be placed in context regarding acceptance or otherwise of such suggestions, with regards to community considerations.
Spirituality
This concept involves comprehension of the elements of faith, healing, and prayer, with regards to one’s view on health issues. As such, healthcare practitioners and institutions can be able to integrate healthcare practices in relation to an ethnic group’s beliefs to facilitate acceptance and support in the process.
Healthcare Practices
These comprise of various healthcare focuses such as acute and preventive care, self-medicating practices, and beliefs about rehabilitation and organ transplant and donation. Since some groups do not believe in some of these aspects such as organ donation, understanding such specification and beliefs will assist healthcare practitioners in relating positively with such groups.
Healthcare Practitioners
In this regard, concepts such as the use and status of practitioners vary across different groups. For instance, some groups may not believe in female doctors. As such, this knowledge will assist practitioners to structure their care in relation to the needs and beliefs of their patients.
In an effort to become a competent health care provider, this model can assist one understand the various spheres and considerations of racial and ethnic groups. In this case, understanding global, community, and individual perspectives about health care will assist one to structure and deliver care in accordance with such considerations (Pérez and Luquis, 2014). As such, this will facilitate a positive relationship between patients and their caregivers and healthcare practitioners, leading to quality care and consequently faster recovery time.
References
National Association of School Nurses (2016). Purnell Model for Cultural Competence. Retrieved from https://www.nasn.org/ToolsResources/CulturalCompetency/PurnellModelforCulturalCompetence
Pérez, M. A., & Luquis, R. R. (2014). Cultural competence in health education and health promotion. San Francisco: Jossey-Bass Publishers.
Purnell, L. D. (2013). Transcultural health care: A culturally competent approach. Philadelphia: F.A Davis Company
Purnell, L. D. (2014). Guide to culturally competent health care. Philadelphia: F.A Davis Company.
Rose, P. R. (2013). Cultural competency for the health professional. Burlington, MA: Jones & Bartlett Learning.
Treas, L. S., & Wilkinson, J. M. (2014). Basic nursing: Concepts, skills, & reasoning. Philadelphia: F.A. Davis Company.
