Purnell Model for Cultural Competence: Concepts and Sub Concepts Essay

Cultural competence in health care systems has become a crucial component as a result of diversity and multiculturalism in health care. The healthcare practice is based on the provision of a more individualised and holistic health care services that have the patient's beliefs and cultural values as its basis. There are have many models that have been developed whose main objectives are to help health care professionals and nurses to ensure that the patients receive cultural congruent social care (Purnell and Paulanka, 2008). This essay discusses the Purnell model for cultural competence and explains its concept and sub-concepts. The article will demonstrate the generality of Purnell model of cultural competence and the impacts and continuing influence on further development.

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The Purnell model of cultural competence is based on various theories and research that have been gained from the theories such as family development, communication, administrative, and organisational as well as from different fields such as sociology, biology, and anatomy (Purnell and Paulanka, 2008). The model consists of implied assumptions of the objective of a cultural group such as music and art.

The schematic representation of Purnell model of cultural competence consists of four rims which indicate the different concepts of the theory. The outermost edge represents the global society, while the second and the third rims represent community and family respectively. The inner periphery of the circle represents the individual. Twelve wedges have pie shapes in the interior of the concentric circle which constitute the cultural domains (Purnel, 2002). The twelve domains are interrelated and affect each other; hence they are known not to stand alone.

The middle of the model is empty which is used to represent the aspects that are unknown about a cultural group. The concept of cultural consciousness is represented by a line that is shaped like a saw at the bottom of the model. This nonlinear line can be used to describe both the organisation and the healthcare provider depending on their competence levels. The metaparadigm reprsen6ted in this model does not reflect the beliefs and values of a particular culture, ethnicity, or tribe since the concepts are formed from a broader perspective. This type of definition recognises that the word for these concepts that are directly translatable do not exist in some cultures (Purnel, 2002). Hence, it is imperative that the health caregiver adapts these concepts depending on the patient's culture. For example, the definition of an individual is different depending on whether his/her culture is individualistic or collectivistic.

The first domain is called heritage/overview whose main principles are based on the patient's country of origin and its impact on the culture. The second domain is called communications, and its concepts include those that are related to language and dialects such as the willingness to share feelings and thoughts and intonation. The used of nonverbal cues as a means of communication are also part of the concepts of the domain of communication (Purnell and Paulanka, 2008). Another area is called family roles and organisations whose main principles are based on the organisation of family and functions such as gender roles and head of the family. Concepts such as a view of alternative lifestyle and social status are also included under this domain.

The domain of workforce issues has the concepts that the patients have acquired from the country of origins such as healthcare practices and ethnic communication styles. The next domain is referred to as biocultural ecology which is the difference that exists between individuals from different race and ethnicity such as genetic and skin colouration. The area of high-risk behaviours includes the various factors which are harmful to the human health that an individual practices such as recreational during and high-risk sexual practices (Purnell and Paulanka, 2008). The domain of nutrition involves the various ways in which people from different cultures choose and use food depending on its availability and its role in the promotion of health.

The domain of pregnancy and childbearing practices include the factors which are related to the birth of children such as fertility practices, pregnancies, and delivery, and postpartum treatment. The other domain of this model is the death rituals which are deals with the cultural view of death and the practices associated with it such as burial practices. The domain of spirituality defines the religious aspect of the community from which the patient originates (Purnel, 2002). The domain of healthcare practice deals with the factors that deal which the factors that promote the well-being of an individual such as views towards mental illness, beliefs on biomedical and medicating oneself. The final domain is referred to as healthcare practitioner whose principle reverberates around the beliefs of the caregiver such as magico-religious as well as the gender.

Application across Culture

The theory can be generalised and applied to different fields of health care system such as research practice and education. In practice, the model is relevant to all the healthcare providers in the numerous environmental contexts. The main factors that contribute to the use of the model to the healthcare system that has staff who are multidisciplinary are the focus of the system on a team approach, case management and managed care(Shen, 2015). The information that is specific to a particular culture can be generalised and used in health care practices and reasoning that are associated with anthropology and sociology. For example, a healthcare system can use the model in guiding the development of the individualised intervention, assessment tool, and planning strategies.

The model can also be generalised and used in academic settings as well as developing staff such as social workers, physical therapists, and nurses. For example, it can be used in universities to teach the students the application of information in the community health setting utilising the care that is based on population. One significant advantage of this model is its simplicity in teaching students since it does not require the students to have an in-depth comprehension of the theories and conceptual models used to incorporate the principles into practice (Shen, 2015). The use of this model in education is seen as a valuable resource that is critical to guiding the study of the lives of clients and cultural practices.

Since one of the domains of this model deals with workforce issue, it can also be applied to the administration of the healthcare systems. It can be used to determine various problems among the staff that are related to the culture of the workforce and the culture of the organisation (Shen, 2015). It is used to determine the tolerance or encouragement of diversity in the healthcare setting. For example, the management can use the framework set by this model to assess the level of acceptance of multicultural and multinational population in the staff.

Finally, the model can be used by those in the healthcare system to conduct research that is based on ethnography or ethnomethodology. The demographic data is collected using the primary and secondary characteristics. For example, the various domains and concepts of this model can be used to define the research questions for qualitative studies (Shen, 2015). Multiple students have used it at a different level of education in the collection of data for scholarly projects and dissertations.

Further Development

The Purnell model for cultural competence is still in its infancy. Hence, the various value and significance to each profession in the health care system in the future will be determined by its continued use. The applications and use of the concepts of this model in practice for each profession in the health care system should be explicated (Purnell, 2002). The model contains various implicit assumptions will be defined more clearly.

References

Purnell, L. (2002). The Purnell model for cultural competence. Journal of transcultural nursing, 13(3), 193-196.

Purnell, L. D., &Paulanka, B. J. (2008). The Purnell model for cultural competence. Transcultural health care: A culturally competent approach, 3, 19-56.

Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: a literature review. Journal of Transcultural Nursing, 26(3), 308-321.