The Great Cultural Competence Purnell Model 1

Cultural Competence

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;

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

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.

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

Copyright © 2013 F.A. Davis Company

Purnell Model for Cultural Competence

Larry Purnell, PhD, RN, FAAN

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

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.

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

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.

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

ClickerCheck

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

Metaparadigm concepts

Variant characteristics

Global society

Cultural worldview

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

Copyright © 2013 F.A. Davis Company

Correct Answer

Correct answer: B

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

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

Domain: Overview/Heritage

• Origins
• Residence
• Topography
• Economics
• Politics
• Education
• Occupation

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

Copyright © 2013 F.A. Davis Company

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

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

Domain: Workforce Issues

• Acculturation
• Autonomy
• Language barriers

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

Copyright © 2013 F.A. Davis Company

Domain: Biocultural Ecology

• Biological variations
• Skin color
• Heredity
• Genetics
• Endemics
• Drug metabolism

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

Copyright © 2013 F.A. Davis Company

Domain: High-Risk Behaviors

• Tobacco
• Alcohol
• Recreational drugs
• Physical activity
• Safety
• Sexual behavior

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

Copyright © 2013 F.A. Davis Company

Domain: Nutrition

• Meaning of food
• Common foods
• Rituals
• Deficiencies
• Limitations
• Health promotion

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

Domain: Death and Dying

• Death rituals during the dying process
• Post mortem practices
• Bereavement

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

Copyright © 2013 F.A. Davis Company

Domain: Spirituality

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

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

Copyright © 2013 F.A. Davis Company

ClickerCheck

Contextual aspect of cultural communication includes

Dominant language

Dialects

Explicit versus implicit communication

Translation versus interpretation

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

Copyright © 2013 F.A. Davis Company

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

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

Copyright © 2013 F.A. Davis Company

Domain: Health-care Practices

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

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

Copyright © 2013 F.A. Davis Company

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

Copyright © 2013 F.A. Davis Company

Domain: Health-care Practitioners

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