In the process of interaction with patients, the medical staff is forced to adhere to a number of rules that include not only professional but also moral and ethical principles. One of these conditions is culturally competent nursing that is based on a certain approach when interacting with patients. In particular, this principle is based on the observance of such methods of care that do not cause moral contradictions and allow achieving a positive treatment environment. In order to consider the feature of this nursing practice in real mode, it is possible to resort to the Purnell Model for Cultural Competence described by the author “as a guide for assessing the culture of patients” (Purnell, 2014, p. 9).
Based on the twelve domains included in this methodology, an interview will be conducted with a person, and the features of the national background will be described in accordance with these criteria. The use of such a technique allows obtaining a comprehensive picture of the cultural characteristics of a particular patient and identifying those unique features that are inherent in a particular socio-cultural group.
Description of the Purnell Model for Cultural Competence
The presented model contains twelve domains, and each of them relates to the specific area of the national background. Shen (2015) lists: “overview, inhabited localities, and topography; communication; family roles and organization; workforce issues; biocultural ecology; high-risk health behaviors; nutrition; pregnancy and childbearing practices; death rituals; spirituality; healthcare practices; and healthcare practitioners” (p. 314).
All these domains are required to be included as a basis for an interview and to talk to a specific person in order to obtain valuable information that may form the basis of a culturally competent approach. As an object of the survey, Mr. L., the Asian American neighbor, will be involved, and his Chinese origin can help to find interesting and unique features inherent in his culture.
Interview Results
Overview, Inhabited Localities, and Topography
Today, Mr. L. lives in the USA, but he was born in China and moved to America as a child with his parents. He almost does not remember his homeland; however, his family honors national traditions. The emigration was due to the profitable business proposal for the father of Mr. L. Today, the man is a healthcare employee with a rather high educational level and a stable financial position.
Communication
English is Mr. L.’s primary means of communication since he does not remember Chinese and cannot communicate in it. His speech does not differ in any particular dialects and is filled with those speech patterns that are typical for his field of activity and place of residence. Non-verbal communication is on the average level, and no manifestations of excessive emotionality are observed. Intonation and voice loudness does not differ from most other people’s ones.
Family Roles and Organization
In terms of opinions regarding gender roles in the family, Mr. L. adheres to a classical approach. According to NASN (2018), this domain also provides for the assessment of parenting practices, but the respondent is not married and has no children. Nevertheless, he is the representative of traditional sexual orientation and intends to create his own family in the future. Mr. L. appreciates the relationship with loved ones and respects the older members of his generation.
Workforce Issues
The respondent is quite well assimilated into society and perceives American culture as his own. The level of his autonomy does not differ from the standard one, and most healthcare practices are borrowed from the US system, despite the rich history of Oriental medicine. The style of communication is friendly and does not have special features. Individualism is not pronounced, and the propensity to cooperate is obvious, which underlines the high level of Mr. L.’s communication skills.
Biocultural Ecology
The Asian origin of the respondent is clearly expressed in his appearance. According to NASN (2018), this domain implies “genetic, heredity, endemic, and topographical diseases” (para. 6). Mr. L. has chronic tonsillitis, but this ailment is not hereditary and is not typical for his cultural background. The physical characteristics of the body do not appear unique; his growth is average, which is usual for people of Asian descent. Also, immunity to specific drugs and medical procedures is not detected.
High-Risk Health Behaviors
Mr. L. does not smoke and tries to adhere to the principle of healthy nutrition, although he sometimes takes alcohol in the company of friends and relatives. The respondent argues that he does not have unprotected sex. He attends the pool twice a week and plays baseball once a month. When driving his car, he always uses a seat belt. Also, the respondent denies using any dangerous and potent drugs.
Nutrition
Mr. L.’s food choices are quite typical for an ordinary citizen. However, he avoids eating fast food and other harmful products that lead to overweight. During illness, the respondent prefers fruit and consumes those with a high content of vitamin C. Mr. L. does not confirm that he has certain rituals and taboos, but he notes that several times a month, he has dinner with his parents and sometimes goes to catering establishments with friends.
Pregnancy and Childbearing Practices
The views of the respondent on the family and parenting are traditional. Despite the fact that he is not yet a father and husband, he is not against starting a family in the near future. Mr. L. confirms that neither he nor his relatives promote special rituals and taboos relating to pregnancy and marriage with a woman of another race. However, the respondent intends to become the father of several children, which corresponds to his traditional culture, where large families are a frequent phenomenon.
Death Rituals
Mr. L. did not encounter the death of loved ones since his parents live not far from him, and all other relatives are in China. However, he argues that there are certain ritual traditions in his national culture which are associated with bereavement. The respondent knows the Eastern religion quite well and intends to abide by those burial practices that are typical for his community, in particular, cremation.
Spirituality
Although the respondent is well versed in the national religions of his homeland, he does not adhere to one specific teaching. According to Purnell (2014), there are several concepts of spirituality in China, and each of them has its own unique features. Mr. L. does not mention his earthly existence in the context of the divine principle, but he is also not skeptical, and based on his reasoning about death rituals, he intends to follow certain rites.
Healthcare Practices
The respondent has medical insurance and is not in favor of traditional medicine and self-treatment. He has no serious chronic diseases except for tonsillitis and does not mention any barriers to healthcare. Mr. L. refers to his health responsibly and adheres to modern diagnostic methods. His views on organ donation and transplantation are positive, and he finds it useful to develop this sphere of medicine.
Healthcare Practitioners
For Mr. L., the gender of healthcare providers is insignificant, and he is not biased towards the whole sphere. According to the respondent, the scope of activities of both senior and junior employees in this field is essential and responsible. Moreover, he perceives any difficulties as the integral component of the work of healthcare representatives. Therefore, his views concerning caregivers are not associated with any dissatisfaction.
Assessment of Results
In accordance with the results of the interview, the respondent adheres to traditional views on family values, spirituality, lifestyle, and healthcare services. Mr. L. is not distinguished by any unique ideas concerning culture and is not a supporter of many traditional customs. The level of his assimilation into American society is high. The respondent’s national identity is not expressed comprehensively, and many habits are the result of living in the United States.
Conclusion
The Purnell Model for Cultural Competence is the mechanism that allows assessing any patient’s level of cultural preferences. Also, this system helps to identify those features that should be taken into account when making a plan of care for a person of a different socio-cultural group. The principles of culturally competent nursing involve the analysis of certain patient attitudes, and the interview conducted helps determine the person’s key preferences and positions regarding the essential aspects of life.
References
National Association of School Nurses (NASN). (2018). Purnell model. Web.
Purnell, L. D. (2014). Guide to culturally competent health care (3rd ed.). Philadelphia, PA: FA Davis.
Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: A literature review. Journal of Transcultural Nursing, 26(3), 308-321. Web.