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Culturally Sensitive Care: The Purnell’ Model for Cultural Competence

The diversity of cultures and nations raises opportunities and challenges for health care workers and policymakers to develop and deliver more culturally competent services. In this context, cultural competence may be determined as the ability of health institutions to supply clients with the healthcare services that would meet their social, cultural, and linguistic needs. Such competence is aimed to enhance the quality of healthcare, receive better outcomes, and dissolve racial or ethnic issues.

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Nowadays, there are many courses directed towards improving the presence of cultural competence for the health professionals that allow reducing barriers to healthcare services. The purpose of this paper is to explore and explain the culturally sensitive care and its appliance based on the Purnell’ model for cultural competence.

Culturally sensitive care is crucial in understanding the individual’s needs to promote further satisfaction with the services provided. It also implies that the clinician should be able to reflect upon the cultural values, traditions, beliefs, and preferences of a patient (Brooks, Manias, & Bloomer, 2018). When communication lacks sensitivity, the patient perception of health care may be misinterpreted. Culturally sensitive care is widely applied within healthcare, as it allows nurses to provide patient-centered care by responding to their cultural views. Patient’s choice and their well-being are the essential values, and they imply further listening and perceiving the patient’s ethnocultural opinions. The integration of the elements helps to establish a specific care plan to achieve health goals.

Various models have been implemented to provide clients having a varied background with high-quality health services. One of them belongs to Larry Purnell, who realized the urgent necessity of creating better cultural competence while he was working with the staff and the students within different clinical settings. According to Purnell (2000), “The model focuses on both the emic and etiquettes of the client, family, and community” (p. 40). Purnell extracted primary and secondary characteristics that shape people’s world perspectives. The primary ones include nationality, race, gender, religion, age, while the secondary ones encircle political beliefs, gender issues, occupation, educational and socioeconomic status, etc.

Moreover, the described model represents a conceptualization from different theories. Thus, it is interpreted through five central circles: community, family, global society, person, and health. Health is further divided into “12 pie-shaped wedges depicting cultural domains and their concepts” (Purnell, 2000, p. 41). Therefore, Purnell determined 12 domains that affect the diversity of healthcare, and do not stand alone, but influence each other and form the unified entity. The fields are described namely in the following way:

  1. Overview/heritage includes concepts concerning the country of residence, origin, reasons for immigration, etc.
  2. Communication comprises of concepts related to verbal and nonverbal elements, such as the native language, body language, eye contact, acceptable greetings, etc.
  3. Organization and family roles describe gender roles, family roles, and priorities, roles of children and aged people within the family.
  4. Workforce issues prescribe the autonomy, assimilation, ethnic communication style from the country of origin.
  5. Biocultural ecology concerns variations of body statures and skin coloration.
  6. High-risk behaviors are related to the abuse of tobacco, alcohol, or drugs, high-calorie diets, insufficient physical activity.
  7. Nutrition signifies an adequate amount of food capable of satisfying hunger, food choice, and how it affects well-being.
  8. Pregnancy and childbearing deals with the information about fertility, methods of birth control, views towards pregnancy, taboos concerning pregnancy.
  9. Death practices affect bereavement behavior, perception of death, and rituals.
  10. Spirituality includes religious practices, the meaning of prayers.
  11. Health care practices denote attitude towards the illness, different medical beliefs, and practices.
  12. “Health care practitioner concepts include the status, use, and perceptions of traditional, magicoreligious, and Western biomedical health care providers” (Purnell, 2000, p. 43).

All of the above mentioned domains are interconnected and interrelated, and play an active role in shaping a person’s cultural views. In my specific field, they can help clinicians see people from different perspectives and realize that each individual is to be respected regardless of their background. What is more, cultural understanding can minimize the prejudices and biases.

Purnell Model for Cultural Competence has a broad application in the nursing sphere and high relevance in the transcultural context. First of all, delivering quality medical services with a high level of cultural competence is crucial for health promotion, disease prevention, and effective interventions. Moreover, culturally sensitive healthcare workers have a more significant opportunity to provide patients with better health improvements. All health providers can implement the model; therefore, it is flexible and holistic.

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The model can be applied when a clinician works with the patient of different origins, as culturally sensitive care needs to be provided within any culture. The primary issue is the awareness that implies understanding the patient’s views and values, and therefore establishing communication with them and improving satisfaction with services (Gallagher & Polanin, 2015).

The other point is to learn about the background of the culture, its language, and peculiarities, to find the way of communicating with the patient and their family (Johnstone, Hutchinson, Rawson, & Redley, 2016). It is also critical to practice active listening and educate patients about medical practices to assure them that the provided services are accredited. These simple but essential points of the model will help to become a more competent healthcare provider.

In the fast-moving world, there is no choice of being culturally sensitive to health care work because it is a necessity. All healthcare providers should work hard to create better conditions for people of diverse origins and eliminate cultural disparities. Implementing Purnell’s model is efficient in providing high-quality health assistance as it describes all the variables necessary for understanding cultural competence.


Brooks, L. A., Manias, E., & Bloomer, M. J. (2018). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 1-10.

Gallagher, R. W., & Polanin, J. R. (2015). A meta-analysis of educational interventions designed to enhance cultural competence in professional nurses and nursing students. Nurse Education Today, 35(2), 333–340.

Johnstone, M. J., Hutchinson, A. M., Rawson, H., & Redley, B. (2016). Nursing strategies for engaging families of older immigrants hospitalized for end-of-life care: An Australian study. Journal of Patient Experience, 3(3), 57–63.

Purnell, L. (2000). A description of the Purnell model for cultural competence. Journal of Transcultural Nursing, 11(1), 40–46.

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StudyCorgi. (2022, January 21). Culturally Sensitive Care: The Purnell’ Model for Cultural Competence. Retrieved from


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