Purnell’s Model for Cultural Competence is characterized by four rings that describe the forces affecting people’s health outcomes. The theory is “treated as a powerful framework that can guide healthcare providers to address the major cultural forces impacting people’s health needs” (Pay, 2014, p. 191). The first ring in the theoretical framework represents the global society characterized by disasters, politics, health technology developments, and globalization (Loftin, Hartin, Branson, & Reyes, 2013).
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The second ring is represents the community and is characterized by individuals who share similar interests. Hagginbottom, Richter, Mogale, Ortiz, Young, and Mollel (2011) indicate that the third ring represents a person’s immediate family. The model defines a family as a group of individuals who have emotional attachment and involvement (Pay, 2014). The other ring represents the individual. The individual is defined “as a biopsychosociocultural human being who adapts new forces and environments constantly” (Pay, 2014, p. 192). The next ring describes the twelve domains or concepts of culture.
These cultural dimensions include workforce issues, family roles and organizations, communication, heritage, high-risk behavior, bio-cultural ecology, death rituals, spirituality, nutrition, childbearing and pregnancy practices, medical practitioners, and health practices (Loftin et al., 2013).
This model is therefore useful towards providing trans-cultural health care. This is the case because the model helps caregivers analyze and use the concepts of culture. Nurses can use the model to define the issues and circumstances that affect a person’s worldview. That being the case, medical practitioners can combine these cultural attributes to develop personalized healthcare delivery plans. The plans should reflect the major cultural attributes of the targeted patient.
As well, caregivers can “examine the health needs of their patients based on the context of their family and ethno-cultural environments” (Hagginbottom et al., 2011, p. 6). The model makes it easier for health practitioners to develop evidence-based and culturally-sensitive care delivery systems. The practice can therefore be embraced in order to provide culturally-competent health support to more patients.
Domains of Culture
The model outlines 12 domains that define a person’s culture. Heritage focuses on a people’s origins, residences, political orientations, education statuses, and economic positions. The second domain is communication. Human beings have their dominant languages and dialects. Cultural communications patterns range from “touch, body language, personal space, and relationship” (Loftin et al., 2013, p. 4). The third domain focuses on family roles, goals, patterns and responsibilities. Workforce issues include individualism, acculturation, gender roles, and health policies. Bio-cultural ecology examines issues “such as skin color, genetic diseases, and body types” (Purnell, 2005, p. 9).
Some of the high risk behaviors identified by the model include sexual malpractices, nicotine and alcohol use, and sedentary lifestyles. Issues of nutrition include food types, eating behaviors, and cultural practices. Pregnancy and childbirth practices are also outlined in the model. Concepts of death and related rituals are also described (Hagginbottom et al., 2011). These issues include burial practices, bereavements, euthanasia, and view of death.
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Spirituality is concerned with practices such as prayers, rituals, and religious views (Pay, 2014). Healthcare practices include use of medicines, traditional practices, treatment procedures, views towards mental diseases, and expression of pain. The last domain examines the roles and philosophies of healthcare practitioners.
These domains contribute a lot to the health position of an individual. A caregiver providing medical support to different patients should be aware of their 12 domains (Loftin et al., 2013). This knowledge will play a positive role towards designing the business healthcare model. This means that the caregiver should consider the religious view, healthcare practices, background, values, nutritional status, high-risk behavior, communication practices associated with every patient (Pay, 2014). This understanding will make it easier for the caregiver to offer culturally-competent health support. These domains should be examined as a whole in order to empower more nurses to offer culturally-competent care.
Application of the Model
Nurses and caregivers can benefit a lot from this model because it presents meaningful concepts that can make a difference in health care. Nurses providing care to persons from different cultures will have to consider each of the twelve domains. The approach will make it easier for them to promote culturally-sensitive treatment plans for the patients (Loftin et al., 2013). This is a critical approach because individuals from diverse backgrounds tend to have unique needs and expectations.
The model will guide more nurses to examine the behaviors and cultural aspects that affect the health goals of the targeted patients (Purnell, 2005). The nurses will also find it easier to collaborate with different parties throughout the treatment process.
Purnell’s model is applicable in different healthcare settings. The framework also equips nurses with adequate ideas about the major domains and forces that dictate the health positions of individuals from diverse backgrounds. The important goal for caregivers is to address the diverse health needs of their patients using the model. The caregivers will also design personalized treatment plans that are guided by these domains. A nurse who embraces these concepts and domains will deliver evidence-based care to individuals from different cultures. This model can therefore help more nurses and caregivers to become culturally-competent professionals (Purnell, 2005). This practice will support the health needs of many patients.
Hagginbottom, G., Richter, M., Mogale, R., Ortiz, L., Young, S., & Mollel, O. (2011). Identification of Nursing Assessment Models/tools Validated in Clinical Practice for Use with Diverse Ethno-Cultural Groups: An Integrative Review of the Literature. BMC Nursing, 1(1), 1-21.
Loftin, C., Hartin, V., Branson, M., & Reyes, H. (2013). Measures of Cultural Competence in Nurses: An Integrative Review. The Scientific World Journal, 1(1), 1-10.
Pay, C. (2014). Teaching Cultural Competency in Legal Clinics. Journal of Law and Social Policy, 23(1), 187-219.
Purnell, L. (2005). The Purnell Model for Cultural Competence. The Journal of Multicultural Nursing and Health, 11(2), 7-15.