Purnell model was developed for nursing students for purposes of establishing a framework of assessment in nursing. However, after some time issues, cultural competence and meta-paradigm ideas were incorporated to enrich the theory. The model, therefore, became relevant in the health care real setting. Healthcare stakeholders including nurses and physicians use this model to understand the cultural differences of their patients and family members. The theory is also relevant in healthcare because every discipline in this area focuses on the communication issues and influence of ethno cultural views on discharging healthcare services (Purnell, 2012). The organization of Purnell model holds significant assumptions to ensure the provision of care by nurses is not influenced by personal beliefs, thoughts, emotions, and environment but instead focus on care as per the patients' cultural needs. Purnell model, as a broader discipline, it is applicable in multiple settings to create awareness in handling clients. The following are the critical assumptions of the theory;
Similar information on cultural diversity is shared among all healthcare disciplines.
There is congruence in metaparadigm ideas globally including the global society, persons, family, and health across all healthcare disciplines.
There is no culture superior to another culture; they are fundamentally unique.
All cultures have common key features.
There are differences between, within and among cultures.
In a stable society, cultures transform over time.
The degree at which a culture differs from the dominant culture depends on secondary and primary features.
If the patients are co-participants in selecting health-related plans, goals, and interventions, it improves the results.
Culture is influential on how clients understand and respond to care.
Families and individuals suit in different cultural groups.
In any setting, respect is for all despite the difference brought about by the culture.
Healthcare professionals require specific and general information on cultural diversity to discharge sensitive care that is culturally competent.
Care assessments, interventions, and plans rooted from cultural diversity promote patient care.
Education on cultures is progressive through a continuous encounter with different cultures.
Cultural understanding mitigates biases and prejudices.
Adequate care is a reflection of unique understanding of the different way of life, attitudes, values, and beliefs of various populations and individuals.
Variation in races and cultures need an adaptation of typical interventions.
Cultural awareness impacts positively on healthcare professional self-awareness.
Every profession, association, and organization have its culture which can be evaluated by applying a grant theory.
Purnell's 12 Domains of Culture in Nursing Care
Overview. In nursing care, understanding the heritage of a patient helps to understand the background on the country of origin, the influence of topography from the country of origin, economics, current residence, politics, education status, occupation and motives for immigration. Currently, patients travel from one continent to another to seek for proper medication; it is empowering for a nurse or a physician to have an overview knowledge of patients country of origin. For example, most cancer patients move from Africa to India to seek advanced treatment because there are few experts in Africa to handle the disease. More so, different countries treat patients differently depending on the citizenship rights, Australian government gives treatment cost privileges to its citizens and not the immigrants who have to bear the full costs of treatment.
Communication. Dialect is a significant determinant of nurse-client relationship. Understand the context of language use and parameters of language variation matters most especially during drug prescription. In most circumstances, use of English language is universally accepted in nursing because it is easy to comprehend.
Family roles and organization. A family as a system in a social setting, understanding its dynamics such as gender roles, head of the family, childrearing practices, sexual orientation, marriages, and divorce, makes it make a collective decision on matters family planning to improve family nursing. More so, nursing care is conducted by nurturing, nourishing, protecting, preserving and raising of family values (Giger et al., 2007). Understanding the family also makes it easy to predict family inherited diseases such as sickle cell and diabetes. Care for such patients leads to the better outcome because of understanding the history of the family health.
Workforce issues. Autonomy, acculturation, individualism, and assimilation in nursing care promote a sense of independence while carrying out duties.
Biocultural ecology. It helps to increase awareness of ethnic and racial subjects. It is a collection of skin decoration, physical differences, and body structure. It is easy for a practicing nurse to understand the topographical, hereditary and genetic diseases. Biocultural ecology also promotes access equity care without discrimination along racial lines.
High-risk behavior. Drug addiction is a significant social problem today; victims number are on the rise some of these characters are violent to handle. Understanding safety measures on how to handle such behaviors in a rehabilitation center promote quality care.
Nutrition. Food choices vary depending on the staple food and country of origin. The merit of imbalance nutrition intervention plan depends on understanding this domain. It is easy to provide what the patient's body requires to become stable.
Pregnancy and Childrearing practices. It is easy to understand fertility practices, taboos related to birthing, pregnancy, and postpartum treatment, restrictive and prescriptive practices.
Death rituals. The view on how the dead are treated until burial makes it easy for nurses to tolerate different bereavement behaviors.
Spirituality. Understanding different religions right from Christianity to Islam attaches meaning to the use of prayer to give hope to the patient, supports treatment process to add value to life.
Healthcare practice. Nursing care focuses on preventive, acute, biomedical and traditional beliefs to improve the health outcome. Evaluating individual's self-medication practices and personal concern for care becomes mandatory.
Healthcare practitioner. Appreciating the personal thought, emotion, perception, and beliefs as a caregiver not to undermine care provision promotes cultural conscious in the workplace.
Application of Purnell model to create cultural competency. A health provider can be culturally competent if he or she understands the diversity of healthcare systems, culture and policies to fulfill patients cultural, social and linguistic interests. For instance, racial and ethnic sensitivity reduces the burden of discrimination to access health. Cultural-specific information can be applied in intervention programs regarding acute care home health and long-term care (Campinha-Bacote, 2002). Knowledge on the traditions, beliefs, and values of indigenous groups helps to develop cultural specific policies that guide the conduct of health care providers in handling the African American, whites, Latinos, Asians, and Indians. The model also helps to identify and profile cultures with chronic illnesses and financial burdens. The model, therefore, enhances cultural sensitivity, awareness, competence, and knowledge to acknowledge the differences.
Campinha-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of transcultural nursing, 13(3), 181-184.
Giger, J., Davidhizar, R. E., Purnell, L., Harden, J. T., Phillips, J., & Strickland, O. (2007). American academy of nursing expert panel report: Developing cultural competence to eliminate health disparities in ethnic minorities and other vulnerable populations. Journal of Transcultural Nursing, 18(2), 95-102.
Purnell, L. D. (2012). Transcultural health care: A culturally competent approach. FA Davis.
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