Diversity has a significant influence on health care. Studying transcultural health care helps health professionals understand different cultures in order to provide holistic and individualized health care. Review the Purnell Model for Cultural Competence, including the theory, framework and 12 domains. Write 750-1,000 word paper exploring the Purnell Model for Cultural Competence. Include the following:
Explain the theory and organizational framework of the Purnell Model, and discuss its relevance to transcultural health care.
Describe Purnell’s 12 domains of culture, and assess how each of these domains plays an active role in the diversity of health care in your specific field.
Discuss how this model can be applied when working with different cultures in order to become a more culturally competent health care provider.
Cite at least three references, including the course textbook.Purnell, L. D., & Paulanka, B. J. (2013). Transcultural health care: A culturally competent approach (4th ed.). Philadelphia, PA: F. A. Davis Company. ISBN-13: 9780803637054
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There are as many cultures as there are groups of people across the globe. Culture is the essence of the group to which one belongs. One would think that persons living in the United States would all be part of an “American” culture, but the culture of those living in Arizona differs from that of those living in California. Certainly the Arizona culture varies from the culture that exists in Georgia. Maine, Vermont, or other New England residents represent still more cultural diversity. Yet, some cultural markers are the same. Generally speaking, Americans value their civil rights and support an individualistic attitude. Some Americans might call it “rugged individualism” while, in some areas, this sentiment might be expressed with the adage, “Every tub sits on its own bottom.” The thought is the same. Customs, hospitality, and remedies for diseases will vary throughout the United States, once considered a melting pot in which cultures merged. Today, the salad bowl concept is more acceptable: Various ingredients come together to make a desirable outcome, but each component maintains its own identity and taste. Transcultural Communication Although tolerance is promoted, learning to interact with other cultures instead of merely tolerating them is more beneficial. Thus, the study of intercultural, or transcultural, communication has risen to importance, particularly in the fields of education, business, and health care. Schools are transformed by children from many nations and cultures. Teachers must know what roles family members play in a child’s education. Businesses are trading across the world and must learn business practices that reflect multiple cultures. Health care professionals deal with culturally diverse patients who have a myriad of beliefs about their healing processes. Teaching all there is to know about the cultures of all the peoples of the world would require extensive, voluminous texts. By the time these volumes are completed and considered valid, the cultures will have changed. The way to learn to communicate cross-culturally is to learn concepts and to be able to designate what cultural areas to red-flag. Health care professionals should know their own particular culture. This will help to identify the beliefs that impact their own world. When the actions of patients violate one’s beliefs, the questions should be asked, “Is it wrong, or is it just different? What is worth fighting for? Will the practice bring harm to the patient? What are the rights of the patient?” Sometimes the practices are not so significant. Various cultures have diverse death and dying rituals, for example. Honoring these rituals makes the passing of a loved one more bearable for the mourners, a small consideration for a lasting remembrance. Another example of these differences is reflected in the various views different cultures have toward touching. Being aware of these customs makes health providers seem more caring. Cultural Adaptation When people of one culture emigrate from their place of origin into a new culture, many adjustments must be made. One would think that assimilation into the new culture would take place, but that is not true. Often, older immigrants or at-home caretakers do not learn the new language, and therefore adapt more slowly. Picturing oneself in a new country without the benefit of language–without knowledge of what items in the grocery store are, how to ask for certain items, or how to make an emergency call to 911–only partially illustrates the problems that arise when adapting to a new country. The Native American is a study in adaptation to a new culture. Many Native Americans choose to stay on the reservation in their own culture, which they may feel is better than assimilating into the culture of the Caucasian American. Others, mostly young people, move into the culture outside of the reservation and acculturate and assimilate quickly. This is not all there is to adaptation to life outside the reservation. There are many stages between reservation life and urban life. A Native American may live in the urban areas of nearby cities to make a living while holding tightly to the rituals of his culture in his family life and returning to the reservation often. Living in a new country does not inspire families to give up their own cultures. Older immigrants often cling to their old ways while the children grab iPods and MP3 players and become Americanized quickly. To better understand cultural adaptation, one should consider the question, “What would be difficult to give up or change?” The Purnell Model for Cultural Competence in Health Care The student should keep in mind that one psychological model is neither conclusive evidence nor a law. It is very much like a scientific theory, true for the information available at that time. An example would be that of an organ. A very short time ago, it was thought that people of different races would not be able to accept organs from each other. Many African American, Latin American, and Asian Americans suffered and died for want of organ transplants because there were too few donors from their own cultures. It is now known, thanks to the Genome Project, that all human DNA is 99% identical. Organs are now transplanted regardless of race. The Purnell model (Purnell, 2013) includes 12 domains of culture. These are some basic ethnocultural attributes used to assess various cultures. Basically, these domains address some simple questions: 1) Where is the group of people from, and why did it migrate to its present location? 2) What language(s) is the group comfortable speaking? 3) What are the roles played in the family? Is the father the voice of authority, or is the society matriarchal? What is the format for names? 4) What is the attitude toward work? Who should be the breadwinner? Are women allowed to work? 5) What biological aspects of race affect health care? 6) What high-risk behaviors might take place in the culture? 7) Is the diet in the home sufficient? Are there some foods which are believed to be “magical”? 8) What are the pregnancy and childbearing practices? 9) What are the rituals of death and dying? 10) Do religious values and beliefs influence health care practices? 11) What is the attitude toward health care? Have folk practices been in place? 12) Is there a lack of trust toward doctors and nurses? Does the culture have its own health care practitioners? These domains are oversimplified here. Details are elaborated within the textbook for deeper understanding. Conclusion Dr. Purnell’s model encompasses the 12 factors that help define a culture. Throughout this course, the unique characteristics that make up the different cultures of the world will be discussed and compared. These are the characteristics that will be used to contrast and compare the 10 groups chosen for each learner’s area. References Purnell, L. D. (2013). Transcultural health care: A culturally competent approach (4th ed.). Philadelphia, PA: F. A. Davis.
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