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Running Head: PURNELL MODEL FOR CULTURAL COMPETENCE Dilsy Ricardo Florida National University Nursing Department BSN Program NUR 4636 1/16/2019 Prof. Cassandre Milien 1 PURNELL MODEL FOR CULTURAL

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COMPETENCE 2 Purnell Model Multicultural diversity has been an issue for healthcare professionals as well as the caregiving institutions. Due to many encounters with individuals from different cultures the healthcare institutions have initiated some standards, initiatives as well as statements encouraging its members to be sensitive in terms of cultural competence. Due to this, the American Academy of Nursing Expert Panel was able to develop in terms of sensitizing the cultural competence issue where later the Purnell model was developed Purnell model is a model that helps in putting across the cultural competence of society and health care. Assumptions The model has some assumptions, for instance, it states that all healthcare professions need to have similar information concerning cultural diversity as well as sharing the metaparadigm concepts of the society at large, that is, the global society, community, family, and health. Also, according to the model, all cultures are the same meaning that no culture should be termed as better than the other, but they are just different. (Purnell, 2018). All cultures share similarities as well as differences and therefore every individual must be respected in relation to all differences in their cultures. Having in mind that all cultures change over time gradually or slowly the change should be appreciated and respected. In this case, caregivers and health professionals are highly affected by the individual interpretations of different cultures who respond to healthcare (Shen, 2015). For PURNELL MODEL FOR CULTURAL COMPETENCE 3 instance, if those individuals decide in participating on issues related to health to achieve the goals, to succeed in its plan and the results will be of high quality. From the model, it is assumed that the process of learning the culture is always on a process and since one encounters with different individuals from a different culture. After learning about other cultures and understanding them, the cultural bias will be limited hence appreciating everyone. Finally, the model assumes that for effective healthcare services, the health care itself should focus on understanding values of different people of different cultures as well as their beliefs, attitudes, their way of life and the way the world views them. How the Model Helps With the model having such assumptions it helps in providing cultural competences on the basis of health care where it is used. The model shows the cultural competence of the patients who belong to different cultural beliefs (Stennis et al, 2015). Since the cultural competence of any healthcare organization recognizes as appreciating the cultural competence of other immigrants who are moving into America. The model fulfills this in the following ways: first, it helps in creating the framework for healthcare enabling them to understand critical concepts of different cultures. With this, the healthcare providers are able to handle and deal with individuals of different cultures. For instance, there are those female individuals who according to their culture it is difficult for them to face a male health officer. In this case, a health officer will understand the situation and make the patient comfortable by explaining the situation or bringing in a female healthcare giver. The Purnell model is essential since it helps in identifying individuals, their families as well as their group ethnocultural environment which is essential healthcare practices. With a different background of personnel, the health care will appreciate every culture competence PURNELL MODEL FOR CULTURAL COMPETENCE 4 and acknowledge their practices they will understand how to handle them, in the process of administering health services. In every health care center, there are workers who are from different cultural backgrounds which include families. For the workers to get along, the knowledge and understanding of cultural competence is essential. This will improve the respect among each other at the workplace as well as that of their clients. Therefore, cultural competence is essential in healthcare since, in every society, there are individuals of different cultures who should be understood, respected and appreciated. The Purnell model assumptions seem to match the expectations of many and help in creating awareness of the necessary individuals. The Purnell mode plays a great role in the enhancement of cultural competence in health care and therefore very recommendable to follow. PURNELL MODEL FOR CULTURAL COMPETENCE 5 References Purnell, L. (2018). Update: The Purnell Theory and Model for Culturally Competent Health Care. Journal of Transcultural Nursing, 1043659618817587. Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: a literature review. Journal of Transcultural Nursing, 26(3), 308-321. Stennis, K. B., Fischle, H., Bent-Goodley, T., Purnell, K., & Williams, H. (2015). The Development of a Culturally Competent Intimate Partner Violence InterventionSTART©: Implications for Competency-Based Social Work Practice. Social Work and Christianity, 42(1), 96. Running head: The Purnell Model 1 Discussion # 2 Elsa Sosa Florida National University Culture in Nursing Prof. Cassandre Milian. MSN Running head: The Purnell Model 2 The demographics of the United States is changing at such a rapid speed that in 2030 there will be a minority-majority nation. This means that there will be no predominant racial group. (Jen,2016, p. 85). Regarding this point, the nurse must use their cultural competence level. The Purnell Model for Cultural Competence, its framework, acceptance and practical application is treat in this paper. The Purnell Model for Cultural Competence helps nurses to united many cultural attributes permitting to get notions of the patient about the health state objectively and proposing the culturally change treatment plan. According to Jen (2016), there are twelve domains under the Purnell Model for Cultural Competence. They include nutrition, communication, heritage, family impact, biocultural ecology, high-risk factors, spiritually, childbearing, death, workforce issues. Besides, it covers heathcare practices and healthcare practitioners. The value of this model is that it is inclusive and discussed many diversity feature in the processs of each of the domains. This model also plays high attention to the interactions of the person with the external environment, family, and community, and global society. The mentioned elements combine with the level of healthcare practitioner’s cultural competence form the circle of cultural domains marks that the real relationships between the nurse and the patient begin from the communication patters. It includes eye contact, facial expresions, greetings, spatial distance, voice tone and volume. The nurse must be informed of the differences in many cultures to demonstrate the respect to the patient’s background from the early start of the interaction. Time, names, temporality, contextual use and language use are also critical to establish the first contact. In order to perform the skills in cultural understanding, it is basic for the nurse to evaluate the level of his/her cultural competence. According to the Purnell Model for Cultural Running head: The Purnell Model 3 Competence, there are four states: unconsciously incompetent, unconsciously competent, consciously competent and consciously incompetent. The purpose of cultural competence improvement is to be a consciously competent nurse, then to learn about the patient’s culture, to verify if generalization about the patient’s culture is real and modify them to prepare culturally specific interventions. The culturally competent nurse according to the Purnell Model for Cultural Competence should be tuned in of different cultural peculiarity. They imply age, nationality, generation, gender, race, color and religion. These peculiarities also have socioeconomic status, educational level, occupation, residence, political beliefs, and military status. A nurse must known the marital and parental status, physical characteristics and sexual orientation, the cause for migration. This model helps in determination of the cultural differences of the many ethnic groups. The Purnell Model for Cultural Competence helps the nurse to be aware of the differences in he cultural understanding about all elements of patient’s life cycle stage. For example, a attention in the Purnell Model for Cultural Competence is drained for pregnancy, childbearing and postpartum care differentiate in the ethnic groups. In order to improve the best health outcomes, a nurse must be alert of the rituals in different cultures and make a good decision how to know the need for safety with the need to add the cultural preferences of the patient. Running head: The Purnell Model 4 In conclusion , The Purnell Cultural Competency Model provides a basis for nurses to improve understanding and knowledge about the twelve domains that are critical to the reason for differences and the impact of cultures on their discrepancies and also on the perception of health condition and the corresponding treatment. Regarding this point, the nurse must use their level of cultural competence. The Purnell Cultural Competency Model helps nurses unite many cultural attributes that allow them to obtain the patient’s notions of health status objectively and propose a treatment plan for cultural change Running head: The Purnell Model 5 References Arellano, D. (2014). Cultural competence: The voice of the practitioner. Potter, P. A. (2014). Basic nursing. St. Louis, MO: Mosby Elsevier. Running head: The Purnell Model 6 Running head: The Purnell Model 7 Running head: The Purnell Model 8 Running head: The Purnell Model 9
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Response to peers

Prof. Cassandre Milien, MSN 01/15/2019 THE PURNELL MODEL 2 The Purnell Model Due to the increasing diversity

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in many parts of the world, providers now face an unprecedented number of challenges when responding to matters of healthcare. It is almost impossible to deliver high quality care without taking into consideration the need for cultural competence. Cultural competence serves as a means to effectively deliver healthcare services to meet the social and cultural needs of the patients. The Purnell model is an organizing framework in the nursing profession, aimed at guiding the cultural competences the multidisciplinary members of the nursing teams (Doğu, 2016). The model developed by Larry Purnell outlines various elements and ideas about cultures and persons and healthcare professionals and how they can be used to extend cultural competence in the healthcare sector. The Framework of The Purnell Model The Purnell model contains twelve domains of organizing frameworks which describe the characteristics of culture and other variations such as beliefs, values and own cultural heritage. The domains of organizing frameworks include the culture and heritage domain; which evaluates the influence of country of derivation and the influence of the present home. i.e. education, and political affairs (Doğu, 2016). Also, the other domain includes the means of communication, including language differences. Family organization and family roles also form part of the framework domains. The other framework domains under the Purnell model concerning cultural competencies include; bio-cultural ecology, i.e. ethnic and racial origins; high-risk behaviors; nutrition; pregnancy; spirituality; death rituals, and the perception of traditional healthcare practices. THE PURNELL MODEL 3 To achieve cultural competence, healthcare practitioners need to follow competency processes. The processes are developed from the unconscious competence to conscious competence. The cultural competences include religion, race, gender, and nationality (Doğu, 2016). The model social domains are interrelated; thus, the healthcare providers are supposed to adapt to the various cultural needs of individuals ensuring effective healthcare provision. Assumptions of The Purnell Model According to (Shen, 2015), the Purnell model is based on various assumptions for instance; the model assumes that there are core similarities shared by all cultures. However, there also are differences within, between and among the cultures that may affect the provision of healthcare. Similarly, the model assumes that there are changes in culture over time and that culture can have influence in an individual’s interpretation and response to healthcare. Thus, it is essential that the healthcare provides adapt to the possible changes in culture as well as understand the possible influences of various cultures to healthcare response to ensure efficiency. Also, the Purnell model is based on the assumptions that patients are participants in the healthcare goals, and their plans may lead to improved outcomes. Also, different variations to cultural characteristics determine the degree to which individuals vary from their beliefs and values (Shen, 2015). Understanding individual healthcare goals based on variant cultural characteristics thus forms the basis for improved healthcare provision. The Effectiveness of The Purnell Model in Providing Cultural Competence in Healthcare The Purnell model domains have effectively improved the provision of healthcare in various healthcare interventions. For instance, the communication domain is and part in nursing interventions where individuals are unable to express their feeling due to psychological THE PURNELL MODEL obstacles, as well as inability to express thoughts in mother tongue (Hendson, 2015). Nursing interventions in these cases use communication through translators and encouragement to share feeling leading to better healthcare provision. Also, different cultures have different death rituals and how they perceive death. Often individuals with terminal illnesses find it hard to come to terms with their death. The Purnell model addresses this issue through nursing interventions aimed at sharing the feelings of death with the patients (Hendson, 2015). Nurses encourage the patients to tell stories and reminisce about their lives as well as remember all the losses they have had to go through their lives. The patient thus is encouraged to think about their death as well as restructuring the view of the world without them. These intervention techniques are used in every Purnell model domain to achieve improved healthcare provision. In conclusion, the healthcare providers play an essential role in providing healthcare solutions to different patients with different cultures, beliefs, and values. There are different variations in the perception of healthcare from different cultures. The Purnell model, therefore, aims at improving the healthcare provision among the nursing community by adopting the various components of cultural competence. 4 THE PURNELL MODEL 5 References Doğu, Ö. C. (2016). Purnell Model for Cultural Competence: Nursing Care of an Afghan Patient. IOSR Journal of Nursing and Health Science (IOSR-JNHS), PP 44-48. Hendson, L. R. (2015). Health care providers’ perspectives of providing culturally competent care in the NICU. Journal of Obstetric, Gynecologic & Neonatal Nursing, 44(1), 17-27. Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: a literature review. Journal of Transcultural Nursing, 26(3), 308-321. Running head: The Purnell Model 1 Discussion # 2 Elsa Sosa Florida National University Culture in Nursing Prof. Cassandre Milian. MSN Running head: The Purnell Model 2 The demographics of the United States is changing at such a rapid speed that in 2030 there will be a minority-majority nation. This means that there will be no predominant racial group. (Jen,2016, p. 85). Regarding this point, the nurse must use their cultural competence level. The Purnell Model for Cultural Competence, its framework, acceptance and practical application is treat in this paper. The Purnell Model for Cultural Competence helps nurses to united many cultural attributes permitting to get notions of the patient about the health state objectively and proposing the culturally change treatment plan. According to Jen (2016), there are twelve domains under the Purnell Model for Cultural Competence. They include nutrition, communication, heritage, family impact, biocultural ecology, high-risk factors, spiritually, childbearing, death, workforce issues. Besides, it covers heathcare practices and healthcare practitioners. The value of this model is that it is inclusive and discussed many diversity feature in the processs of each of the domains. This model also plays high attention to the interactions of the person with the external environment, family, and community, and global society. The mentioned elements combine with the level of healthcare practitioner’s cultural competence form the circle of cultural domains marks that the real relationships between the nurse and the patient begin from the communication patters. It includes eye contact, facial expresions, greetings, spatial distance, voice tone and volume. The nurse must be informed of the differences in many cultures to demonstrate the respect to the patient’s background from the early start of the interaction. Time, names, temporality, contextual use and language use are also critical to establish the first contact. In order to perform the skills in cultural understanding, it is basic for the nurse to evaluate the level of his/her cultural competence. According to the Purnell Model for Cultural Running head: The Purnell Model 3 Competence, there are four states: unconsciously incompetent, unconsciously competent, consciously competent and consciously incompetent. The purpose of cultural competence improvement is to be a consciously competent nurse, then to learn about the patient’s culture, to verify if generalization about the patient’s culture is real and modify them to prepare culturally specific interventions. The culturally competent nurse according to the Purnell Model for Cultural Competence should be tuned in of different cultural peculiarity. They imply age, nationality, generation, gender, race, color and religion. These peculiarities also have socioeconomic status, educational level, occupation, residence, political beliefs, and military status. A nurse must known the marital and parental status, physical characteristics and sexual orientation, the cause for migration. This model helps in determination of the cultural differences of the many ethnic groups. The Purnell Model for Cultural Competence helps the nurse to be aware of the differences in he cultural understanding about all elements of patient’s life cycle stage. For example, a attention in the Purnell Model for Cultural Competence is drained for pregnancy, childbearing and postpartum care differentiate in the ethnic groups. In order to improve the best health outcomes, a nurse must be alert of the rituals in different cultures and make a good decision how to know the need for safety with the need to add the cultural preferences of the patient. Running head: The Purnell Model 4 In conclusion , The Purnell Cultural Competency Model provides a basis for nurses to improve understanding and knowledge about the twelve domains that are critical to the reason for differences and the impact of cultures on their discrepancies and also on the perception of health condition and the corresponding treatment. Regarding this point, the nurse must use their level of cultural competence. The Purnell Cultural Competency Model helps nurses unite many cultural attributes that allow them to obtain the patient’s notions of health status objectively and propose a treatment plan for cultural change Running head: The Purnell Model 5 References Arellano, D. (2014). Cultural competence: The voice of the practitioner. Potter, P. A. (2014). Basic nursing. St. Louis, MO: Mosby Elsevier. Running head: The Purnell Model 6 Running head: The Purnell Model 7 Running head: The Purnell Model 8 Running head: The Purnell Model 9
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