Nursing: Purnel Model for Cultural Competence, Coursework Example

Introduction

Cultural competence relates to a social refinement, which enables people to interact appropriately with each other from a premise of both understanding and appreciating values held sacred by another person, country, discipline or gender due to their ethnicity, country of birth and parental upbringing. Traditional cultural competence models embody four components (Doman, 2005).

First it is becoming aware one’s personal cultural paradigm of the world; secondly examining personal attitudes when interacting with persons of different ethnicity, race countries and families as they display cultural differences. Thirdly the person demonstrating cultural competence must exhibit a sound knowledge of various cultural practices and a matured interpretation of international cultures. The fourth and final component embodies articulating Cross-cultural skills effectively. Importantly, cultural competence is best manifested when professionals can appropriately communicate through speech, body language, facial expression with people from African American decent, Caucasian, Caribbean, Asia among many other present in the society across cultures (Doman, 2005).

Question 1:-Why are models of cultural competence important a frameworks for program planning in multicultural populations?

 Rumay Alexander (2008) quoting Dr. Martin Luther King Jr. affirmed that,

Of all the forms of inequality, injustice in health

care is the most shocking and inhumane.

Dr. Martin Luther King, Jr

Hence, models of cultural competence are the only identities/ guidelines health promotion specialists have of the populations for which health activities are designed. Subsequently, the American Organization of Nurse Executives in 2007 advanced a position statement pertaining to the relevance of models of cultural competence as frameworks for program planning in multicultural populations. The organization posits that ‘globalization, new technology,

war, threats of bioterrorism, and ecosystem imbalances’ (Alexander, 2008, p 415) signal the entrance of America’s escalated consciousness towards a movement between cultures and countries. This has far reaching impacts on health promotion programs. If then, Nurse Executives do not understand the appropriateness of these models when targeting high risk populations more inequalities in health care accessibility and availability will be created (Alexander, 2008).

For example, the Purnel model encompasses four basic assumptions related to cultural competence when planning health promotion programs. It advocates viewing cultural competence from the perspective of a global society first and slowly moving towards interpreting the person/individual for whom actual care is targeted. From the global conception the model suggests that health promotion ventures examine the community through a data collection process, which identifies needs based on the community’s cultural composition. Thirdly, the focus is shifted towards family before getting to the person (Perez & Luquts, 2005)

In the center of this circle is a nucleus of cultural predisposing factors, which could affect the person, family, community and global society’s receptivity of the particular health promotion venture. These include an overview understanding of the population’s heritage; communication methods inclusive of language/s; family roles and organizational patterns; workforce issues; biocultural implications; high risk factors and behaviors; nutritional values; interpretation of pregnancy incidences, fertility and human sexuality; death rituals; spirituality; present healthcare practices and health care practitioners’ perception of these factors (Perez & Luquts, 2005). Importantly, knowledge and interpretation of this data applying a distinct model can significantly reduce all the forms of inequality and injustice in health care (Dr. Martin Luther King, 1963)

Question: 2 Is there a model you gravitate to more than another?

While the Purnel model of cultural competency is popular and adequate its application is relatively complicated for the immature professional who is new to theoretical cultural competency models in health education and promotion practices. For example, Huff and Kline (1999) adapted the Cultural Assessment Framework for health education programs consisting of five assumptions (Huff & Kline, 2007).

The theorists advance that a thorough evaluation of cultural or ethnic group-specific demographic characteristics must be undertaken along with cultural or ethnic group-specific epidemiological and environmental influences. Thirdly, a differentiation between general and specific cultural or ethnic group characteristics must be made; then general and specific health care beliefs and practices profile designed including Western health care organization and service delivery variables (Huff & Kline, 2007).

 Explain why and why not.

Huff and Kline (1999) contend that the more health promotion/education specialists know about a population’s cultural or ethnic group-specific demographic characteristics the more relevant data will be obtained for targeting a particular program. For example, there is an African Americans predisposition to essential hypertension. I planning health promotion/education for hypertension it makes sense to understand the cultural beliefs that influence this high essential hypertension incidence among African Americans (Huff & Kline, 2007).

Based on research conducted in specific geographic locations applying various models, it is my opinion that the mean for normal blood pressure among African Americans ought to be revaluated based on their culture. The message fed to them that a blood pressure of 140/80 is normal for them and everyone else in the community may be a mis-representation of their health profile. Perhaps, using Huff and Kline’s (1999)’s model may help in defining a realistic normal blood pressure for African Americans who have been termed hypertensive. Are they hypertensive or health care professional missing some cultural or ethnic group-specific demographic characteristic?

References

Alexander, R. (2008). Cultural Competence Models in Nursing. Crit Care Nurs Clin N Am. 20 (2008) 415–421

Doman, L. (2005). Cultural Competence, Practice Stages, and Client Systems: A Case Study Approach. Centage Learning

Huff, R., & Kline, M. (2007). The cultural assessment framework. In M. V. Kline & R. M. Huff (Eds.), Health Promotion in Multicultural Populations. Los Angeles: SAGE.

Perez, M., & Luquts ( 2005). Cultural Competence in Health Education and Promotion. Wiley