Question 1:- Could this be partially the cause of why nurses do not see the value of models in their daily practice?
This could be and could not be the reason. Sure enough, the Purnell model in structure is complicated to an immature health education practitioner. Importantly, the diagram itself is intricate and may be the first step in the resentment process. However, after this initial buffer, the matured approach is to devise a system of simplifying basic theoretical assumptions for application to the real world. Cultural competence is not merely a requirement in health education/ promotion it is actually the channel through which the education/promotion is disseminated (Perez & Luquts, 2005).
Alternatively, it is my opinion that nurses do value cultural competency theoretical models irrespective of whether they are complicated or not. At this point the health education/promotion training for nurses may need to focus more on teaching application of these models than merely teaching about the models. These models have been perceived as valuable, but how can I as a health promotion practitioner apply them to my community health education program? The barrier is not the model, but its application. Learning occurs from abstract to concrete. The abstract is the theoretical models with which students struggle. The concrete is application of these models which will prove that the student has grasped the concepts (Claxton & Arnold, 2013).
Question 2:- Are these models too complex to be practical?
The basic assumptions embodying the Purnel model is not complex. There are four concepts any novice can perceive, the global society which is contained in world culture concepts, next is the community for which a health education/promotion program will be targeted, thirdly the family and finally the individual/person. In my opinion there is no complexity at this point as it pertains to Purnell model to make it impractical (Alexander, 2008).
Huff and Kline advance a model, which appears simpler to perceive. It embraces a thorough evaluation of cultural or ethnic group-specific demographic characteristics along with cultural or ethnic group-specific epidemiological and environmental influences. Up to this point there is no impracticality in the application. All health promotion practitioners understand the importance of epidemiological and environmental influences in health promotion. For example, African Americans have been targeted as being hypertensive with an epidemiology of essential hypertension as it pertains to the environment and ethnic group-specific criteria of this model (Huff & Kline, 2007). Hence, no impracticality exists at this level.
A third assumption is that, 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. When linking these assumptions to Purnell’s model Huff and Kline (2007) ends where Purnel begins. The global society begins Purnell’s assumptions and the person or individual ends the assessment process. Ethnic group-specific demographic characteristics begins Huff and Kline’s (2007) Cultural Assessment Framework and Western health care organization and service delivery variables culminates the framework from a global perspective (Huff & Kline, 2007). Hence, no impracticality exists in this model too.
Alexander, R. (2008). Cultural Competence Models in Nursing. Crit Care Nurs Clin N Am. 20 (2008) 415–421
Claxton, R., & Arnold, R. (2013). The Practical Application of Learning Theory. University of Pittsburgh Medical Center
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