Transcultural Health Care

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Purnell Model for Cultural Competence

Larry Purnell, PhD, RN, FAAN

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Purnell Model: Assumptions

  • All healthcare professions need much of the same information about cultural diversity and share the metaparadigm concepts of global society, community, family, person, and health.
  • One culture is not better than another culture; they are just different.

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Purnell Model: Assumptions

  • There are core similarities shared by all cultures.
  • There are differences within, between, and among cultures.
  • Cultures change over time, but slowly.
  • Culture has powerful influences on one’s interpretations and responses to health care.

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Purnell Model: Assumptions

  • If clients are co-participants in care and have a choice in health-related goals, plans, and interventions, health outcomes will be improved.
  • Variant cultural characteristics determine the degree to which people vary from their dominant culture beliefs, values, and practices.

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Purnell Model: Assumptions

  • Individuals and families belong to several cultural groups, usually known as subcultures.
  • Each individual has the right to be respected for his or her unique differences and cultural heritage.
  • Caregivers who can assess, plan, and intervene in a culturally competent manner will improve the care of clients for whom they care.

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Purnell Model: Assumptions

  • Caregivers know themselves better by learning about their own cultures.
  • Professions, organizations, and associations have their own cultures.
  • Healthcare teams can benefit from a Model and Organizing Framework that is useable by all healthcare disciplines.

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Variant Cultural Characteristics

  • Nationality
  • Race
  • Color
  • Gender
  • Age
  • Religious affiliation
  • Educational status
  • Socioeconomic status
  • Occupation
  • Military experience
  • Political beliefs
  • Urban versus rural residence

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Variant Cultural Characteristics

  • Marital status
  • Parental status
  • Physical characteristics
  • Sexual orientation
  • Gender issues
  • Length of time away from the home country
  • Reason for immigration—sojourner, immigrant, undocumented status

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

 

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Metaparadigm Concept: Global Society

  • Seeing the world as one large community of multicultural people
  • Evidence of global society
  • What happens in other parts of the world affects each community

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

ClickerCheck

What determines a person’s adherence with his/her dominant culture?

Metaparadigm concepts

Variant characteristics

Global society

Cultural worldview

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Correct Answer

Correct answer: B

Variant cultural characteristics determine the degree to which a person adheres to his/her dominant cultural beliefs and practices.

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Metaparadigm concept: Community

  • A group or class of people having a common interest or identity living in a specified locality but can be an online community as well now
  • What happens in the community has an effect on the family.

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Metaparadigm concept: Family

  • Two or more people who are emotionally involved with each other
  • They may, but not necessarily, live in close proximity to each other.
  • What affects the individual, affects the person.

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Metaparadigm concept: Person

  • A human being, one who is constantly adapting to his or her environment biologically, physically, socially, or psychologically
  • Person is defined differently in other cultures.

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Overview/Heritage

  • Origins
  • Residence
  • Topography
  • Economics
  • Politics
  • Education
  • Occupation

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Communication

  • Dominant language and dialects
  • Contextual use of the language
  • Paralanguage—volume and tone
  • Temporality—time—and spatial distancing
  • Use of touch
  • Eye contact and facial expressions
  • Greetings and name format

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Family Organization

  • Head of household
  • Gender roles
  • Goals and priorities
  • Developmental tasks
  • Roles of the aged and extended family
  • Social status
  • Alternative lifestyles

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Workforce Issues

  • Acculturation
  • Autonomy
  • Language barriers

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Biocultural Ecology

  • Biological variations
  • Skin color
  • Heredity
  • Genetics
  • Endemics
  • Drug metabolism

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: High-Risk Behaviors

  • Tobacco
  • Alcohol
  • Recreational drugs
  • Physical activity
  • Safety
  • Sexual behavior

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Nutrition

  • Meaning of food
  • Common foods
  • Rituals
  • Deficiencies
  • Limitations
  • Health promotion

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Pregnancy and Childbearing

  • Fertility practices
  • Views toward pregnancy
  • Pregnancy beliefs
  • Birthing practices
  • Postpartum
  • Prescriptive, restrictive, and taboo practices

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Death and Dying

  • Death rituals during the dying process
  • Post mortem practices
  • Bereavement

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Spirituality

  • Religious practices
  • Use of prayer
  • Meaning of life
  • Individual strength
  • Spirituality and health

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

ClickerCheck

Contextual aspect of cultural communication includes

Dominant language

Dialects

Explicit versus implicit communication

Translation versus interpretation

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Correct Answer

Correct answer: C

Contextual use of a language is concerned with the number of words used to express a thought. High-contexted communication uses fewer words to express a thought.

Low-contexted communication uses a lot of words to express a thought

 

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Health-care Practices

  • Focus of health care
  • Traditional practices
  • Magicoreligious beliefs
  • Responsibility for health
  • Self-medication practices

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Health-care Practices

  • Responses to pain
  • Sick role
  • Mental health
  • Rehabilitation
  • Chronicity
  • Blood transfusion
  • Transplantation

 

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Copyright © 2013 F.A. Davis Company

Domain: Health-care Practitioners

  • Perceptions of practitioners
  • Folk practitioners
  • Gender and health care
  • Status of healthcare providers

 

 

 

 

 

 

 

 

 

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