Abstract
The Purnell Model for Cultural Competence is a framework that guides healthcare providers in understanding and respecting cultural diversity when providing care to patients. The model consists of twelve domains that entail cultural beliefs, values, and practices, which influence individuals’ and groups’ health behaviors and outcomes from different cultures. These domains include communication, family roles and organization, workforce issues, healthcare practices, biocultural ecology, high-risk behaviors, nutrition, pregnancy and childbirth, death rituals, spirituality, healthcare providers’ attitudes, and cultural-specific knowledge.
Adherence to dominant cultural practices and beliefs can vary among individuals within the same ethnic group, depending on factors such as upbringing, personal experiences, and exposure to other cultures. It is essential to recognize and respect cultural differences and avoid stereotyping or generalizing individuals based on their cultural background. One should learn to appreciate other people’s cultures and theirs too. There are various dominant cultural practices I adhere to, and some I do not base on my own decisions and understanding.
Keywords: Purnell model, dominant cultural practices, beliefs, practices, cultural identity
Self-Assessment: The Purnell Model for Cultural Competence
The Purnell Model for Cultural Competence is a framework developed to help healthcare providers provide culturally competent care to patients from diverse backgrounds (Purnell, 2021). The model is based on the belief that cultural competence is essential to improving health outcomes and reducing health disparities. The Purnell Model includes 12 domains for understanding a patient’s culture and providing culturally sensitive care. Overview/heritage, as one of the domains, refers to a patient’s ethnic and cultural background, including their history, values, and traditions (Purnell, 2021). The other domain, communication, includes the patient’s preferred language, nonverbal communication style, and other factors that may impact communication. Family Roles and Organization examines the role of the family in the patient’s culture, including family structure, hierarchy, and gender roles. Workforce Issues include factors related to the patient’s occupation, including access to healthcare, work-related stressors, and cultural beliefs about work. Biocultural Ecology examines the patient’s physical environment, including their living conditions, diet, and access to healthcare. High-risk Behaviors explore health behaviors specific to the patient’s culture, including substance abuse, risky sexual behavior, and other behaviors that may contribute to poor health outcomes.
Nutrition examines the patient’s dietary practices, including traditional foods, taboos, and food-related rituals (Purnell, 2021). Pregnancy and Childbearing Practices include cultural beliefs and practices related to pregnancy, childbirth, and parenting. Death Rituals explores cultural beliefs and practices related to death, dying, and mourning. Spirituality examines the patient’s religious and spiritual beliefs, including practices related to prayer, meditation, and other spiritual practices (Purnell et al., 2019). Healthcare Practices explore the patient’s beliefs and practices related to healthcare, including alternative medicine, the use of traditional healers, and beliefs about health and illness. Health Disparities examine the patient’s experiences with healthcare disparities, including access to care, quality of care, and health outcomes (Purnell et al., 2019). By considering each domain when caring for a patient, healthcare providers can better understand the patient’s culture and provide more effective, culturally sensitive care. The Purnell Model helps providers be more inclusive, equitable, and empathetic towards patients with diverse cultural backgrounds, leading to better health outcomes and patient satisfaction.
Adherence to the dominant cultural practices and beliefs of the ethnic group with which one basically identifies can provide a sense of belonging and connection to one’s cultural heritage (Hamer et al., 2018). Cultural practices and beliefs are often passed down through generations and are deeply rooted in history and tradition. They can include customs, rituals, language, and values that define a group’s identity and way of life.
I am part of a given ethnic group, in which I fully subscribe to its cultural practices, which include beliefs, norms, values, language, and other things. Cultural practices and beliefs are sources of pride and help me celebrate my cultural identity. They are an essential part of an individual’s identity, shaping how we see the world and interact with others. They provide a sense of continuity with the past and can be a way to honor the sacrifices and struggles of previous generations. Cultural practices and beliefs can offer comfort and security, especially during stress and uncertainty. However, cultural practices and beliefs can also be a source of conflict and tension, especially when they clash with dominant cultural norms or practices (Hamer et al., 2018). Therefore, it requires one to apply knowledge when adhering to this dominant cultural practice of the ethnic group they are affiliated to. On understanding the essence of belonging to a certain ethnic group, I adhere to our cultural practices to maintain my identity and have a place of belonging.
In my interactions with others from my own and other communities, I’ve learned that it’s crucial to recognize, understand, and respect the cultural practices, values, and beliefs of others, even when they differ from our own. Understanding and appreciating the cultural practices and beliefs of others can help build empathy and understanding and promote social cohesion and inclusion. However, this doesn’t mean that individuals should abandon their cultural identity or conform to dominant cultural practices and beliefs if they don’t align with their values. This knowledge helps me to stick and fully subscribe to our cultural practices and beliefs, maintaining a strong identity of our dominant cultural patterns.
From this case, I now navigate my relationship with our cultural identity by balancing honoring their cultural practices and beliefs and respecting the dominant cultural practices and beliefs. This can involve being open to new experiences and perspectives while connecting to one’s cultural identity and values. It can also involve advocating for and promoting cultural diversity and inclusivity while respecting the cultural practices and beliefs of others.
I think identifying strongly with my ethnic group and adhering to dominant cultural practices and beliefs can provide comfort and familiarity. It can also foster a sense of community, connection, and belonging by creating shared experiences and solidarity with those with the same cultural background. Cultural practices and beliefs are a source of pride and help me celebrate our cultural identity. They also provide a sense of continuity with the past and become a way to honor the sacrifices and struggles of previous generations from our culture.
I am respectful and open-minded when interacting with individuals from diverse cultural backgrounds while maintaining a connection to my cultural identity and values. It encourages me to explore my cultural identity and history to better understand our practices and beliefs. Adherence to cultural practices and beliefs is a personal choice, and individuals may navigate their relationship with their cultural identity differently. It’s essential to recognize and respect the cultural practices and beliefs of others while also maintaining a connection to one’s cultural identity and values. Therefore, promoting cultural diversity and inclusivity can help build a more inclusive and harmonious society, where individuals can celebrate their cultural identity while also embracing the diversity of others.
However, besides my adherence to some dominant cultural practices, I also understand that these cultural practices and beliefs can change or evolve and may not be fixed or static. This is why I hold a different interpretation or some level of adherence, even within the same ethnic group. This is because what was once considered a dominant cultural practice or belief may no longer hold or be inappropriate in the current cultural context. Adhering to outdated or inappropriate cultural practices or beliefs can lead to harm or misunderstanding within and outside our community (Hamer et al., 2018). In some cases, adherence to dominant cultural practices and beliefs may conflict with broader societal norms or expectations, and individuals may need to navigate these tensions carefully. Though the Purnell Model emphasizes the importance of being respectful and open-minded when interacting with individuals from diverse cultural backgrounds while also maintaining a connection to one’s cultural identity and values, some practices from our cultural values exist that I fail to subscribe to, especially with the changing times. I do not follow all practices and social norms due to my varying views of the practices.
Another issue why I fail to adhere to some dominant cultural practices and beliefs is because they can create barriers to understanding and respecting other cultures. In a diverse and interconnected world, it is essential to cultivate an open mind and be ready to learn about and understand different cultural perspectives. Strict adherence to cultural practices and beliefs can limit one’s ability to empathize and communicate effectively with others from diverse backgrounds (Hamer et al., 2018). Moreover, cultural practices and beliefs conflict with broader societal norms or expectations, such as laws or ethical standards. In such cases, we must traverse these tensions carefully, weighing the importance of our cultural identity and values against the potential harm or consequences of non-adherence.
Adherence to dominant cultural practices and beliefs can also perpetuate discrimination and inequality (Hamer et al., 2018). Cultural practices and beliefs may reinforce harmful stereotypes or discriminatory attitudes toward certain groups. It is essential to critically examine cultural practices and beliefs, ensure they align with ethical standards, and promote equality and respect for all individuals.
Therefore, while adherence to dominant cultural practices and beliefs can provide a sense of belonging and connection to cultural heritage and other significant benefits, it is important to recognize that cultural practices and beliefs are not static and may evolve. Adherence to outdated or inappropriate cultural practices or beliefs can lead to harm or misunderstanding. It is essential to cultivate an open mind and be ready to learn about and understand different cultural perspectives. Moreover, respecting individual differences and being open to examining cultural practices and beliefs is crucial to promote equality and respect for all individuals.
References
Hamer, K., McFarland, S., Czarnecka, B., Golińska, A., Cadena, L. M., Łużniak-Piecha, M., & Jułkowski, T. (2018). What is an “Ethnic Group” in Ordinary People’s Eyes? Different Ways of Understanding It among American, British, Mexican, and Polish Respondents. Cross-Cultural Research, 54(1), 28–72. https://doi.org/10.1177/1069397118816939
Purnell, L. D. (2021). The Purnell model and theory for cultural competence. Textbook for Transcultural Health Care: A Population Approach: Cultural Competence Concepts in Nursing Care, 19-59.
Purnell, L. D., Fenkl, E. A., Purnell, L. D., & Fenkl, E. A. (2019). The Purnell model for cultural competence. Handbook for Culturally Competent Care, 7-18.
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