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Chapter 2 Nursing Discussion
Chapter 2 Nursing Discussion
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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
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
*
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.
*
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
*
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
*
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