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Introduction
It goes without saying that nursing theories and conceptual models currently play an immeasurably essential role in the research and practice of any competent nurse specialist. In general, the nursing theory is a framework that was designed to support evidence-based nursing practice, organize knowledge, and explain specific phenomena in a concrete, well-structured, and appropriate way. In addition, a theory may be regarded as a particular set of definitions, relationships, concepts, and assumptions derived from other disciplines of nursing models. In turn, models represent nursing, the disciplines aims, and different components. They are elaborated for the solution of nursing issues in a certain context or setting.
This presentation is dedicated to the Purnell Model for Cultural Competence and its practical application in order to address the challenge of health care delivery to patients with completely different cultural backgrounds. The models choice for examination was determined by the general significance of cultural competence and person-centered care in any area of advanced practice nursing. The work is divided into three sections at first, the description of the Purnell Model and its relevance. The second part includes the definition of a certain problem related to health care for culturally diverse patients. Finally, the third section contains an explanation of how the practical application of the model may support the evidence-based nursing practice in the context of the defined concern.
Purnell Model for Cultural Competence
The Purnell Model for Cultural Competence is defined as an organizing framework that provides a foundation for nurse professionals understanding of the patients cultural attributes. Due to this model, health care providers have the ability to interpret peoples experiences, visions, incitements, and attitudes to health, health care delivery, and diseases in a correct and adequate way (Albougami, Pounds, & Alotaibi, 2016). In general, cultural competence reflected in the Purnell Model may be currently regarded as one of the most essential nursing concepts due to travel and increased globalization. In the present day, cultural diversity is additionally caused by discrimination, socioeconomic conditions, wars, and political strife in a substantial number of countries across the globe. Competent health care providers who understand the patients cultural beliefs, values, and practices have more chances to interact with them appropriately and provide effective and culturally acceptable care.
Twelve Domains of the Purnell Model
The Purnell Model for Cultural Competence includes twelve main domains elaborated for the evaluation of characteristics and traits of different ethnic groups.
The first domain implies culture and heritage that includes native country, the geographical influence of the original and present home, economics, political affairs, profession, and educational status (Albougami, Pounds, & Alotaibi, 2016, p. 3). The second domain is connected with communication and includes primary language, nonverbal communication, paralinguistic differences, and dialects. The third domain relates to family and its roles and organization in terms of priorities, responsibilities, and lifestyle. The fourth domain refers to workforce issues, acculturation, language barriers, and autonomy. The fifth domain includes bio-cultural ecology and factors that encompass racial and ethnic differences. The sixth domain relates not only to high-risk behaviors (the use of alcohol, tobacco, and recreational drugs) but physical activity and preventative measures as well. The seventh domain implies nutrition, certain nutritional limitations connected with cultural values and beliefs, and eating behaviors. The eighth domain includes pregnancy, the postpartum period, and their perception in various cultures. The ninth domain is connected with death rituals and related religious practices. The tenth domain is religion and the connection of spirituality with health (Albougami, Pounds, & Alotaibi, 2016). The eleventh domain directly relates to health care practices, such as magical religious practices, traditional practices, mental-health practices, and chronic-disease treatment. This domain additionally reflects essential measures for successful health outcomes. The twelfth domain involves the roles and perceptions of health care professionals.
Modern Nursing Concern
One of the most disturbing concerns of contemporary nursing that may be observed worldwide is connected with peoples migration caused by negative conditions in their native countries. Unfortunately, these migrants will inevitably face social isolation and particular issues related to adaptation if their cultural values and beliefs substantially differ from the cultural background of host countries. That is why the specific guidance that helps to adapt and establish contact is highly essential for nurses who provide health care for culturally diverse patients. The cultural competence of nurse practitioners and their actions based on their understanding of the patients cultural peculiarities have a substantive impact on the outcomes of medical treatment (Tucker, Arthur, & Roncoroni, 2015). In addition, the culturally insensitive nursing practice may result in the patients dissatisfaction with provided health care and costly health disparities.
Practical Application
The support of evidence-based nursing practice by the Purnell Model for Cultural Competence may be observed in a specific context. Do u et al. (2016) conducted research that demonstrated the efficiency of the models application to health care delivery. An Afghan patient applied to the hospital with vomiting, nausea, and sharp abdominal pain. According to the result of the examination that had detected peptic ulcer perforation, the man underwent an operation and required intensive care. However, nurse practitioners noticed that the patient avoided communication and eye contact, especially with female health care providers, preferred to keep distance, expressed shyness, and a lack of necessary skills for fulfilling self-care or household care (Do u et al., 2016, p. 46). In this situation, health care specialists decided to apply cultural evaluation in order to develop an individual approach to the patient for his positive health outcome in the future.
Health care providers investigated and evaluated the culture of the Afghan patient on the basis of all twelve domains of the Purnell Model for Cultural Competence. In Afghanistan, religion plays a highly significant role in peoples lives and the countrys regime. Certain strict religious rules determined limitations and substantively affect individual habits and behaviors connected with nutrition, lifestyle, family, and health. For example, women who are traditionally responsible for the majority of the household cannot touch men if they are not their spouses, mothers, or daughters. In health services, people prefer nurse practitioners and physicians of the same sex (Do u et al., 2016). These cultural peculiarities completely explained the patients behavior that was evaluated and understood. Nurse practitioners supported and trusted the patient who determined suitable distance and got an opportunity to receive health care from nurses of the same sex.
Conclusion
To summarize, this presentation illustrates the advantages of the Purnell Models practical application in order to enhance nursing practice when health care providers deal with culturally diverse patients. Twelve domains provide a comprehensive evaluation of the patients background. The combination of observed behaviors and collected data help nurses to form the correct approach that contributes to the patients health outcome.
References
Albougami, A. S., Pounds, K. G., & Alotaibi, J. S. (2016). Comparison of four cultural competence models in transcultural nursing: A discussion paper. International Archives of Nursing and Health Care, 2 (4), 1-5.
Do u, Ö., Co_kun, E. Y., Üzen, ^., & Ulay, G. (2016). Purnell Model for Cultural Competence: Nursing care of an Afghan patient. Journal of Nursing and Health Science, 5 (5), 44-48.
Tucker, C. M., Arthur, T. M., & Roncoroni, J. (2015). Patient-centered, culturally sensitive health care. American Journal of Lifestyle Medicine, 9 (1), 63-77. Web.
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