Larry Purnell

The Purnell Model for Cultural Competence.

This article provides an overview of the Purnell Model for Cultural Competence and the assumptions on which the model is based. The 12 domains comprising the organizing framework are briefly described along with the primary and secondary characteristics of culture, which determine variations in values, beliefs, and practices of an individual’s cultural heritage. All health care providers in any practice setting can use the model, which makes it especially desirable in today’s team-oriented health care environment. The model has been used by nurses, physicians, and physical and occupational therapists in practice, education, administration, and research in Australia, Belgium, Canada, Central America, Great Britain, Korea, South America, and Sweden. The model has also been translated into Flemish, French, Korean, and Spanish. Although the model is only 4 years old, it shows promise for becoming a major contribution to transcultural nursing and health care.

American Academy of Nursing Expert Panel Report Developing Cultural Competence to Eliminate Health Disparities in Ethnic Minorities and Other Vulnerable Populations

The members of the Expert Panel on Cultural Competence of the American Academy of Nursing (AAN) envisioned this article to serve as a catalyst to action by the Academy to take the lead in ensuring that measurable outcomes be achieved that reduce or eliminate health disparities commonly found among racial, ethnic, uninsured, underserved, and underrepresented populations residing throughout the United States. The purposes of this article are to (a) assess current issues related to closing the gap in health disparities and achieving cultural competence, (b) discuss a beginning plan of action from the Expert Panel on Cultural Competence for future endeavors and continued work in these areas beyond the 2002 annual conference on Closing the Gap in Health Disparities, and (c) provide clearly delineated recommendations to assist the Academy to plan strategies and to step forward in taking the lead in reshaping health care policies to eliminate health care and health disparities.

Standards of Practice for Culturally Competent Nursing Care 2011 Update

University of California, San Francisco, San Francisco, CA, USA Pierce and Associates Nursing Consultants, Knoxville, TN, USA Georgia Health Sciences University, Augusta, GA, USA University of Medicine and Dentistry of New Jersey, Newark, NJ, USA Brigham Young University, Provo, UT, USA California State University, Northridge, CA, USA Vanderbilt University, Nashville, TN, USA University of Toledo, Toledo, OH, USA University of St. Francis, Joliet, IL, USA University of Delaware, Newark, DE, USA

A Description of the Purnell Model for Cultural Competence

To meet the needs of a multicultural society, health care in the new millennium stresses teamwork in providing culturally sensitive and competent care to improve client outcomes. Publications addressing the future predict an increasingly diverse workforce. Accordingly, care providers can benefit from a conceptual model of cultural competence that can be used by all health disciplines in all practice settings. The Purnell Model for Cultural Competence, developed in 1995, is applicable to all health care providers. This article (a) describes the development of the model; (b) provides a description of the model; (c) lists the major assumptions on which the model is based; (d) describes the model’s use in practice, education, administration, and research across disciplines; and (e) includes a brief evaluation of the model. Important cultural domains missing from other transcultural and cross-cultural models, which are found in the Purnell Model, are biocultural ecology and workforce issues.

Guatemalans’ Practices for Health Promotion and the Meaning of Respect Afforded them by Health Care Providers

This descriptive study, the second part of a multinational study of Central Americans and Mexicans, describes Guatemalans’ practices for health promotion and wellness, disease and illness prevention, and the meaning of respect afforded them by health care providers. Understanding a person’s beliefs and values when planning nursing and health care interventions helps the caregiver provide culturally acceptable care that improves clients’ satisfaction and health status. Culturally respectful, acceptable, and appropriate care conserves the utilization of human, material, and financial resources. There were 25 participants in this sample. This study uses selected primary and secondary characteristics of culture and selected domains from the Purnell model for cultural competence as guides for questionnaire development, review of the literature, data analysis, and discussion of the findings.

A Guide to Developing a Culturally Competent Organization

The journey to organizational cultural competence for a health care organization, educational setting, freestanding clinic, or long-term-care organization is a process that requires the collaborative efforts from people at all levels in every department as well as external consumers such as public policy officials, students, and community leaders. Broadly speaking, four main but overlapping areas must be considered in institute activities and strategies to accomplish a comprehensive culturally competent organization. These four areas are (a) administration and governance, (b) orientation and education, (c) language, and (d) staff competencies. This article presents key content areas and activities to consider on the journey to cultural competence. Tables with suggested departmental responsibilities for implementation are included. In some cases, the journey may best be facilitated by a consultant who is well versed in cultural competence and organizational dynamics.

Chapter 3: Theoretical Basis for Transcultural Care

Margaret Andrews, PhD, RN, CTN, FAAN1 Jeffrey R. Backstrand, PhD2 Joyceen S. Boyle, PhD, RN, CTN, FAAN3 Josepha Campinha-Bacote, PhD, MAR, PMHCNS-BC, CTN-A, FAAN4 Ruth E. Davidhizar, DNSc, RN, APRN, BC, FAAN (deceased)5 Dawn Doutrich, PhD, RN, CNS6 Mercedes Echevarria, DNP, APN7 Joyce Newman Giger, EdD, APRN, BC, FAAN8 Jody Glittenberg, PhD, RN, FAAN, TNS9 Carol Holtz, PhD, RN10 Marianne R. Jeffreys, EdD, RN11 Janet R. Katz, PhD, RN12 Marilyn R. McFarland, PhD, RN, FNP-BC, CTN-A13 Gloria J. McNeal, PhD, MSN, ACNS-BC, FAAN14 Dula F. Pacquiao, EdD, RN, CTN15 Irena Papadopoulos, PhD, MA, RN, RM, FHEA16 Larry Purnell, PhD, RN, FAAN17 Marilyn A. Ray, PhD, MA, RN, CTN-A18 Mary C. Sobralske, PhD, RN, CTN19 Rachel Spector, PhD, RN, CTN-A, FAAN20 Marian K. Yoder, EdD, RN21 Rick Zoucha, PhD, PMHCNS-BC, CTN22

Are We Really Measuring Cultural Competence

One of the major goals of culturally competent nursing and healthcare practice is to decrease health and healthcare disparities. All healthcare professionals need similar information for cultural competence. However, to date, most of the tools measure knowledge, skills and abilities but not true competence from a clinical practice setting. Several tools measure and/or evaluate the organization’s cultural diversity mission but not the providers of healthcare.

Cultural aspects of alcohol use (Part 1)

This is the first of a two‐part article on cultural aspects of alcohol use and includes information on alcohol consumption among Koreans, British, Americans, Jews, Italians, Irish and Hispanics. Drinking practices and customs, like all other lifeways, are culture bound, multi‐faceted, and learned behaviour. People from all ethno‐cultural groups use alcohol in some form, even in those societies where drinking is highly stigmatised or tabooed. Behavioural problems with alcohol misuse are as important as the physiological and psychological variants. There is remarkably little correspondence between the amount of alcohol consumption and behavioural problems encountered when cross‐cultural comparisons of drinking are examined. Learning about cross‐culture comparisons of alcohol use and misuse can have the potential to promote more responsible and sensible drinking behaviour.

Standards of practice for culturally competent nursing care: 2011 Update

The purpose of this document is to initiate a discussion of a set of universally applicable standards of practice for culturally competent care that nurses around the globe may use to guide clinical practice, research, education, and administration. The recipient of the nursing care described in these standards is assumed to be an individual, a family, a community, or a population. These standards are based on a framework of social justice (Rawls, 1971), that is, the belief that every individual and group is entitled to fair and equal rights and participation in social, educational, economic, and, specifically in this context, health care opportunities. Culturally competent care is informed by the principles of social justice and human rights regardless of social context. Through the application of the principles of social justice and the provision of culturally competent care, inequalities in health outcomes may be reduced.