The Purnell Model: A Framework for Cultural Competence in Healthcare

This paper explores the Purnell model of cultural competence and its significance within the setting of health care services. It outlines the twelve Purnell model’s domains and assesses how each domain performs a critical part whenever utilized by the health care providers in serving the patients from various cultural backgrounds.

Running head: THE PURNELS MODEL 1
The Purnell Model
Student’s Name
Institutional Affiliation

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Cultural competency has become a necessary component in healthcare provision because
of the trending health care diversity and multiculturalism. Provision of intergrated and more
individuals’ services of healthcare according to values and practices of the patients’ the culture
has become the building block of health care services and practices. Various models have been
used to provide cultural consistent care. This paper explores the Purnell model of cultural
competence and its significance within the setting of health care services. It outlines the twelve
Purnell model’s domains and assesses how each domain performs a critical part whenever
utilized by the health care providers in serving the patients from various cultural backgrounds.
The organizational framework and theory of the model was developed by Larry Purnell
while he was teaching the students regarding cultural difference. The model included the circles
with the twelve concepts that have impact on a culture. The circles’ inner room is a
representation of the person, preceded by the circle standing for the development of the family,
organizational theories, communication and other related disciplines such as ecology, nutrition
and religion (Purnell & Fenkl, 2019). The model is relevant because it enables meeting of the
needs of a society that is intercultural, health care in the new dispensational stresses, working
together as a team in provision of the cultural sensitive and competent care in improving the
outcomes of the clients or patients. Also, according to Purnell (2019), the Purnell model could be
used by all the disciplines in the health care in all practice settings
Constantinou et al. (2018) observes that developing cultural concepts requires that the
health care providers get competent through the four major ways. There’s a need to originally
develop competence before one can become a cultural competent heath car provider. The central
components of culture include affiliation on religion, age, color and nationality. The
characteristics that are regarded as secondary include “political and marital status,” and

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characteristics of the physical outlook among others (Constantinou et al., 2018). The inner circles
consist of twelve pieces shaped blocks that are representation of domains of a culture and their
concepts with each one having an interrelationship with another. The core of the model only gets
the meaning when there are known facts regarding ethnic groups.
The following are the twelve domains and their significance in health care diversity. One
of the domains include an overview or heritage. These involves concepts associated to county of
origin, the residence, the topographical effects of the country, the existing economic status, status
of educational and occupation. The other domain is communication. This one majorly involves
concepts that have a direct relationship with the language and the dialect including paralanguage,
tone, volume and intonation and the desire and willingness to share the thoughts. Also, the
nonverbal cues like use of eyes or the eye contact, facial expressions, touch are among other
forms of communication that are necessary in provision of health. The other one is family roles
and organisations. This involve all concepts that are related to gender and household roles,
family, children and adolescents’ developmental of tasks. The social status and alternative
lifestyles like the single parental and the sexual orientation are also among other factors. The
other domain is workforce issues. It includes concepts on autonomy, assimilating ethnic styles of
communication and practices in health care from the original country. Bicultural ecology is
another domain and it includes ethnic and racial origin variations like skin coloration and the
physical differences in body. For instance, one can know how the body metabolizes drugs. The
other domain is high risk practices or behaviors like alcohol and tobacco use, indulging in sexual
malpractices. The other domains include nutrition, pregnancy and child bearing, death rituals,
spirituality, health care practices and health care practitioner.

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One of the ways by which the model can be applied especially when working with
various cultures is through physiology, sociology, social work, nursing and in general medical
practice. Employing this model ensures that the healthcare provider gives a highly culturally
competent care to the patients. This enables accommodating every patient/client the way they are
regardless of their cultural background.

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References
Constantinou, C. S., Papageorgiou, A., Samoutis, G., & McCrorie, P. (2018). Acquire, apply, and
activate knowledge: A pyramid model for teaching and integrating cultural competence
in medical curricula. Patient education and counseling, 101(6), 1147-1151.
Purnell, L. (2019). Update: The Purnell Theory and Model for Culturally Competent Health
Care. Journal of Transcultural Nursing, 30(2), 98-105.
Purnell, L. D., & Fenkl, E. A. (2019). The Purnell Model for Cultural Competence. In Handbook
for Culturally Competent Care (pp. 7-18). Springer, Cham.