Culturally Sensitive Care

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Culturally Sensitive Care

Healthcare professionals are trained and committed to providing healthcare services

that meet the specific healthcare needs of an individual or a population. Cultural diversity

presents a new challenge to healthcare providers to provide comprehensive patient-centered

care. According to Purnell and Fenkl (2019), cultural diversities have created health care

disparities that impact healthcare practices and outcomes for a population. Therefore,

providing integrated healthcare that focuses on cultural aspects such as beliefs and values is

important in achieving the goals for comprehensive patient-centered care. Healthcare

professionals must be culturally sensitive to their diverse patients, apply an organized

framework for cultural diversity like the Purnell model, understand the model's components,

and define its relevance to different groups.

Culturally Sensitive Care

People have become culturally diverse, which has changed how healthcare services

are delivered and the achievement of health care goals. Initially, the focus of health care was

addressing physical needs related to an illness. However, with diversity and cultures

influencing health care outcomes, cultural care has become important. As described by

Claeys et al. (2021), culturally sensitive care is the ability of a healthcare professional to be

responsive to the feelings, attitudes, and circumstances of an individual or a group that shares

a distinctive, common racial, religious, national, linguistic or cultural heritage. It is applicable

in practice when such values and beliefs of a patient vary from those of a provider and seek to

ensure that the patient receives the care needed to respect and recognize the patient's cultural

orientation.
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The Purnell Model and Relevance

Providing culturally sensitive care is not a straightforward practice, and a healthcare

provider will need to conduct a cultural assessment to identify key cultural issues and factors

that must be addressed to provide culturally sensitive care. The Purnell Model in one cultural

framework helps one understand the culture of a given group, enabling them to meet their

cultural needs. The model has four rights that provide an overview of the forces that impact

an individual or a population's health outcomes. These rights include the theoretical

framework describing the global society's general socioeconomic, environmental, and

cultural conditions, social and community networks, immediate family, and individual

lifestyle factors (Purnell & Fenkl, 2020). In transcultural care, healthcare professionals must

recognize cultural differences and enforce actions and strategies that address these specific

differences. The model becomes relevant in identifying and understanding these cultural

factors of an individual or a group leading to the delivery of culturally sensitive care.

Purnell's 12 Domains of Culture

Developed by Larry Purnell, the model explores the issue of culture based on 12 key

domains that help shape a culture. The first domain is the overview, topography, and

inhabited localities. According to Purnell and Fenkl (2020), this domain helps explore

cultural information relating to an individual/group's origins and topography, current

residence, politics, education, treason for migration, economics, and occupations.

Communication is the second domain that interrelates with all other domains and relates to

verbal language, dialects, nonverbal communication, and all other communication cues.

Family roles and organization relate to a family's organization in terms of gender roles,

priorities, child-rearing practices, family roles, social status, and authority (Purnell & Fenkl,

2019). Workforce issues are associated with acculturation, autonomy, gender roles, health

practices, assimilation, and individualism. Purnell and Fenkl (2020) describe biocultural
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ecology as the variations in racial and ethnic origins and physical differences like topographic

diseases, genetics, stature, endemic, and heredity, while high-risk behaviors are the practices

of a group that increases its risk of adverse health outcomes including tobacco and alcohol

use, physical inactivity, and risky sexual practices.

Nutrition is another domain that explores a culture's eating habits, including the food

choices, the meaning of food, taboos, rituals, and food substances to promote health. The

eight domains, pregnancy and childbearing define the district cultural practices related to

fertility, contraception, postpartum treatment, birthing, and pregnancy (Purnell & Fenkl,

2020). Death rituals are also essential and include how death is viewed, the rituals and

behaviors for preparation, and the burial practices. One of the most significant domains in

practice is spirituality which focuses on a culture's religious practices that impact their coping

abilities. Health care practices and professionals are the last domains, including perceptions

about health, practices, and views towards certain health issues and their level of use of

traditional and biomedical care services.

Application

The Purnell model provides healthcare professionals with a framework for exploring

the different cultural aspects of a community or a society, leading to understanding specific

cultural differences that drive their behaviors and actions. For instance, Yalçın Gürsoy, and

Tanrıverdi (2020), demonstrate how this model can be used to develop a questionnaire to

explore and understand violence against older adults. The model can also be applied to

understand the relationship between modifiable risk factors such as physical inactivity, poor

dietary practices, tobacco smoking, alcohol consumption, and risky sexual behaviors to health

issues like diabetes, hypertension, lung cancer, and sexually transmitted infections.
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Conclusion

Providing culturally sensitive care is a complex process. However, identifying and

adapting a cultural framework like the Purnell model helps providers identify key cultural

domains that impact the population's behaviors, actions, and practices. Through this

understanding, they can provide culturally sensitive care to their patients.

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References

Claeys, A., Berdai-Chaouni, S., Tricas-Sauras, S., & De Donder, L. (2021). Culturally

sensitive care: Definitions, perceptions, and practices of health care professionals.

Journal of Transcultural Nursing, 32(5), 484-492.

https://doi.org/10.1177%2F1043659620970625

Purnell, L. D., & Fenkl, E. A. (2019). Transcultural diversity and health care. In Handbook

for culturally competent care (pp. 1-6). Springer, Cham. https://doi.org/10.1007/978-

3-030-21946-8_1

Purnell, L. D., & Fenkl, E. A. (Eds.). (2020). Textbook for transcultural health care: A

population approach: Cultural competence concepts in nursing care. Springer

Nature.

Yalçın Gürsoy, M., & Tanrıverdi, G. (2020). Evaluation of Violence Against Elderly People

of Different Cultures by Using The "Purnell Model for Cultural Competence."

Florence Nightingale journal of nursing, 28(1), 83–96.

https://doi.org/10.5152/FNJN.2020.18088