Cultural

Competence Model
by Larry. D. Purnell

Presenters:

Larry Magwegwe 17570 Grp 23;

Tatenda Masuku 17572 Grp 23; Nomatemba Ndlovu

17581 Grp 22,

Tatenda Musokeri 17574 Grp 23

Vongai Taziveyi 17575 Grp 23

Introduction The "Purnell Model for Cultural Competence" was developed by Larry D.
Purnell as an outline to classify and arrange elements that have an effect on
the culture of an individual.

 Cultural competence has been described as a process, which is constantly

occurring and through which one slowly advances from lacking knowledge to
developing it.

 An individual begins as unconsciously unskilled due to their absence of

personal knowledge that they are lacking awareness about other cultures.

 Next, an individual becomes aware of their incompetence due to their

acknowledgement that they have insufficient comprehension of other cultures.

 Individuals then become deliberately competent (through learning about

others’ cultures) so that they are able to apply personalized interventions.

 Finally, individuals gradually become oblivious to their competence due to

their ability to instinctively provide patients with culturally competent care.
  Provide a framework for all healthcare providers to learn concepts and characteristics of

culture;

Objectives of  Define circumstances that affect a person's cultural worldview in the context  of historical

perspectives;

Cultural  Provide a model that links the most central relationships of culture;

Competence  Interrelate characteristics of culture to promote congruence and to facilitate  the delivery of

consciously sensitive and competent health care;

 Provide a framework that reflects human characteristics such as motivation,  intentionality,

and meaning;

 Provide a structure for analyzing cultural data;

 View the individual, family, or group within their unique ethnocultural  environment.
Ethnographic
Model
Illustration
Model Features Centre of mode

 The black circle featured in the center of the diagram

remains vacant to symbolize that which is still
unknown.

Pointed line

 The line that is present under the circular figure is

representative of the progressions and lapses, which
occur to cultural proficiency, that are dependent on
situations and occurrences that individuals are
confronted with.
Metaparadigm ideas  The outer circles of the model are
(outer circles) interconnected metaparadigm ideas that relate to
nursing, and are involved within the process of
providing an individual with care. 

 The outermost (first) circle is used to represent the

global society, the second circle represents the
concept of community, the third of family, and the
innermost (fourth) circle illustrates
the individual person.
Global Society  Global society relates to observing the world as an
interconnected whole that consists of a range of individuals
from various cultural and ethnic backgrounds. Concepts
that are present and influence this unified world include
globalization forces and the rapid growth of communication
technologies that impact upon how the global society is
maintained. It is critical to consider a person's place within
the diverse world community as influencing forces on the
global society can impact not only the civilization, but also
an individual's world outlook.
Community  Community is included in the model, as
a metaparadigm, as in the provision of culturally
competent care; an individual's situation within a
community must be addressed.

 Through considering a patient's sense of

community, care providers acknowledge that
different communities may have divergent values,
ethics and goals.
Family  An individual's relationship with their family is
essential to consider in the deliverance of care.

 This is because each individual may want to

differently consider/explain who constitutes
family, and additionally the degree to which they
want family members to be involved in their care
may fluctuate.
Person  Persons must be considered in the performance
of culturally competent care, as each individual has
their own sense of self, values, beliefs and ideas.

 Due to every person having their own distinct way of

relating to their environment, forming social
relationships and communicating with others in
their community and broader society.

 Individual's beliefs and values may impact upon how

they wish to be treated.
The 12 Domains  The twelve inner pieces of the model are cultural
(inner circle) domains that are composed of concepts that should
be focused upon when evaluating patients.

 Each of the twelve domains should not be viewed

as separate or diverse entities, instead it should
recognized that they can influence and inform each
other and hence should be viewed as unified parts
of a whole.
Overview/Heritage

 This domain refers to concepts such as one's origin that are

vital in the aptitude of an individual in understanding both
themselves and their patients.

Communication

This construct relates to the interactions an individual has been

exposed to throughout their life and socialization process,
for example with family, peers and the wider community. It
also conveys the importance of an individual's ability to
provide verbal cues such as volume/tone and non-verbal
cues such as body language and eye contact
Family Roles & Family roles and organization

Workforce Issues  This domain refers to hierarchies and structures existent

within families that may be dependent on gender or
age, which have the ability to influence not only family
interactions but also the way in which an individual both
communicates and acts.

Workforce issues

 Workforce issues denotes the way in which aspects present

within a workplace such as language barriers, may have an
effect on an individual and their sense of being and
belonging.
Biocultural Ecology Biocultural ecology

& High Risk  The concept of biocultural ecology relates to disparities

that exist between the diverse range of racial and cultural
Behaviors groups such as biological variations, which need to be
considered to gain a greater understanding and appreciation
for other cultures.

High-risk behaviors

 High-risk behaviors like consumption of alcohol are vital to

consider as they exist within all cultures but the degrees to
which they are used and subsequent impacts fluctuate.
Nutrition & Nutrition


Pregnancy
Nutrition should be considered due to variations that exist between
different cultures such as food intake and the values of certain foods.

Pregnancy and childbearing

 This concept is important for an individual to understand whilst

providing culturally competent care due to the presence of diverse
cultural beliefs about pregnancy. There are also various practices
and traditions that exist within ethnocultural groups at need to be
respected when providing care.

For Example: Pregnancy custom in China. Burying the placenta. "It was

believed that placing the placenta in a pit in the doorway helped the child
to become healthy, powerful, strong, wise and unafraid of strangers
Death Rituals & Death rituals

Spirituality  This domain is fundamental in the deliverance of culturally

competent healthcare, as the care provider must recognize
patients’ opinions towards death, and their customs towards
occasions such as burial ceremonies.

Spirituality

 Spirituality is essential to consider in the acquisition of

knowledge about others’ cultures and their practices, for
example an individual's views and habits of prayer.
Health Care Health care practices

Practices & Health  This domain should be considered in the provision of

culturally competent care, as practices like organ
Care Practitioner transplantation require the comprehension of an
individual's situation and necessity for care as well as
cultural considerations.

Health care practitioner

 This concept should be considered when providing an

individual with care due to there being varying opinions
and views that are existent among cultures, for example in
relation to health care providers.
  Today, each subgroup has the right to be respected for its unique

Conclusion individuality. Most health-related educational programs and service

providers have statements addressing multicultural diversity.
Organizations and individuals who understand their clients' cultural
values, beliefs, and practices are in a better position to be co-
participants with their clients and provide culturally  acceptable care.

 To this end, healthcare providers need both general and specific

cultural knowledge. One cannot possibly know all the diverse world
cultures and their characteristics. Cultural general knowledge and
skills ensures that providers have a process for "becoming" culturally
competent. 

THANK YOU!