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The Purnell Model and Its Framework

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Concepts related to the dominant language and dialects; contextual use of the language; paralanguage variations such as voice volume, tone, and intonations; and the willingness to share thoughts and feelings

Nonverbal communications such as the use of eye contact, facial expressions, touch, body language, spatial distancing practices, and acceptable greetings; temporality in terms of past, present, or future worldview orientation; clock versus social time; and the use of names are important concepts.

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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.

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The demographics of the American population are increasingly changing due to a growth in the proportion of persons collectively termed as ethnic minority. It is expected that by the year 2020, 35% of the American population will consist of ethnic minorities (Barrow, 2010). This increase in diversity is expected in the background of long-standing variations in the health status of persons from culturally diverse backgrounds (Barrow, 2010). These variations have been attributed to lack of cultural competence amongst healthcare professionals. Consequently, acquisition of cultural competence for health workers had been prioritized. A number of models for guiding cultural competency amongst multidisciplinary healthcare team members across a variety of settings have been proposed. Purnell’s model of cultural competence is one such model: it helps health professionals understand the concept of cultural competence and provides a process for achievement of this competence (Rose, 2013, p. 54). Purnell’s model of cultural competence consists of a schematic combined with an organizing framework. It was first developed in 1991 as a clinical assessment tool. In 1992, the schematic, metaparadigm concepts, and scale for cultural competence were added

The model was conceptualized from multiple theories, a research base garnered from administrative, communication, family development and organizational theories as well as discipline knowledge in anthropology, nutrition, pharmacology, physiology, anatomy amongst others (Purnell, 2002).

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Briefly, cultural general knowledge and skills ensures that providers have a process for "becoming" cuituraily competent. Healthcare professionals and healthcare organizations are avidly addressing multicultural diversity and racial and ethnic disparities in health

Almost every health journal now has articles addressing "cultural competence."

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Purnell, L. (2002). The Purnell model for cultural competence. Journal of Transcultural Nursing, 13(3), 193-196.

Purnell, L. (2005). The Purnell model for cultural competence. The Journal of Multicultural Nursing and Health, 11(2), 7-17.

Rose, P. R. (2013). Cultural competency for the health professional. Burlington, MA: Jones & Barlett learning.

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