As they perform their duties, healthcare practitioners encounter patients from diverse cultural backgrounds. In order to deliver care that improves patient outcomes, the practitioners need to exhibit sensitivity to and an understanding of the cultures of the different patients. This is the essence of cultural competence. Basically, leveraging cultural competence, practitioners manage to incorporate the beliefs, values and traditions of their patients into the care delivery process. The Purnell model is among the frameworks that the practitioners can adopt in their quest to become more cultural competent. This model identifies the essential components of culture and describes how they relate to one another. After applying the model to my own behaviors, experiences and beliefs, I have determined that I deviate wildly from the culture of my people.
In his theory, Purnell (2012) identified twelve domains that constitute cultural competence. Below, each of these domains is discussed with special focus given to how they relate to my personal experiences.
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Overview/Heritage
Heritage is one of the dimensions of Purnell’s theory. Essentially, it is concerned with one’s origin and the country in which they currently reside (Purnell, 2012). This domain also entails the factors that caused one to move to a new country. I am a second generation American of Italian descent. My grandparents moved to the US in the hope of experiencing the opportunities that the US promised. I share their love for the US and the vision of a better future.
Communication
Communication is indeed a critical aspect of cultural competence. This skill enables practitioners to engage with patients in a manner that allows them to understand and respond to the patients’ needs (Deland, Gordon & Kelly, 2015). Purnell recognized the importance of communication as he included it in his model. As noted earlier, there are stark differences between my behaviors and experiences, and my Italian heritage. These differences can be seen in my primary language, my communication with healthcare providers and my interactions with others. I regard English as my primary language as my command of the Italian language is rather limited. I conduct most of my communication in English.
Family Roles and Organization
Among the crucial aspects of culture that practitioners should consider in their dealings with patients are family roles and organization. For example, they should consider such issues as how decisions are made and the assignment of duties (Purnell, 2012). I understand that the Italian culture is rather patriarchal with male members of the family making most major decisions. This is largely the case in my family where my father is consulted before any important decision is made. However, I feel that we need to move away from this approach. Personally, I disregard one’s gender in decision making and instead focus on the merits of the decision.
Workforce Issues
Workforce issues are another aspect of Purnell’s model. Essentially, these issues include such factors as assimilation, gender roles, individualism and autonomy. Through my interactions with my parents and grandparents, I have gathered that the Italian culture places emphasis on collectivism as opposed to individualism. While individuals are allowed autonomy, they are encouraged to join forces with others. Other workforce issues that Purnell explored include time management and the impact that language has on job performance. In most cases, I report to my job on time and since English is my primary language, I have not encountered serious language barriers.
Bicultural Ecology
Purnell felt that it was important to include bicultural ecology. Basically, this is concerned with such issues as disability and the genetic factors that shape human health (Purnell, 2012). I consulted my parents regarding the role that my genetic composition plays in my health. They assured me that I have no known genetic predisposition to any serious illness. While I was relieved, their response prompted me to reflect on how race shapes human health. In the US, there are some races that face a greater risk of poor health outcomes. These races should be the focus on health interventions.
High-Risk Behaviors
High-risk behaviors threaten health and wellbeing. Purnell must have been driven by the need to challenge practitioners to recognize the link between these behaviors and health. I was unable to identify any particular high-risk behaviors that are rooted in my Italian heritage. Furthermore, after a deep reflection, I determined that I do not engage in any high risk behaviors. For instance, I do not smoke or use any drugs. Furthermore, I engage in physical exercise that mostly takes the form of brisk walks and swimming. Physical exercise has been shown to help protect individuals against such health issues as obesity and heart disease. It is vital for practitioners to understand the high-risk behaviors so that they are able to tackle them, thereby promoting positive outcomes.
Nutrition
Nutrition combines with healthy lifestyles to produce positive health outcomes. In his model, Purnell noted that the foods that individuals consume are rooted in their culture and play a vital role in influencing their health. I have confirmed that in the Italian culture, food carries cultural significance. For example, there are particular foods that are consumed on special occasions and ill individuals are provided with foods such as soups that help to restore their strength and reignite their appetite. In our household, we usually cook food using conventional tools and methods. I understand that our techniques are in violation of Italian tradition where elaborate procedures are followed in the preparation of food.
Pregnancy and Child-bearing
Pregnancy and child-bearing are other important issues that Purnell felt were important elements of culture. According to Purnell, practitioners should be familiar with the cultural practices aimed at boosting fertility, the perspectives on birth control and taboos. Since I am second generation Italian American, I am not intimately familiar with the Italian cultural perspectives and guidelines that govern pregnancy and child-bearing. However, I understand that the Catholic faith plays a vital role and that the family is deeply involved in the pregnancy and child-bearing processes. I find that my own beliefs are inconsistent with Italian tradition. For example, personally, I feel that pregnancy and child-bearing are issues that should be left to healthcare practitioners who possess the competencies and knowledge required. Furthermore, my family does not engage in any special occasions during pregnancy. We do not follow such practices as keeping the placenta or cutting the umbilical cord in any special way. However, we hold celebrations to mark the arrival of a new member.
Death Rituals
Death rituals are part of virtually all cultures. Most communities have established traditions and rituals that are performed following the death of a member. The Italian culture has adopted rituals that define how the community perceives death. Furthermore, burials and funerals are conducted in lie with established procedure. Personally, I regard death as the end of earthly existence and believe that it facilitates transition to the next world. I also feel that the Italian rituals are important as they allow us to maintain connections with the dead. I have observed that women from my culture tend to be unrestrained when they grieve. They weep openly. On the other hand, men tend to contain their emotions and stay clear of theatrical displays of grief.
Spirituality
As noted earlier, the Catholic faith is a powerful force within the Italian culture. Such researchers as Romeo, Gallo and Tagarelli (2015) have determined that religion influences nearly all elements of Italian life. For example, according to these researchers, religion influences the remedies that the Italian people adopt when ill. I agree that religion serves an important function in shaping health practices. I am a Christian who recognizes the power of prayer and I seek the help of medical practitioners. Moreover, as part of my efforts to stay healthy, I meditate and turn to my faith for strength.
Health Care Practices
Health care practices are yet another component of Purnell’s cultural competence model. Preventive measures, the use of alternative and complementary medicine and blood transfusion are among the practices that Purnell addressed (Purnell, 2012). I have determined that the Italian culture places traditional beliefs and approaches above conventional medicine. For example, alternative medicine is highly valued and blood transfusion is viewed with suspicion. My own views deviate from these beliefs. Personally, I think that alternative and complementary medicine are ineffective and undermine conventional approaches. I also believe that blood transfusions are vital to saving lives. Furthermore, I feel that chronic diseases do not have any connections to the spirit world and are simply the result of failure to embrace effective and safe conventional approaches.
Health Care Practitioner
The last component of Purnell’s model is health care practitioner. Essentially, this component is concerned with the use of the services provided by health care practitioners and the attitudes that individuals hold regarding conventional and traditional medicine. When communities are from cultures that discourage the use of conventional approaches, practitioners encounter difficulties in delivering care to these communities. This is why I feel that it is vital to persuade communities to abandon practices and beliefs that are inconsistent with conventional medicine. I am able to readily access the services of health care providers.
In closing, human health is complex given that there are various factors that interact to shape it. Culture is among the factors that are understood to have a tremendous impact on human health. Through his model of cultural competence, Purnell acknowledged the association between culture and health. He outlined 12 dimensions of culture that practitioners should understand if they are to be effective in providing culturally-sensitive and effective care. By performing this assignment, I have gained deeper insights into how my cultural heritage influence my beliefs and health practices. I have determined that by rejecting some elements of my culture, I have been able to make wise decisions about my health. I would challenge others to ensure that their cultural values and practices do not pose any threat to their wellbeing.
References
Deland, E., Gordon, J. E., & Kelly, R. E. (2015). Let’s talk about improving communication in healthcare. Columbia Medical Review, 1 (1), 23-7.
Purnell, L. D. (2012). Transcultural health care: a culturally competent approach. F.A. Davis.
Romeo, N., Gallo, O., & Tagarelli, G. (2015). From disease to holiness: religious-based health remedies of Italian folk medicine (XIX-XX century). Journal of Ethnobiology and Ethnomedicine. doi: 10.1186/s13002-015-0037-z
