Cross-Cultural Perspectives – An Interview and Analysis of a Different Cultural Background

Cross-Cultural Perspectives – An Interview and Analysis of a Different Cultural Background

The growing ethnic and cultural diversity in the United States has made the provision of transcultural care a critical nursing competency (Handtke et al., 2019). However, the provision of such care is complicated due to the many challenges to transcultural care, including intrapersonal struggle, conflicts due to cultural differences, culturally diverse perspectives of pain and suffering, and personal- and organizational-level constraints (Shahzad et al., 2021). The Purnell Model for Cultural Competence provides an essential framework for the development of cultural competence and the provision of transcultural care. This paper analyses and discusses the Purnell Model for Cultural Competence, including the model’s 12 domains, as well as the implications of the model for health practices with a focus on understanding Chinese culture and providing culturally competent care to people of Chinese origin in the U.S.

The 12 Domains from the Purnell Model for Cultural Competence

The Purnell Model for Cultural Competence provides 12 domains that are considerably essential for assessing the ethnocultural attributes of an individual or family for the sake of providing culturally competent care (Purnell, 2013). These include an overview, inhabited localities and topography, communication, family roles and organization, workforce issues, biocultural ecology, high-risk behaviors, nutrition, pregnancy and childbearing practices, death rituals, spirituality, healthcare practices, and healthcare providers.

Overview, Inhabited Localities, and Topography

This domain focuses on the aspects of the patient’s or a family’s country or region of origin, the topography of their country of origin, as well as their current residence (Purnell, 2013). It also helps understand the religious beliefs of their region of origin. For instance, for the people of Chinese origin in the U.S., analyzing the country and region of origin can help understand the disease-predisposing factors and the religious beliefs they subscribe to, such as Confucianism, Taoism, and Buddhism. This can help understand the diseases the individual is predisposed to, their reasons for migrating to the current residence, and the challenges they face in accessing the care provided.

Communication

The Purnell Model identifies communication as the most essential aspect of providing quality care. In this case, Purnell (2013) notes that care providers need to focus on communication, including the patient’s dominant language, dialects, and use of nonverbal cues, as it is interrelated with all other domains of culturally competent care. Culturally sensitive communication in nursing settings includes realizing and appreciating one’s own culture, including language and associated biases, ensuring sensitive and open communication, and incorporating strategies to interact and collaborate with the patient and family for optimal patient care regardless of language barriers (Brooks, Manias, et al., 2019). In the case of attending to a Chinese patient or a patient of Asian origin, culturally competent care would focus on the aspects of communication in the patient’s language proficiency and use of nonverbal cues, including bodily and facial expressions.

Family Roles and Organization

The family and organization domain defines how an individual relates with insiders and outsiders (Purnell, 2013). Chinese family dynamics differ a lot from family dynamics from other regions, especially in the U.S. Providing culturally competent care to a patient would include analyzing the family dynamics from the individual’s background, including the roles of individuals within the family, familial ties, and what they mean, and how decisions are made within the family.

Workforce Issues

Workforce issues as a cultural domain focus on identifying an individual’s views on work including teamwork and autonomy, age and generational differences, timeliness and punctuality (Purnell, 2013).

Biocultural Ecology

This cultural domain defines the specific physical, biological, and physiological aspects of the individual including ethnic and racial variations based on origins (Purnell, 2013). For instance, skin color variations, differences in biology, and various biological processes, including metabolism. For a Chinese patient, the nurse must understand skin variations and differences in skin color with a condition. It can also be considered in drug administration by focusing on various drug metabolism among individuals from Asian or Chinese backgrounds.

High-risk Behaviors

The high-risk behaviors cultural domain focuses on the various lifestyles and behaviors that risk the development of various diseases, such as tobacco smoking, alcohol drinking, rates of physical activity, use of recreational drugs, food consumption behaviors, or other risky behaviors that may cause physical harm or infections (Purnell, 2013). The views of the Chinese may vary in degree and type of risk as compared to other ethnocultural groups. However, as a multicultural society such as the U.S. has a significant influence on individual culture and identity (Schlesinger, 2018), it is important for a nurse to understand such influences on the Chinese cultural views on high-risk behaviors.

Nutrition

The cultural domain of nutrition goes beyond access to food to focus on culture related to food, including food rituals, eating habits, cultural foods, deficiencies in foods, and how food is viewed or used for wellness and disease prevention (Purnell, 2013). It is important to evaluate the various food behaviors of Chinese including eating habits, common foods, and how certain foods predispose the Chinese to certain diseases.

Pregnancy and Childbearing Practices

The Purnell Model notes that views on fertility, pregnancy, childbearing, and related practices vary across ethnocultural groups (Purnell, 2013). The essence of delivering culturally competent care to the Chinese, therefore, includes analyzing, identifying, and respecting the Chinese cultural traditions, practices, and rituals related to pregnancy and childbirth regardless of the care provider’s views on the same.

Death Rituals

This domain includes social views, rituals, and other practices related to death, including mourning (Purnell, 2013). Understanding the traditional views on death can facilitate palliative and end-of-life care communication within care settings that aligns with the cultural views of the patient and their family (Brooks, Bloomer, et al., 2019). Notably, as Purnell (2013) notes, as death rituals are the least likely to change over time, the Chinese cultural practices related to death are likely to remain the same regardless of their current region or country of residence.

Spirituality

The Spirituality domain of the Purnell Model defines formal religious beliefs, affiliations, faiths, and practices (Purnell, 2013). A healthcare provider providing care to a patient from a Chinese background must inquire about the patient’s religious views and beliefs, including whether the individual is related to traditional beliefs such as Confucianism, Taoism, and Buddhism.

Health-care Practices and Healthcare Providers

These two domains of the Purnell Model focus on practices in healthcare provision from an ethnocultural perspective, including health-seeking behaviors, responsibility to health, biomedical practices by both individuals and the care providers, and other practices, including organ donation and transplant (Purnell, 2013). From a Chinese perspective based on the Purnell Model, both domains focus on assessing health attitudes, behaviors, and practices, including the use of Chinese traditional medicine and socioeconomic factors that include access to healthcare.

Implications for Health Practices

Purnell Model for Cultural Competence provides a critical framework for education, health administration, clinical practice, and research (Purnell, 2013). Based on its 12 domains, it guides the delivery of culturally competent healthcare for culturally diverse communities. Given the diversity in the U.S., the Purnell Model has significant implications for healthcare practice. For instance, it helps tailor care to the culture of the patient including providing care that is sensitive to the specific cultural views of the individual. For instance, providing care to a patient from a Chinese background based on the Purnell Model can help deliver nursing care that is sensitive to Chinese cultural values, beliefs, practices, and views on medicine and life.

It can also guide communication during care, including culturally sensitive communication in matters of death and communication at the end of life (Brooks, Bloomer, et al., 2019). Culturally sensitive communication also considers the various non-verbal cues to use during the delivery of care in multicultural settings including cues to show and express kindness and empathy contextually (Singh Sarla, 2020). It can also help understand the various communication strategies including the use of interpreters to overcome communication barriers to ensure effective therapeutic communication (Kwame & Petrucka, 2021).

The Purnell Model, as it focuses on an individual and their family background, can improve practice by guiding the delivery of patient- and family-centered care. Additionally, in the context of Chinese culture, the Purnell Model can help integrate Western medicine with Chinese traditional medicine, helping provide the patient with a number of care options.

Conclusion

The Purnell Model provides a framework for comprehensive assessment of a patient’s cultural background and their cultural perspectives on aspects of healthcare including medicines, health and disease, pain and suffering, biology, and health practices. Such understanding of the individual can help deliver culturally competent care, leading to the delivery of more accessible, equitable, and quality care with better and enhanced patient and health outcomes.

References

Brooks, L. A., Bloomer, M. J., & Manias, E. (2019). Culturally sensitive communication at the end-of-life in the intensive care unit: A systematic review. In Australian Critical Care (Vol. 32, Issue 6). https://doi.org/10.1016/j.aucc.2018.07.003

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383–391. https://doi.org/10.1016/J.COLEGN.2018.09.007

Handtke, O., Schilgen, B., & Mösko, M. (2019). Culturally competent healthcare – A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PLoS ONE, 14(7). https://doi.org/10.1371/JOURNAL.PONE.0219971

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20(1), 1–10. https://doi.org/10.1186/S12912-021-00684-2/FIGURES/1

Purnell, L. D. (2013). Transcultural Health Care: A Culturally Competent Approach (4th ed.). F. A. Davis Company.

Schlesinger, A. M. (2018). The disuniting of America: Reflections on a multicultural society. Color – Class – Identity: The New Politics Of Race, 199–212. https://doi.org/10.4324/9780429501531-19/DISUNITING-AMERICA-REFLECTIONS-MULTICULTURAL-SOCIETY-ARTHUR-SCHLESINGER

Shahzad, S., Ali, N., Younas, A., & Tayaben, J. L. (2021). Challenges and approaches to transcultural care: An integrative review of nurses’ and nursing students’ experiences. In Journal of Professional Nursing (Vol. 37, Issue 6). https://doi.org/10.1016/j.profnurs.2021.10.001

Singh Sarla, G. (2020). Non-verbal Communication: Be Kind with What You Wordlessly Say. Practique Clinique et Investigation, 4(1), 8–11. https://www.researchgate.net/publication/344037351

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

Culturally Competent Nursing
In a Microsoft Word document of 4-5 pages formatted in APA style, you will describe an interview of a person from a cultural background that is different from your own.
Select a person from a cultural group different from your own. You may choose a patient, friend, or work colleague. For the sake of confidentiality, do not reveal the name of the person you interview; use only initials.
In your paper, include the following:

Cross-Cultural Perspectives – An Interview and Analysis of a Different Cultural Background

A complete cultural assessment using the 12 domains from the Purnell Model for Cultural Competence in your textbook, Transcultural Health Care: A Culturally Competent Approach.
A description of implications for health practices.