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Diversity in Health Care

Diversity in Health Care

The current working environment that nurses operate in is culturally diverse. All healthcare delivery industry has healthcare professionals and patients from diverse social and cultural backgrounds. Nurses must be aware of the patient’s cultural needs since they spend the most time with them. They must understand that individuals come from different cultures, and they must respect this diversity. This paper will discuss the application of culturally sensitive care in healthcare. In addition to this, it will examine the theory and organizational frame of the Purnell model. Finally, it will discuss Purnells’ twelve domains of culture and their application in the culturally diverse healthcare environment.

Culturally Sensitive Care

Culturally sensitive care is patient-centered care. It includes the attitudes and behavior of healthcare professionals, healthcare organization policies, and physical healthcare environment that patients from different cultures identify as respectful to their culture and enable them to feel comfortable and trust healthcare workers (Handtke et al., 2019). This type of care is unique since it considers the views of culturally diverse patients and not those of healthcare professionals.

This type of care considers the patient’s ethnicity, gender, language, socioeconomic status, mental ability, and sexual orientation. All these patient factors are integrated into the delivery of medical services. Cultural sensitivity can be applied in all healthcare environments. Healthcare professionals should offer medical services to patients regardless of ethnicity, literacy, or socioeconomic status.

The Theory and Organizational Structure of the Purnell Model

Larry Punnel developed the first model for cultural sensitivity when teaching his students. He realized a need for cultural competence tools that doctors and nurses can use when providing healthcare services to patients. This model has five circles. The outermost circle represents the global society; the second cycle represents the community; the third represents family; and the innermost circle represents twelve domains that influence Culture (Purnell and Fenkl, 2019).

Developing cultural competence requires healthcare professionals to go through four processes. The processes are being aware, curious, learning, and participating in cultural competence (Alizadeh & Chavan, 2015). For one to be consciously competent, one must be unconsciously incompetent. Purnell’s model can be applied in transcultural care since it acknowledges that the standard concepts of medical care cannot manage different cultures. Healthcare professionals must thus adapt their ways of providing care to the patient’s culture and needs.

Purnell’s 12 Domains of Culture

The 12 models are:

Heritage– This domain relates to the native country, residence, economics, reasons for emigration, occupation, and educational status (Purnell and Fenkl, 2019). In my field, nurses consider the heritage of patients when evaluating patients.

Communication– This domain is related to language and dialects, paralanguage variations, and willingness to share personal information. Other important aspects include non-verbal communication, such as eye contact, body language, and acceptable greetings (Purnell and Fenkl, 2019). Nurses analyze communication features and address language barriers during care by providing translators.

Family roles and organization– This domain is related to gender roles, priorities, family roles, and childbearing practices (Purnell and Fenkl, 2019). Others include social status and alternative lifestyles such as sexual orientation, divorce, and single parenting. Nurses respect childbearing practices and implement care aligned with these practices.

Workforce issues– This domain is related to independence, assimilation, acculturation, and healthcare practices in the native country (Purnell and Fenkl, 2019). Nurses consider the healthcare practices the patients had in their native country when implementing care.

Bicultural ecology– Includes racial variations such as skin color, body stature, heredity, and differences in the metabolization of medications (Purnell and Fenkl, 2019). Physicians consider genetic differences in the metabolization of medications when prescribing drugs.

High-risk behaviors – include tobacco use, alcohol and other recreational drugs, sedentary lifestyles, and high-risk sexual activities (Purnell and Fenkl, 2019). Nurses become aware of high-risk behaviors and advise patients on the dangers of high-risk behaviors.

Nutrition– Includes adequate food, food choices, taboos, and rituals, as well as how food is used for health promotion (Purnell and Fenkl, 2019). Nurses determine the impact of nutrition on the health status of the patient.

Pregnancy and childrearing – Include fertility practices, contraceptive methods, taboos related to pregnancy, and postpartum treatment (Purnell and Fenkl, 2019). Nurses understand patient’s contraception methods or lack of them.

Death rituals– Include how individuals view death, death preparation rituals, burial practices, and bereavement behaviors (Purnell and Fenkl, 2019). Nurses understand how patients grieve.

Spirituality– Includes prayers, religious practices, and sources of strength (Purnell and Fenkl, 2019). Nurses practice holistic care when offering medical services.

Healthcare practices – Include preventive behaviors, traditional practices, biomedical beliefs, responsibility for health, mental health views, self-medication behaviors, barriers to achieving health, and sick roles (Purnell and Fenkl, 2019). Nurses determine obstacles to access and help the patient address them.

Healthcare practitioners– Include status, perceptions of traditional healthcare professionals, and gender of healthcare professionals. Nurses respect the patient’s wish if they want a specific gender.

Application of Purnell’s Model in Healthcare

Healthcare professionals can use Purnells’ model’s organizational framework to learn about culture and how culture affects healthcare services. Healthcare professionals can use this model when assessing patients and implementing interventions. Being knowledgeable helps medical professionals to be culturally competent. They should understand the patient’s worldview to help patients’ beliefs that can impact care. They should also employ active listening and interpret the nonverbal communication that the patients present.


The healthcare environment is culturally diverse, so professionals must be culturally competent. Nurses, in particular, must use Purnell’s model and apply it to become culturally competent when offering nursing care. Nurses must understand that we are all different, so care must be individualized.


Alizadeh, S., & Chavan, M. (2015). Cultural competence dimensions and outcomes: A systematic review of the literature. Health & Social Care in the Community24(6), e117-e130.

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 ONE14(7), e0219971.

Purnell L.D., Fenkl E.A. (2019) The Purnell Model for Cultural Competence. In: Handbook for Culturally Competent Care. Springer, Cham.


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Diversity has a significant influence on health care. Studying transcultural health care helps health professionals understand different cultures to provide holistic and individualized health care. Review the Purnell Model for Cultural Competence, including the theory, framework, and 12 domains. Write a 750-1,000-word paper exploring the Purnell Model for Cultural Competence. Include the following:

Diversity in Health Care

Diversity in Health Care

Explain culturally sensitive care and its application within health care.
Explain the theory and organizational framework of the Purnell Model and discuss its relevance to transcultural health care.
Describe Purnell’s 12 domains of culture, and assess how each of these domains plays an active role in the diversity of health care in your specific field.
Discuss how this model can be applied when working with different cultures to become a more culturally competent healthcare provider.
Cite at least three references, including the course textbook.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the title before beginning the work to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

This benchmark assignment assesses the following programmatic competency:

BS Health Sciences

1.1 Explain culturally sensitive care and its application within health care.

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