Overview/heritage Concepts related to country of origin, current residence, the effects of the topography of the country of origin and current residence, economics, politics, reasons for emigration, educational status, and occupations. Purnell Model For Population Sub Group
Communication 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.
Family roles and organization Concepts related to the head of the household and gender roles; family roles, priorities, and developmental tasks of children and adolescents; child-rearing practices; and roles of the ages and extended family members. Social status and views toward alternative lifestyles such as single parenting, sexual orientation, child-less marriages, and divorce are also included in the domain.
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Workforce issues Concepts related to autonomy, acculturation, assimilation, gender roles, ethnic communication styles, individualism, and health care practices from the country of origin.
Bicultural ecology Includes variations in ethnic and racial origins such as skin coloration and physical differences in body stature; genetic, heredity, endemic, and topographical diseases; and differences in how the body metabolizes drugs.
High-risk behaviors Includes the use of tobacco, alcohol and recreational drugs; lack of physical activity; nonuse of safety measures such as seatbelts and helmets; and high-risk sexual practices.
Nutrition Includes having adequate food; the meaning of food; food choices, rituals, and taboos; and how food and food substances are used during illness and for health promotion and wellness.
Pregnancy and childbearing Includes fertility practices; methods for birth control; views towards pregnancy; and prescriptive, restrictive, and taboo practices related to pregnancy, birthing, and postpartum treatment. Purnell Model For Population Sub Group
Death rituals Includes how the individual and the culture view death, rituals and behaviors to prepare for death, and burial practices. Bereavement behaviors are also included in this domain.
Spirituality Includes religious practices and the use of prayer, behaviors that give meaning to life, and individual sources of strength.
Health care practices Includes the focus of health care such as acute or preventive; traditional, magicoreligious, and biomedical beliefs; individual responsibility for health; self-medication practices; and views towards mental illness, chronicity, and organ donation and transplantation. Barriers to health care and one’s response to pain and the sick role are included in this domain. Purnell Model For Population Sub Group
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Health care practitioner Concepts include the status, use, and perceptions of traditional, magicoreligious, and allopathic biomedical health care providers. In addition, the gender of the health care provider may have significance.
Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency or among professionals and enable that system, agency or those professions to work effectively in cross-cultural situations. Purnell Model For Population Sub Group
PRIMARY AND SECONDARY OF CULTURE
The primary characteristics are nationality, race, color, gender, age, and religious affiliation. Primary characteristics cannot easily be changed. If these characteristics such as religion or gender are changed, a significant stigma may attach to the individual from society.
The secondary characteristics include educational status, socioeconomic status, occupation, military experience, political beliefs, urban versus rural residence, enclave identity, marital status, parental status, physical characteristics, sexual orientation, gender issues, reason for migration (sojourner, immigrant, or undocumented status}, and length of time away from the country of origin.
Purnell, L. (2005). The Purnell Model for Cultural Competence. Journal of Multicultural Nursing &Health, 11(2),7.
Baumeister, R., Smart, L, & Boden, J. (1996). Relation of threatened egoism to violence and aggression: The dark side of self-esteem. Ps\^chological Review, 105, 5-33.
Schneider, D. (1981). Tactical self-presentation: Towards a broader conception. In J. T. Tedecshi (Ed.), Impression management theory and social psychological research (pp. 23-40). NY: Academic Press. Purnell Model For Population Sub Group