Diversity in Health Care Essay
Grand Canyon University:
Diversity in Health Care Essay
The world is getting smaller with globalization and health care providers are challenged with caring for individuals from many diverse cultures. Health care organizations have recognized the need to have the ability to provide effective care for patients from diverse backgrounds. This care incorporates more than having a translator to communicate with the patient, but a holistic approach to understand the patient’s mind, body, and spirit (Ray, 2016). This compassionate care has become effective in the healing process of the patient. A transcultural methodology will facilitate health organizations in improving quality of care and identifying health disparities among susceptible populations (Ray, 2016). Understanding cultural diversity first begins with self-reflection of one’s own culture and then the willingness to learn about other cultures. Nelson Mandela once said,” that if you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart”. Larry Purnell and Betty Paulanka saw a need for a resource that health care providers can use to incorporate culturally proficient care (Purnell, 2005). Therefore, The Purnell Model for Cultural Competence will be examined and the theory, organizational framework and its relevance to transcultural health care and cardiovascular health care will be explained.
The theory behind The Purnell model was to provide a foundation for learning about cultural diversity, cultural awareness, and cultural sensitivity in a society that pan ethnicity
and multiculturalism is prevalent. The Purnell Model for Cultural Competence was developed when Larry Purnell saw his students fall short in the knowledge and understanding of different cultures. In health care the possibility of coming in contact with people of different ethnicity is a high probability, The Purnell Model gives health care workers a foundation to understand the patient better and deliver holistic, exceptional, and effective care. The theory and model were developed with a multi-science approach which included anthropology, biology, psychology, political science, and nutrition to name a few (Purnell, 2005). Using this tool will help the provider from stereotyping, generalizing, and preconceiving the values of each patient they come in contact with (Purnell, 2005). Working with The Purnell model will in essence make the health care worker a more competent provider, as they come to understand the organizational framework of the model.
What is equally important for the health caregiver is to be able to understand the organizational framework of The Purnell Model for Cultural Competence. Familiarity of the model will make it easier to use as a valuable tool for patient care. The model is a circle divided that has four rims. The outer rim signifies global society, the second rim symbolizes community, the third rim represents family, and the inner rim represents the person. These rims represent the nursing metaparadigm theories that give the care giver a wholistic and global view of their patient. Technology and travel have enabled people around the world to interact closely with different societies. Some global events like war, politics, conflicts have affected people either personally or indirectly. These global events have made people alter their worldview and lifeways (Purnell, 2005). The inside of the circle portrays 12 domains. The domains are concepts that are mandatory in understanding a patient as an individual and how they relate to family or a group. These domains are common conceptions that can relate to all cultures. Overview/heritage pertains to the country of origin and reason for emigration. This domain also looks at education, politics, economic status, and what job they have. The communication domain examines the patient’s primary language, dialect and other concepts that are important when a provider communicates with the patient. Some of these concepts are facial expressions, body language, touch, and how they see their worldview past, present, and future. Family roles and organization is a domain that helps the health care worker to understand the patient’s family dynamics and roles of the family or group that they belong to. This domain takes into consideration that there is variance and diversity of to what everyone believes is a family. Another domain is workforce issues. This domain examines the gender roles, the independence, and the integration into another culture. Also, this domain investigates health care practices that the patient identifies with from their country of origin (Purnell, 2005). Bicultural ecology deals with ethnic issues that can cause health problems. This takes into consideration that difference races can have different medical needs because of their genetic disposition. High risk behaviors deal with the addictions and sexual practices of the individual. The nutrition domain investigates the diet and availability of adequate food sources for the patient. This domain takes into consideration if the patient abstains from certain foods for religious or health purposes. Pregnancy and childbearing relate to the how the patient views their pregnancy, birth, and postpartum care. This domain examines any cultural behaviors that can be dangerous for the fetus. It also researches what birth control and practices that are acceptable with the patient. Death rituals is the domain that explores what a person believes about death, burial, and bereavement. Spirituality examines the religious practice of that person. Health care practices takes into consideration how the person views health, mental health, prevention of illness, and how the patient will participate in their health care. Finally, the 12th domain is the health practitioner. The provider’s gender, practices, and status are all considered for the best of the patient. The center of the model is empty and represents what we do not know about culture. The sawtooth line depicts how competent we are about the culture of the patient we are investigating. There are four different possibilities. The first one, unconsciously competent, pertains to the fact that a provider can be unaware and lack any understanding about a culture. Consciously incompetent relates to the truth that some people have no awareness of other cultures. Consciously competent is when a provider understands the culture and obtains information from the patient to verify practices. The fourth concept is to be unconsciously competent, and this is when you provide culturally accepted care for the patient that meets their needs no matter how diverse their culture is.
Using the Purnell model one can investigate and understand their patient better and enable the provider to diagnose and treat various heart related syndromes that occur in various cultures. Depending on ethnicity some groups can be predisposed to heart disease. Using the Purnell model one can identify if a patient is prone to diabetes 1 or 2. This could be because of race, social economic status, addictive behaviors and many other variants. African-American women have higher rates of high blood pressure, diabetes, and high cholesterol then other races. African-Americans can have high blood pressure at a young age which causes the arteries to dilate. This makes them susceptible to have coronary events at a young age (Kamble & Boyd).
Brugada syndrome is a repolarization syndrome that has caused young people to die in their sleep. This problem can be genetic and is prevalent in Southeast Asia. Marfan syndrome is a condition the causes abnormal growth in a person and affects the connective tissue in the body and ultimately cause mitral valve issues. This can be hereditary, so it is important to know the family background of a person. Utilizing the Purnell model will allow a provider to understand a patient better and meet the persons needs and make them comfortable in the procedural environment. Ultimately, it will enable the technologist to help the cardiologist with the procedures just by the shear knowledge of the different conditions that each culture could be susceptible to. Contributing to the procedure about cultural knowledge would make the radiologic technologist more than a person who hands equipment off, wipes interventional wires, and shutters and panes the x-ray table.
All in all, cultural diversity is here to stay. In health care we will come across patients that are from different cultures and mixed cultures. With this in mind, it is important to have resources and tools available at the facility one works that will enable the healthcare professional to deliver holistic care to all people. The Purnell Model of Cultural Competency should be a part of any health care persons toolkit. Below is an image of the Purnell Model.
Kamble S, & Boyd AS. (2008). Health disparities and social determinants of health among African-American women undergoing percutaneous coronary interventions (PCI). Journal of Cultural Diversity, 15(3), 132–142. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105563814&site=eds-live&scope=site
Purnell L. (2005). The Purnell Model for Cultural Competence. Journal of Multicultural Nursing & Health (JMCNH), 11(2), 7–15. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106515040&site=eds-live&scope=site
Ray, M. A. (2016). Transcultural Care Dynamics in Nursing and Health Care (2nd ed.). Philadelphia: F. A. Davis Company.