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Purnell's Model of Cultural Competence in Dementia Care

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Abstract

This paper examines the application of Purnell's Model of Cultural Competence to the care of elderly dementia patients in a nursing facility. The author focuses on two of Purnell's domains — health care practice and health care practitioner — as frameworks for addressing a rise in combative patient behavior. Drawing on Purnell's (2002) definition of culturally competent care and supplementary guidelines from the Health Resources and Services Administration, the paper argues that cultural sensitivity and awareness alone are insufficient; staff must develop the practical competence to translate that awareness into effective, compassionate palliative care delivery.

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What makes this paper effective

The paper grounds its argument in a specific clinical problem — a spike in combative behavior among dementia patients — which gives the theoretical discussion practical relevance.
It draws a clear, useful distinction between cultural sensitivity/awareness and cultural competence, showing that the latter requires actionable application of knowledge.
The author uses both a foundational nursing model (Purnell, 2002) and an authoritative federal resource (HRSA) to support claims, demonstrating appropriate use of dual sources.

Key academic technique demonstrated

The paper demonstrates applied theoretical analysis: it does not merely describe Purnell's model but maps specific domains (health care practice and health care practitioner) directly onto a real institutional problem. This technique — selecting and justifying the subset of a framework most relevant to a given context — is a valuable skill in nursing and health sciences writing.

Structure breakdown

The paper follows a concise three-part structure: an introduction that identifies the clinical setting and theoretical lens, an analytical body that unpacks the relevant Purnell domains and connects them to the patient population, and a brief conclusion that positions the analysis as a starting methodology rather than a final solution. The honest, measured conclusion reflects good academic restraint.

Introduction

This paper reviews the treatment of patients at a university nursing facility in light of Purnell's Model of Cultural Competence. Given the difficulties that many staff members face in dealing with patients, this and related knowledge would greatly help improve the ability to ease patient suffering and offer competent palliative care. The project idea explored here may need to be tailored to the needs of elderly patients with dementia in light of Purnell's and other models of cultural competence in nursing — particularly the two domains of the Purnell model that deal with health care practice and the health care practitioner.

According to Purnell, "A culturally competent health care provider develops an awareness of his or her existence, sensations, thoughts, and environment without letting these factors have an undue effect on those for whom care is provided" (Purnell, 2002, p. 193).

Applying Purnell's Model of Cultural Competence

Cultural competence can be compared to cultural sensitivity and cultural awareness in that it extends beyond both. A good nurse will naturally be sensitive and aware of a patient's needs — that disposition is a baseline expectation of the profession. However, a culturally competent health care provider goes further by knowing how to assess and respond to each of the aspects captured in Purnell's domains that apply to their specific situation.

In the context of this analysis, the most relevant domains are health care practice and health care practitioner. The health care practice domain encompasses the following facets: (1) acute or preventive care, (2) traditional practices, (3) magicoreligious and biomedical beliefs, (4) individual responsibility for health, (5) self-medicating practices, (6) views toward mental illness, chronic conditions, and organ donation and transplantation, and (7) barriers to health care and one's response to pain and the sick role. The health care practitioner domain includes: (1) status, (2) use, (3) perceptions of traditional practitioners, (4) magicoreligious practitioners, (5) allopathic and biomedical health care providers, and (6) gender of the health care provider (Purnell, 2002, pp. 195–196).

The Health Resources and Services Administration (HRSA) has developed its own guidelines for cultural competency among health care providers. One domain specifically relevant to this setting is People with Disabilities. Those with dementia constitute precisely such a population (HRSA, 2012). Applying these guidelines to this patient group would help staff address the increase in unusual occurrence reports centered on combative behavior by recently admitted patients.

Something has clearly shifted in the population's needs. Special emphasis must therefore be placed on identifying and responding to the changing requirements of this group in order to reduce incidents of combative behavior between staff and patients. In such circumstances, being culturally sensitive and aware is not sufficient on its own. Rather, the ability to translate that knowledge into practical action — managing combative behaviors and delivering effective palliative care — is the most critical issue, and it is what allows the nursing mission to be carried out competently.

1 Locked Section · 120 words remaining

Addressing Combative Behavior Through Cultural Competence · 120 words

"Links HRSA guidelines to rising combative incidents"

Conclusion

Purnell, L. (2002). The Purnell Model for Cultural Competence. Journal of Transcultural Nursing, 13(3), 193–196.

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Key Concepts in This Paper

Purnell Model Cultural Competence Dementia Care Palliative Care Health Care Practice Health Care Practitioner Cultural Sensitivity Combative Behavior Transcultural Nursing HRSA Guidelines