For the purpose of a unified definition in using the book “Guide To Culturally Competent Health Care,” culture is being defined by Purnell as referring to beliefs, customs, traditions, music, arts, values, patterns of behaviour, all summed up together and have been passed on from one person to another, from one generation to another through social actions. These connections can be made of the same factors such as education, sexual orientation, language, economic status, etc. Learning starts within the family, then in the school premises, with more explorations in the community and extending to larger institutions.
Initially mistaken to be a conceptual framework because it was examined to have a mode and a systematic structure, the Purnell Theory has been proved to be a big theory by a group of three famous nurses/theorists in the year 1998. But eventhough the debate between the two has existed to be very controversial, this big theory’s significance serves as a helpful documentary in the evolution of cultural competence in a variety of disciplines and also in future knowledge exploration (Purnell, 2005). Purnell (2005) described that his model is circular with 4 rims, each representing a certain societal group.
The rim at the most inner portion represents an individual or a person. The second rim represents the family group. The third rim represents the community group. The fourth or the rim at the outer portion represents the worldwide society group. The circle’s inner portion divides into 12 wedges that are pie-shaped which represent the domains and concepts of culture which build up the whole structure of the model. There is a dark portion at the middle of the circle and that is the representation of an unknown phenomena. The portion below the model is a jagged line representing the cultural consciousness’ nonlinear concept.
The design and the creation of the Theory of Purnell (2005) was for the benefit of the healthcare workers/providers that they may be able to: (1) learn the culture characteristics, (2) identify situations affecting the global perspective of a person’s culture through history, (3) create a model that will centralize the different culture relationships, (4) interconnect culture variations to be able to provide absolute proper healthcare, (5) design a structure for an easy analysis of information on culture, and (6) see the global group, the community, the family and the individual as pertaining to their specific ethnic and cultural characteristics. In addition to this, there is a term called “subculture”.
This term refers to the smaller culture group and it differs from the “dominant” culture in ways. These two both share some characteristic beliefs which are based from the primary and the secondary culture characteristics. Anne Fadiman (1998) showed through the context of the book the essence of the primary and the secondary culture characteristics that has the capability of forming a global view and the extent to which they could conform to the origin of culture. Primary characteristics refer to the nationality, age, gender, race, color and religion. Secondary characteristics are those which include acquired education, economic status, employment, beliefs, place of residence (urban or rural), sexual orientation, etc.
In her book called “If The Spirit Catches You and You Fall Down,” she portrayed how misunderstanding between cultures are being separated by gap abstractions through a family belonging to Hmong refugees. The whole story revolved around a 3-month-old child named Lia Lee and how it was hard for Lia’s parents to overcome the things that they’ve been going through because no one could understand them, the language they’re speaking and their culture. Lia was suffering from an epilepsy case and when Lia was sent to a hospital in Merced, California, they had a hard time speaking to the hospital staff because they cannot be understood by their Hmong language.
Lia had been undergoing seizures but these are both a good and a bad thing to Lia’s parents. It was a bad thing because Lia’s mind and body are extremely suffering. On the other hand, it was a good thing because Hmong culture believes that Lia’s seizures were because of the leaving of her soul from its body which they call the condition as “quag dab peg” (meaning, “the spirit catches you and you fall down”). There was even a conflict that existed between Lia’s parents and her doctors regarding competence in taking care of her condition. The parents got mad because they said that the medicine that was prescribed to their daughter had side effects. The doctors got angry because Lia’s parents gave her a different dose of medication.
In Chapter 14, called the Melting Point, there it has showed how the Hmongs had difficulty when they came to America. They were not very familiar with the culture there. Fadiman (1998) was very successful in illustrating the discrepancies between two different cultures and the misunderstanding they had to go through the process. She absolutely have described every detail from complex medical processes and protocols in the ER up to healing ceremonies in Hmong culture and the lives they have lived in Thailand refugee camps. Diversity in the multicultural aspect, as well as in race and ethnic differences concerning health, is already being addressed by worldwide organizations and professionals.
They have created standards to educate healthworkers to become sensitive to the culture of their patients which in turn, making them competent service providers. But then, culture is complex where providers can be extremely pushed to view every detail that relates to the health service they give. This includes their employment environment, different perceptions, colleagues, communities, the patients they are handling and most especially, themselves. They should see to it that these details act accordingly (Purnell, 2005). Through this book written by Purnell (2005), it was very important for healthworkers and other service providers to know a lot about variations in culture.
Moreover, being sensitive and knowledgeable to the different subcultures are more important. In the development of expertise and exploration all over the world, every subgroup deserves all the respect they are worth for their uniqueness. References: Purnell, L. (2005). The Purnell Model for Cultural Competence. Retrieved May 3, 2008, from http://findarticles. com/p/articles/mi_qa3919/is_200507/ai_n14825638/pg_10 Ameri & Golerkite (2004). The Spirit Catches You and You Fall Down – Summary and Reading Log. Retrieved May 3, 2008, from http://web. pdx. edu/%7Emegr/ethical_spiritreading log. htm Fadiman, A. (1998). The Spirit Catches You and You Fall Down. Retrieved May 3, 2008, from http://www. spiritcatchesyou. com/bookdescription. htm