Summary
Nurses need to perform cultural assessments on patients to determine the health interventions that conform to the patient’s culture. One of the ideal models for conducting a cultural assessment is Purnell Model for Cultural Competence. This model uses twelve domains: heritage, communication, family roles and organization, workforce issues, biocultural ecology, high-risk behaviors, nutrition, pregnancy, childbearing practices, death rituals, spirituality, healthcare practices, and medical practitioners (Purnell & Paulanka, 2008). I will use this model to conduct a cultural assessment of my friend, whom I will refer to as Mr. TT.
Heritage
Mr. TT is an African immigrant who works as a part-time cashier at a grocery store. He is the firstborn in a family of six. The rest of his family lives in his native country, South Africa. Mr. TT stated his education in South Africa, where he spent most of his school life. After competing in high school, he got a scholarship to pursue a bachelor’s degree in economics at the University of Florida. He considers his salary enough to meet his basic and other secondary needs. However, he is considering looking for another job to support his family in South Africa.
Communication
English and French are the primary languages that Mr. TT uses for communication. Furthermore, he can speak fluently using his native dialects of Xhosa and Zulu. His family is from the Zulu ethnic group but resides in a community dominated by Xhosa speakers. Mr. TT’s communication is highly contextual, where he utilizes more non-verbal cues such as facial expressions and gestures. He does not rely on verbal expression when making a point or listening to another person communicate. This form of communication is prominent in his native home and is prominently practiced by most of his friends.
Family Roles and Organization
According to Mr. TT’s culture, the head of the man is the head of the family. He is responsible for making major family decisions regarding the family members’ healthcare. Family roles are greatly influenced by gender, where most of the house chores are assigned to women while men are assigned income-generating duties. Mr. TT’s culture emphasizes family unity and interdependence, where one family member has a responsibility for taking care of the others.
Workforce Issues
One of the major workforce issues that are valued in Mr. TT’s culture is time management and competence. Moreover, he values collaboration and teamwork when interacting with his colleagues. His workplace consists of workers from different ethnic backgrounds. The workplace communication form is majorly informal, and roles are assigned randomly without considering gender. However, his workplace does not encourage autonomy, and workers are encouraged to operate based on the company’s policy. Additionally, workers are encouraged to communicate in English to facilitate fluent communication.
Biocultural Ecology
Being a native African, Mr. TT has dark skin, which makes it challenging to assess skin conditions such as rashes and sunburns. Given his skin color, Mr. TT takes little precaution to shield himself from the sun because he rarely notices sunburns. There are no common illnesses that Mr. TT suffers from, but he occasionally experiences headaches, especially when he is stressed or has had a busy day. However, his family in South Africa has had frequent cases of tuberculosis, which Mr. TT claims to be a common infection in his native village.
High-Risk Behavior
Tobacco use and unsafe sexual practices are considered high-risk behaviors in Mr. TT’s culture. These behaviors are prevalent among the youth, significantly increasing HIV and other STI cases in the South African population. Although Mr. TT engages in protected sex occasionally, he admits that he has multiple sexual partners. Additionally, Mr. TT occasionally reveals smoking, although he does not consider this behavior addictive. However, he is considering quitting this behavior because he feels it risks his health.
Nutrition
Nutrition is highly valued in Mr. TT’s culture, although they do not prioritize a balanced diet, but food choice depends on the available food. In his culture, weight is closely associated with health, where those who have a higher weight are considered healthy than those with a low weight. However, being overweight is considered to be unhealthy. Mr. TT disagrees with the American notion that associates thinness with beauty and desirability. Many people, especially women, prefer having a thicker and curvy body.
Pregnancy and Childbearing Practices
Pregnancy is highly valuable in Mr. TT’s culture because it symbolizes the development of a new member of the community. Therefore, pregnant women are usually subjected to exceptional care, including special foods, especially fruits, and are often restrained from engaging in tedious activities. Abortion is considered murder and is highly prohibited unless it poses a health risk to the mother. Besides, birth control methods are highly discouraged because they are believed to cause infertility and promote immorality in society.
Death Rituals
Death is considered a bad omen to the community in Mr. TT’s culture. The dead are often accorded high respect to appreciate the period they were alive. Speaking ill of the dead is often considered taboo and disrespectful to the deceased’s family. The dead are usually mourned with ululations and wailing to express the sadness and loneliness that they have left behind. The Zulu people believe in burying the dead as a sign of respect. After the burial, a ceremony is conducted to celebrate the deceased’s life.
Spirituality
Spiritually, Mr. TT considers himself a protestant Christian, which he inherited from his parents. He does not go to church consistently but claims he prays frequently. Mr. TT argues that what one believes and professes matters more than going to church. He believes God controls all aspects of life, including health. According to him, the family gives life meaning and prays to God occasionally to protect his family. Additionally, Mr. TT believes the body is a temple of God, and therefore one has the responsibility to maintain good health.
Healthcare Practices
Engaging in healthy practices is believed to be one’s responsibility in Mr. TT’s culture. Some of the health practices that he embraces include eating a balanced diet, having enough sleep, physical exercise, regular medical checkups, and having health insurance. However, Mr. TT is highly reluctant to take vaccines because he believes they tend to lower one’s immunity. Additionally, in his culture, people tend to associate western medicine with immunity weakness, thus being reluctant to visit healthcare facilities until the condition worsens.
Healthcare Practitioners
Mr. TT highly favors allopathic practitioners for his medical conditions. However, he occasionally visits martial artists to learn Tai Chi when he feels depressed. Additionally, he values yoga to achieve mental stability and emotional calmness. Mr. TT believes that all healthcare practitioners should be accorded equal respect regardless of their education, gender or ethnicity. Besides, he does not mind having a female practitioner for intimate care. However, Mr. TT prefers having western trained healthcare officials because they are more competent than others.
Healthcare implications
Understanding the cultural diversity of patients is essential in improving the healthcare services delivered to patients. Furthermore, cultural diversity enables nurses to address health needs that conform to the beliefs and values of the patients. It allows healthcare officials to understand the preferences of different patients. Besides, comprehending different cultures promote innovation and creativity in healthcare to solve the various problems that different cultures are experiencing. It enables healthcare practitioners to identify cultural practices that patients embrace that risk causing healthcare implications and advise them according.
Reference
Purnell, L., & Paulanka, B. (2008). Transcultural Healthcare: A Culturally Competent Approach (3rd ed., pp. 18-53). F.A. Davis.