Community Health Based On Purnell’s Model

Pernell’s Community Conceptual Model Presented by Faith Vaughn RN, BSN, MSN

Overview of The Model

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Relevance of the Model to Community/Aggregate Population Care  Relevant for all health care providers, and

educators, in a diverse environmental contexts.  Guide the development of assessment tools, planning strategies, and group interventions  Can guide data collection  Valuable resource for the study of cultural practices

Definition of the Concepts  Global society: Includes the ability for

people to travel around the world and to interact with diverse societies  Community: Is a group of people having a common interest or identity and living in a specified locality  Family: Is two or more people who are emotionally involved with each other  Person: Is a bio-psychosociocultural human being who is constantly adapting

Relationship of the Major Concepts  Family roles and organization: can affect

health care decisions  Economic and political conditions: may affect one’s reason for migration  Education: is usually interrelated with employment choices  Sociopolitical and socioeconomic conditions: influence individual behavioral responses to health and illness

Application/Scenario

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A teenage mother brings her 3 year old son to the clinic, accompanied by her parents. She c/o her son having a bothersome persistent dry cough for the past 3 months. Within the past year, he has been coughing and wheezing every time he gets a cold.

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He was diagnosed with mild persistent asthma. The physician ordered Flovent 44mcg 2 puffs BID, (increase to 4 puffs BID in yellow zones X2 weeks), and albuterol 2-4 puffs as needed for asthma symptoms and prior to exercise.

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Both parents revealed smoking 1-2 packs of cigarettes a day x 2yrs, and has limited knowledge of its link with asthma

Purnell’s Model for Cultural Competence

 Communication  Family

roles and organization

 Education  High-risk

behaviors

 Health

care practices

 Health

care practitioners

Objectives Clinician can utilize communication skills to:  Identify

family concerns

 Improve

teaching effectiveness

 Promote

patient self-confidence

Disparity Considerations Work with each family to develop an action plan that takes into consideration:  The families cultural, ethnic, and socioeconomic background  The asthma regimen needed  The families ability to implement the plan, physically, socially and economically  The families high-risk behaviors that may sabotage the plan

Communication Tips for Explaining Asthma  Make

it simple and use pictures of airways

 Use

the “fist” example, asking parent/patient to do it with you.

 Convey

the dynamic

of open/shut airways

Interventions 

Provide written instructions in client’s preferred language Implement some of their cultural practices into the plan of care

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Provide explanations for all Rx and OTC products at family in teaching. Emphasize not to share child’s treatment with others

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Educational level appropriate to client/family. Emphasize to call 911, if there’s no improvement in wheezing or breathing

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Explain the problems associated with smoking and second hand smoking. Explain role modeling, and the benefits of not smoking

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Seek help from primary MD, regarding FDA

Teachable Moments  Office

visits  Checking in  Rooming  Phone calls  Grocery Store  Health fairs  Mentoring

Parents can ask… 

Does my child need a "quick-relief inhaler" more than TWO TIMES A WEEK?

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Does my child wake up at night with asthma more than TWO TIMES A MONTH?

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Do we refill the "quick-relief inhaler" more than TWO TIMES A YEAR?

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Do I smoke EARLY IN THE MORNING or EVENING?

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If yes, the asthma OR SMOKING may not be control

References 

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Association for the Advancement of Health Education, Cultural Awareness and sensitivity: Guidelines for Health Educators. Campinha-Bacote, J. (1999). The process of cultural competence in the delivery of health care services: A culturally competent Model of care (3rd ed.). Cincinnati, OH: Transcultural C.A.R.E. Associates. Diversity in the workplace (1996).Washington DC: Veterans Health Association Management Support Office. Purnell, L., & Paulanka, B. (1998). Transcultural health care: A culturally competent approach. Philadelphia: F. A. Davis.