theoretical models for cultural competence - week 4 Flashcards
Framework for teaching cultural skills to medical students and residents
Pneumonic device made to assist students with communication techniques L: listen E: explain A: acknowledge R: recommend N: negotiate
LEARN model
with sympathy and understanding to the patient’s perceptions of the problem
what do you feel might be causing the problem? How do you feel the illness is affecting you? What do you feel might be of benefit?
Listen
your perceptions of the problem
Diagnosis is often an educated guess at first. Here is some preliminary explanation.
-formulate your diagnosis
explain
discuss the differences and similarities
Find areas of agreement between explanatory models. Bridge gaps between different belief systems.
-where you and your patient are different
acknowledge
treatment
Involve patient in the planning of treatment to incorporate culturally relevant approaches. Check for patient understanding and acceptance of recommendations.
recommend
agreement
recovery is more likely when the therapeutic process fits within the cultural framework of the patient’s perception of healing and health.
-make a deal
negotiate
Originally an organizing framework that
developed into a model
Based on multiple theories
Holographic theory
Practitioners need both general and specific
cultural knowledge
The Purnell Model
12 cultural domains
- Overview/Heritage
- Communication
- Family views/organization
- workforce issues
- bicultural ecology
- high risk behaviors
- nutrition
- pregnancy and childbearing
- death rituals
- spirituality
- health care practices
- health practitioner
Purnell model
Concepts related to country of origin, current residence, the effects of the topography of the country of origin and current residence, economics, politics, reasons for emigration, educational status, and occupations
- overview and heritage of Purnell model
Concepts related to the dominant language and dialects; contextual use of the language; paralanguage variations such as voice volume, tone, and intonations; and the willingness to share thoughts and feelings. Nonverbal communications such as the use of eye contact, facial expressions, touch, body language, spatial distancing practices, and acceptable greetings; temporality in terms of past, present, or future worldview orientation; clock versus social time; and the use of names are important concepts.
- communication of Purnell model
Concepts related to the head of the household and gender roles; family roles, priorities, and developmental tasks of children and adolescents; child-rearing practices; and roles of the ages and extended family members. Social status and views toward alternative lifestyles such as single parenting, sexual orientation, child-less marriages, and divorce are also included in the domain.
- family roles and organization of Purnell model
Concepts related to autonomy, acculturation, assimilation, gender roles, ethnic communication styles, individualism, and health care practices from the country of origin
- workforce issues of Purnell model
Includes variations in ethnic and racial origins such as skin coloration and physical differences in body stature; genetic, heredity, endemic, and topographical diseases; and differences in how the body metabolizes drugs.
knowledge you need to know
- bicultural ecology of Purnell model
Includes the use of tobacco, alcohol and recreational drugs; lack of physical activity; nonuse of safety measures such as seatbelts and helmets; and high-risk sexual practices.
pregnancy or teenage pregnancy
- high risk behaviors of Purnell model
Includes having adequate food; the meaning of food; food choices, rituals, and taboos; and how food and food substances are used during illness and for health promotion and wellness.
- nutrition of Purnell model
