Transcultural Nursing


Healthcare organizations and healthcare professionals are increasingly addressing racial and ethnic disparities in health through a multicultural diversity approach. Healthcare organizations and professional societies have increasingly encouraged their members to be culturally competent and sensitive. Embracing diversity in healthcare results in cultural competence in healthcare provisions since the professionals can offer services that meet the patients’ distinctive cultural, social, and linguistic needs (Cuevas, O’Brien, and Saha, 2017). Ideally, the better a patient is understood and characterized, the better they can be treated. This paper will focus on culturally sensitive care and its relevance in healthcare and how the organizational framework of the Purnell Model is essential in transcultural healthcare. When the healthcare teams easily reflect on the diversity of the patients, it is easier for them to develop cultural competence, which allows providers and patients to have open communication that leads to high-quality care.

Culturally Sensitive Care and Its Application within Health Care

Culturally sensitive care reflects on the capacity to consider the feelings, approaches, beliefs, and conditions of a specific group of individuals that share typical and collective religious, national, dialectal, and cultural custom (Pacquiao, 2018). This care is extraordinary since it’s based on the opinions and views of the patient rather than the views and opinions of the healthcare provider. The provision of culturally sensitive care is an essential element of patient-centered care. This is because it empowers the patients to share their opinions and views regarding culturally sensitive care in patient-centered care.

The care providers have to enhance their capacity to offer patient-centered care through reflecting on their patient values, cultures, and beliefs that influence the patient-provider relationship (Pacquiao, 2018). While providing culturally sensitive care, certain values are deemed important, which include patient choice and well-being. The provider has to listen, comprehend, and respect the opinions, values, needs, and ethnocultural beliefs to meet the patient’s health goals. Healthcare providers have associated culturally sensitive care with positive health outcomes and behaviors in both the majority and minority patients.

Purnell Model of Cultural Competence

The 21st century established an era of diversity and multiculturalism in healthcare. Cultural competence became a significant component and a major initiative. The Purnell model was proposed as an organizational framework that could guide the cultural competence of a multidisciplinary healthcare team. The model explains the link between culturally sensitive care and health-promoting behaviors, treatment adherence, and health outcomes (Purnell, 2021). Purnell considers culture as a wider cultural group that leads to uncertainties for the healthcare providers.

The Purnell model offered a system that all the healthcare professionals use to learn qualities and ideas of specific cultures. The model offers focal links of culture as well as interrelate cultural qualities. Additionally, it offers a basis for all healthcare professions to study characteristics and concepts of culture. This has led to interrelated individualities of culture to facilitate unity in provision competent and sensitive healthcare. Cultural competent care stresses on concern about patient’s heritage and beliefs when developing a healthcare plan. This requires acknowledging that people belong to varying races, cultures, and races, thus demanding treatment that focuses on the distinctiveness of each individual.

Purnell’s model has offered a foundation for transcultural health care where health professionals understand the different attributes in various cultures. Ideally, the model incorporates ideas about culture and persons as a way of integrating transcultural healthcare. Healthcare professionals have employed the Purnell model to aid the provision of culturally competent care to patients. For instance, nurses have acquired the necessary skills and knowledge to acknowledge and appreciate cultural differences in healthcare beliefs, values, and customs. Therefore, the Purnell model offers transcultural knowledge, which has enabled healthcare professionals to address the patients’ psychological, physical, emotional, social, and spiritual needs.

Purnell’s 12 Domains of Culture

Purnell’s 12 domains include heritage, family roles and organization, communication, workforce issues, high-risk behaviors, bio-cultural ecology, pregnancy, nutrition, spirituality, healthcare professionals, death rituals, and healthcare practices (Purnell, 2019). These domains are essential in evaluating characteristics and traits of different ethnic groups, which increasing build cultural awareness. The heritage domain comprises of geographical influence of the present and original home, education status, political affairs, and economics. The communication domain entails relevant notions linked to communication, such as dialects and primary language. Family roles and organization involve the household structure affects social status, goals, and priorities. Workforce issues include language barriers, autonomy, and acculturation.

Bio-cultural ecology includes observational differences in terms of racial and ethnic origins. Nutrition entails the consumption of certain foods that may influence health depending on the place of origin. Pregnancy entails birth and postpartum practices based on myriad beliefs. Death rituals encompass death perception and how it is accepted. Spirituality relates to religious practices such as prayer and the meaning of life and how they affect health (Purnell, 2019). Health practices include the health responsibilities and ways that are used to reach successful health outcomes. The healthcare professionals include the roles and perceptions of the healthcare team and their practices in promoting health. Ideally, these domains are essential in developing knowledge about the attributes of the different cultures, which allows the healthcare professional to deliver care in a culturally diverse population. This boosts cultural competence and eliminates ethnic and racial health disparities due to increased mutual understanding and respect for the patients.

Application of Purnell’s Model

Cultural competence is essential for individuals to respect and understand the cultural differences of the patients. Healthcare professionals apply the Purnell model in their healthcare practice which aids in providing culturally competent care to patients. This prevents them from following their beliefs which may influence care competence. Ideally, the model offers knowledge about cultural practices and cross-cultural skills, and attitudes towards cultural differences (Purnell, 2021). Cultural awareness has enabled healthcare providers to be culturally competent since they have a unique understanding of the belief, values, attitudes, and world views of a diverse population. Purnell’s model puts the healthcare professionals in a better position of interacting and collaborating with the clients to offer culturally acceptable care.


Diversity in healthcare entails understanding the patient’s mindset through a larger context of sexual orientation, gender, culture, social, economic realities, and religious beliefs. Healthcare professionals need to be culturally competent to serve a diverse patient population. Purnell model has been one of the effective models that have been used to improve culturally competent care. Diversity in healthcare is significant in offering opportunities for quality care and making up patients’ value system.




Cuevas, A. G., O’Brien, K., & Saha, S. (2017). What is the key to culturally competent care: Reducing bias or cultural tailoring?. Psychology & Health32(4), 493-507.

Pacquiao, D. (2018). Conceptual framework for culturally competent care. In Global applications of culturally competent health care: Guidelines for practice (pp. 1-27). Springer, Cham.

Purnell, L. (2019). Update: The Purnell theory and model for culturally competent health care. Journal of Transcultural Nursing30(2), 98-105.

Purnell, L. D. (2021). The Purnell Model and Theory for Cultural Competence. In Textbook for Transcultural Health Care: A Population Approach (pp. 19-59). Springer, Cham.

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