The Purnell Model for Cultural Competence

Purnell, Larry D.

doi:10.1177/10459602013003006

Cited by 264 publications

(283 citation statements)

References 5 publications

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“…[31] [76] Certain cultures have strong beliefs about pain and its management. [97] Thus, patients may express pain in ways that are unfamiliar to us, or they may hesitate to complain about unrelieved pain. Therefore, sociocultural variables that may influence pain assessment must be identified and respected by all members of the health care team.…”

Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

Assessment and measurement of pain in older adults

Herr

Garand

2001

Clinics in Geriatric Medicine

342

251

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Although the empirical base is still limited when providing clear directions for pain assessment and management in older adults, it is possible to identify recommendations for guiding practice based on consensus and a developing scientific base to support best practice activities. This article offers a brief overview of the epidemiology and consequences of pain, followed by a summary of issues and approaches relevant to pain assessment in older adults. Cohort specific recommendations for comprehensive pain assessment and measurement are then addressed. Prevalence and Consequences of Pain in Older AdultsOlder individuals frequently suffer from both acute and chronic painful diseases, have multiple diseases, and take numerous pain medications, [2] although relatively little investigative or clinical attention has been paid to the assessment of pain in the geriatric population, compared with the general population. This is surprising because populationbased figures indicate that the prevalence of pain is twofold higher in those over age 60 (250 per thousand), compared with those under age 60 (125 per thousand). [24] [79] [108] Further, prevalence estimates suggest that approximately 60% of community-dwelling older adults and up to 80% of elderly long-term care facility residents experience substantial pain.[24] [79] [108] Because pain is often remediable, [2] [25] it is thought that the high prevalence estimates of unrelieved pain in elderly persons may result from underrecognition, which in turn results in undertreatment. [65] [91] [120] The consequences of untreated pain can profoundly impact the older person's quality of life. In addition to physiologic risks associated with untreated pain (e.g., cough suppression with subsequent retention of pulmonary secretions), depression, [58] [39] [90] Therefore, it is imperative that health care professionals' knowledge and skills related to pain assessment in older adults be improved, and aggressive approaches to comprehensive pain assessment be adopted, to ensure and improve the quality of life of our senior citizens. Approaches to Pain Assessment with Older Adults Clinical AssessmentIn the clinical setting, accurate assessment of pain is critical for the identification of appropriate interventions and for evaluating the effectiveness of such interventions. Patients should be assessed regularly for the presence of pain and for improvement, deterioration, or complications attributable to pain treatment.[2] The frequency of the follow-up should be a function of the severity of the pain and the potential for adverse effects of treatment. Documentation of pain assessment formalizes the pain assessment process and is essential in the provision of individualized care from both a legal and professional perspective. [17] Inherent in the assessment of pain among older adults is the understanding of its potentially remediable components. For example, if a patient has acute pain, assessment should focus on the underlying pathology responsible for the pain stimulus. If th...

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Section: Psychosocial and Functional Assessmentmentioning

confidence: 99%

Assessment and measurement of pain in older adults

Herr

Garand

2001

Clinics in Geriatric Medicine

342

251

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“…Cultures in transition, either due to geographic migration or to societal trends dictating a move from more traditional to Western paradigms, present families with challenges regarding the discourse of health and well-being within the family. Firstly, if in the more traditional model the extended family played a significant role in the individual's health and well-being, the more Western model emphasizes the dominance of the nuclear family [48]. This transition has not only narrowed the base for support, in many cases it changed the role of family members, particularly with regard to gender.…”

Section: Family Relationships Communication and Health Literacy In Tmentioning

confidence: 99%

Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective

Levin-Zamir

Leung

Dodson³

et al. 2017

ISU

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Abstract. International and cultural perspectives of health literacy help deepen the understanding of the global context within which health literacy plays an important role. Throughout this article, we explore the significance of health literacy initiatives, interventions, practices, and research for addressing health challenges on a variety of levels in the international and global context. More specifically, the notion of health literacy as a dynamic construct is introduced, after which we examine health literacy throughout the life course, emphasizing the impact of health literacy among children and the elderly in their families and in the community. Cultural norms and family interpersonal relations, and values influence health literacy and need to be considered when closing the health literacy disparities. Global trends of migration and immigration bring to the forefront the need for unravelling the complexity of health systems, for which health literacy plays a central role; health literacy initiatives address cultural differences between providers and patients to help narrow the communication gap. The importance of cultural competency among health care providers exemplifies how capacity building in health literacy is critical for maximizing the benefits to the public of the health care system. Health literacy provides a conceptual foundation for community participatory research, involving members of the public to take part in the planning, execution and evaluation of health education interventions. Selected case studies and picture boxes from around the globe, exemplify aforementioned topics of interest. Practical recommendations for policy makers, practitioners and research are offered based on the studies conducted in the international context.

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“…Culture is defined as the "totality of socially transmitted pattern of thoughts, values, meanings, and beliefs" (Purnell 2005). It is not limited to any specific ethnic group, geographical area, language, religious belief, manner of clothing, sexual orientation, and socioeconomic status (Fisher 1996).…”

Section: Introductionmentioning

confidence: 99%

“…In Revisiting usog, pasma, and kulam, Tan explains that "culture is inscribed in our bodies and in our minds" (Tan 2008). As such, the relationship of culture and health is important to understand as it impacts an individual's worldview and decision-making process (Purnell 2005). Like in other fields of medicine, the impact of cultural beliefs is increasingly being recognized as an essential component in the genetic counseling process (Cohen et al 1998;Edwards et al 2008;Penn et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Cultural beliefs on disease causation in the Philippines: challenge and implications in genetic counseling

et al. 2014

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The provision of culturally competent health care is an important professional issue recognized by the pioneer genetic counselors in the Philippines. Being an archipelago consisting of 7,107 islands, the Philippines has approximately 175 ethnolinguistic groups with their own unique cultural identity and health practices. The emphasis on culture in our genetic counseling training recognizes its crucial role in molding an individual's conceptualization of health, as well as other life aspects, especially since the Filipino culture is a mixture of indigenous as well as imported and borrowed elements. As part of this endeavor, we will describe in this paper seven common Filipino cultural beliefs: namamana, lihi, sumpa, gaba, pasma, namaligno, and kaloob ng Diyos. We will also share examples on how these common beliefs provide explanation as cause of illness and its implications in our genetic counseling profession.

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The Purnell Model for Cultural Competence

Cited by 264 publications

References 5 publications

Assessment and measurement of pain in older adults

Assessment and measurement of pain in older adults

Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective

Cultural beliefs on disease causation in the Philippines: challenge and implications in genetic counseling

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