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Pernell’s Community Conceptual

Model

Presented by
Faith Vaughn RN, BSN, MSN
Overview of The Model


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
 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.

 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.

 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
 Makeit simple and use pictures of
airways

 Usethe “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

 Provide explanations for all Rx and OTC


products at family in teaching. Emphasize not
to share child’s treatment with others

 Educational level appropriate to client/family.


Emphasize to call 911, if there’s no
improvement in wheezing or breathing

 Explain the problems associated with smoking


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

 Seek help from primary MD, regarding FDA


Teachable Moments

 Officevisits
 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?

 Does my child wake up at night with asthma


more than TWO TIMES A MONTH?

 Do we refill the "quick-relief inhaler" more


than TWO TIMES A YEAR?

 Do I smoke EARLY IN THE MORNING or


EVENING?

 If yes, the asthma OR SMOKING may not be control


References

 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.