Compare And Contrast 2 Cultural Assessment Models (CAM)

Compare and contrast 2 cultural assessment models (CAM), define and explain the history and background of the theorist

In an increasingly diverse healthcare environment, it is essential for professional nurses to possess the skills to assess the cultural needs of their clients accurately. Cultural assessment models (CAMs) serve as structured frameworks guiding healthcare providers in understanding patients' cultural backgrounds, beliefs, and practices. Such understanding enhances the delivery of culturally competent, holistic care, ultimately improving health outcomes and aligning with legal mandates like Title VI of the Civil Rights Act of 1964, which prohibits discrimination based on race, color, or national origin and mandates meaningful access for Limited English Proficiency (LEP) individuals.

This paper compares and contrasts two prominent CAMs: Madeline Leininger's Sunrise Model and Purnell's Model for Cultural Competence. It will include the background and theoretical foundations of each model, their strengths and weaknesses, and an analysis of their applicability in nursing practice when caring for multicultural patients. Based on this comparison, the paper will select one model for future implementation and propose improvements to enhance its effectiveness.

Madeline Leininger's Sunrise Model

Madeline Leininger, a pioneering nurse anthropologist, developed the Sunrise Model in the 1980s to emphasize the significance of cultural factors in nursing care. Her background in anthropology and nursing led her to Tuhami and Culture Care Diversity and Universality theories, which focus on understanding cultural phenomena to provide culturally congruent care (Leininger, 1991). The Sunrise Model visually depicts various cultural influences, including technological, religious, social, and kinship factors affecting health and healthcare practices (Leininger, 1991). Its primary purpose is to guide nurses in conducting comprehensive cultural assessments by considering multiple levels of cultural influence.

The model advocates for culturally competent care by integrating cultural knowledge with professional nursing practices and emphasizes the importance of cultural awareness, sensitivity, and competence. Leininger’s approach underscores that understanding cultural diversity enhances patient trust, satisfaction, and health outcomes.

Strengths of the Sunrise Model include its holistic perspective, emphasis on cultural universality, and its detailed portrayal of influencing factors, which aid nurses in tailoring interventions. However, its complexity and the need for extensive cultural knowledge can pose implementation challenges, especially in fast-paced clinical settings. Additionally, the model may be limited by its focus on broad cultural factors without providing specific assessment tools.

Purnell's Model for Cultural Competence

Developed by Larry Purnell in 1996, the Purnell Model offers a comprehensive framework designed to facilitate cultural competence in healthcare. The model is represented as a circular diagram with concentric rings representing different domains of culture, such as communication, family roles, health practices, and spirituality (Purnell, 1999). Its foundation lies in the premise that understanding the multifaceted nature of culture enhances patient-centered care.

Purnell's background as a nurse and educator contributed to the development of a practical tool for nursing students and practitioners to analyze cultural variables systematically. The model provides assessment prompts across domains, encouraging clinicians to explore patient beliefs, practices, and social structures. It emphasizes the importance of cultural self-awareness among healthcare providers and advocates for ongoing cultural competence development.

Strengths of Purnell's Model include its user-friendly circular format, detailed domains for comprehensive assessment, and applicability across diverse healthcare settings. Conversely, its extensive scope may be time-consuming, and some critics note the potential for oversimplification of complex cultural identities. Nevertheless, its practicality makes it widely useful in clinical practice, especially for nurse-patient interactions involving multicultural populations.

Comparison and Contrast of the Two Models

Both models aim to guide nurses in conducting thorough cultural assessments to promote culturally competent care. The Sunrise Model offers a broad, holistic view emphasizing cultural influences that shape health behaviors, whereas the Purnell Model provides a structured, domain-focused framework that facilitates systematic analysis of cultural factors.

In terms of background, Leininger’s model is rooted in ethnographic and anthropological principles, emphasizing the universality of culture and the importance of cultural care. Purnell’s model, on the other hand, is grounded in nursing education and practical application, with an emphasis on self-awareness and operational assessment domains.

Strength-wise, the Sunrise Model excels in its comprehensive nature and ability to incorporate multiple layers of influence. However, its complexity can hinder quick assessment in clinical practice. The Purnell Model is more straightforward and adaptable, making it suitable for diverse settings, though it may risk oversimplifying intricate cultural identities. Both models highlight communication, beliefs, and family as critical domains but differ in their approach to integrating cultural knowledge into tangible nursing interventions.

When applied to multicultural patients, both models enhance understanding and foster culturally sensitive care. The Sunrise Model's focus on holistic cultural influences facilitates personalized care plans, while Purnell's structured domains enable systematic assessment of specific cultural variables.

Selection of a Model for Future Practice

Considering the benefits and limitations assessed, I would implement the Purnell Model for Cultural Competence in caring for multicultural patients. Its user-friendly structure allows for efficient assessment without sacrificing depth of cultural understanding. Its explicit domains help identify specific cultural factors impacting health behaviors, which is vital when working with diverse populations.

Utilizing the Purnell Model can improve communication, foster trust, and tailor interventions effectively. For example, recognizing how language barriers influence health literacy or understanding religious practices that affect treatment adherence enables nurses to develop culturally congruent care plans that respect patients’ values and preferences.

Recommendations to Improve the Model's Application

Although effective, the Purnell Model can benefit from refinements. First, developing standardized cultural assessment tools based on the model's domains could streamline its use in busy clinical environments. Second, integrating technology, such as electronic health records with built-in cultural assessment prompts, could ensure consistent application. Third, incorporating ongoing cultural competence training and reflective practices for nurses would deepen understanding and foster self-awareness, addressing some limitations of superficial engagement with cultural issues.

Furthermore, expanding the model to include guidelines for cross-cultural communication strategies would enhance its practical utility. Encouraging multidisciplinary collaboration to share cultural insights can also strengthen the model's application across various healthcare settings. Finally, adapting the model to include specific considerations for LEP patients aligns with Title VI mandates and demonstrates a commitment to equitable care.

Conclusion

In summary, both the Sunrise and Purnell's models serve as valuable frameworks for cultural assessment in nursing practice. While the Sunrise Model provides a comprehensive, holistic view rooted in anthropology, the Purnell Model offers a practical, systematic approach suitable for diverse clinical settings. For future application, the Purnell Model's structured format makes it preferable, complemented by targeted improvements to maximize its efficacy. Implementing culturally competent care ensures patients' cultural needs are respected, ultimately leading to better health outcomes and legal compliance with federal anti-discrimination statutes.

References

• Leininger, M. (1991). Culture care diversity and universality: A theory of nursing. NLN Publications.
• Purnell, L. (1999). The Purnell Model for Cultural Competence. Journal of Transcultural Nursing, 10(2), 61–72.
• Campinha-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 13(3), 181–184.
• Andrews, M. M., & Boyle, J. S. (2016). Transcultural Concepts in Nursing Care (8th ed.). Saunders.
• Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in healthcare: A systematic review. BMC Health Services Research, 14, 99.
• Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2003). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293–302.
• Jeffreys, M. R. (2016). Teaching cultural competence in nursing and health care: Inquiry, action, and innovation. Springer Publishing Company.
• Andrews, M., & Pooler, J. (2019). Transcultural Nursing: Assessment and Intervention. Elsevier.
• Spector, R. E. (2017). Culture for Healing: The Appropriation of Native American Healing Practices in Nursing. Journal of Transcultural Nursing, 28(2), 114–121.
• Shen, J. (2014). Cultural competence models and their limitations: A review of the literature. Journal of Nursing Education and Practice, 4(4), 106–112.