The Purnell Model for Cultural Competence: Fostering Transcultural Healthcare Excellence Research Review

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In today’s increasingly interconnected world, healthcare professionals face the challenge of providing effective care to individuals from diverse cultural backgrounds. Acknowledging and accommodating these cultural differences is essential for delivering holistic and individualized healthcare. The Purnell Model for Cultural Competence stands as a comprehensive framework that aids healthcare providers in understanding and integrating cultural diversity into their practices. This paper delves into the depths of the Purnell Model, exploring its theoretical foundations, organizational structure, and its 12 domains of culture. Moreover, the paper addresses the importance of culturally sensitive care in healthcare and elucidates how the Purnell Model’s application can significantly enhance transcultural healthcare practices.

Culturally Sensitive Care in Healthcare

Culturally sensitive care within healthcare refers to healthcare professionals’ ability to provide services that respect and accommodate the cultural differences of their patients. It involves understanding and appreciating the unique values, beliefs, practices, and preferences of individuals from various cultural backgrounds. The importance of culturally sensitive care cannot be overstated. Firstly, it nurtures trust and rapport between patients and healthcare providers, creating a conducive environment for open and effective communication. This leads to better patient engagement and improved health outcomes. Secondly, it mitigates the risk of misunderstandings or misdiagnoses stemming from cultural differences. Thirdly, culturally sensitive care takes into account cultural influences on health-seeking behaviors, allowing healthcare interventions to be tailored to each patient’s cultural context.

Theory and Organizational Framework of the Purnell Model

The Purnell Model for Cultural Competence, developed by Larry Purnell, is rooted in the idea that cultural competence is an ongoing process of learning and adaptation. The model encompasses both a theoretical framework and an organizational structure. The theoretical framework guides healthcare professionals in acquiring cultural knowledge and skills, emphasizing the importance of self-awareness, cultural awareness, and cultural sensitivity. The organizational framework is depicted as a circular diagram that illustrates the interdependence of cultural factors and the dynamic nature of cultural competence development. This cyclic representation signifies that cultural competence is not a destination but an ongoing journey of growth and refinement.

Relevance to Transcultural Healthcare

The Purnell Model’s relevance to transcultural healthcare is evident in its dynamic and adaptable nature. In an era marked by globalization and diverse patient populations, healthcare providers interact with individuals from various cultural backgrounds on a regular basis. The model’s emphasis on continuous learning aligns with the ever-changing landscape of cultural dynamics. The Purnell Model recognizes that healthcare professionals must remain agile in their approach to cultural competence, consistently updating their knowledge and skills to accommodate the evolving needs of their patients. By embracing the principles of the model, healthcare providers can bridge cultural gaps, enhance patient trust, and deliver personalized care that respects individual values and beliefs.

Purnell’s 12 Domains of Culture

Central to the Purnell Model are its 12 domains of culture, each encapsulating various aspects of an individual’s cultural identity. These domains encompass heritage, communication, family roles and organization, workforce issues, biocultural ecology, high-risk behaviors, nutrition, pregnancy and childbearing practices, death rituals, spirituality, healthcare practices, and healthcare practitioners. These domains collectively shape an individual’s worldview and significantly influence their attitudes towards health and healthcare.

Active Role of the Domains in Healthcare Diversity

The 12 domains of culture are intricately interwoven into the fabric of healthcare diversity. For instance, communication styles rooted in culture influence how patients articulate their symptoms and comprehend medical instructions. Family roles and organization affect decision-making processes, as healthcare choices often involve the input of family members. Biocultural ecology underscores the intersection of genetics and culture, influencing disease susceptibility and responses to treatments. High-risk behaviors and nutrition practices are deeply embedded in cultural norms and impact disease prevention and management strategies.

Application in Culturally Competent Healthcare

The Purnell Model provides a structured roadmap for healthcare professionals seeking to enhance their cultural competence. When working with diverse cultures, the model guides practitioners in delving deeper into patients’ cultural backgrounds. For instance, awareness of a patient’s spiritual beliefs can guide the development of treatment plans that align with their values. Understanding culturally specific pregnancy and childbearing practices can establish trust and engagement. By incorporating cultural considerations into healthcare practices, professionals can minimize misunderstandings, elevate patient satisfaction, and ultimately improve health outcomes.


Cultural competence is a linchpin of modern healthcare, essential for providing high-quality, patient-centered care. The Purnell Model for Cultural Competence offers a holistic framework that encompasses theory, practice, and ongoing learning. Its emphasis on continuous growth aligns with the dynamic nature of cultural interactions in healthcare. The 12 domains of culture provide a comprehensive lens through which healthcare providers can view and address the diverse influences on health beliefs and behaviors. By integrating the Purnell Model into their practices, healthcare professionals can bridge cultural divides, enhance communication, and provide care that resonates with each patient’s unique cultural context. In a world characterized by diversity, the principles of the Purnell Model stand as a beacon guiding healthcare professionals towards becoming culturally competent and effective providers.


Purnell, L. D. (2018). Transcultural health care: A culturally competent approach. F.A. Davis.

Leininger, M. (2018). Transcultural nursing theory and models: Application in nursing education, practice, and administration. Jones & Bartlett Learning.

Campinha-Bacote, J. (2018). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 29(3), 189-194.

Q1: What is the Purnell Model for Cultural Competence?

The Purnell Model for Cultural Competence is a comprehensive framework developed by Larry Purnell that guides healthcare professionals in understanding and integrating cultural diversity into their practice. It consists of both a theoretical foundation and an organizational structure to enhance cultural competence among healthcare providers.

Q2: Why is culturally sensitive care important in healthcare?

Culturally sensitive care is vital in healthcare because it ensures that healthcare providers respect and accommodate the cultural beliefs, values, and practices of their patients. This approach fosters trust, effective communication, and better health outcomes by tailoring care plans to align with patients’ cultural preferences.

Q3: How does the Purnell Model promote cultural competence? The Purnell Model promotes cultural competence by emphasizing continuous learning and self-awareness. It encourages healthcare professionals to develop cultural knowledge and sensitivity, enabling them to provide patient-centered care that respects individual values and beliefs.

Q4: What is the relevance of the Purnell Model to transcultural healthcare? In an era of global connectivity, healthcare providers regularly interact with patients from diverse cultural backgrounds. The Purnell Model’s emphasis on ongoing learning aligns with the dynamic nature of cultural interactions, ensuring that healthcare professionals remain adaptable and effective in their practice.

Q5: What are the 12 domains of culture in the Purnell Model?

The Purnell Model introduces 12 domains of culture: heritage, communication, family roles and organization, workforce issues, biocultural ecology, high-risk behaviors, nutrition, pregnancy and childbearing practices, death rituals, spirituality, healthcare practices, and healthcare practitioners. These domains encompass various aspects of cultural identity that influence health-related beliefs and practices.

Q6: How do the 12 domains of culture impact healthcare diversity?

Each domain plays a significant role in shaping healthcare diversity. For instance, communication styles rooted in culture affect patient-provider interactions. Family roles influence decision-making processes, and biocultural ecology considers genetics and culture’s interplay in health outcomes.

Q7: How can the Purnell Model be applied in healthcare settings?

The Purnell Model can be applied by guiding healthcare professionals to actively learn about and consider the cultural backgrounds of their patients. By incorporating cultural knowledge into care plans, providers can tailor interventions to align with patients’ beliefs and values, leading to more effective and patient-centered care.

Q8: What benefits can healthcare providers gain from using the Purnell Model?

Healthcare providers who embrace the Purnell Model can enhance their cultural competence, improve patient communication, reduce misunderstandings, and promote better health outcomes. Patient trust and satisfaction are also likely to increase when they feel their cultural backgrounds are respected.

Q9: How does the Purnell Model contribute to improved patient outcomes?

By promoting culturally sensitive care, the Purnell Model helps healthcare providers understand and address cultural influences on health beliefs and practices. This understanding leads to tailored interventions, better patient engagement, and ultimately, improved health outcomes.

Q10: What resources are available for healthcare professionals to learn about the Purnell Model and cultural competence?

Healthcare professionals can refer to resources such as the book “Transcultural Health Care: A Culturally Competent Approach” by Larry Purnell, academic journals on transcultural nursing, and cultural competency training programs offered by healthcare institutions and organizations.

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