Pernell’s Community Conceptual Pernell’s Community Conceptual ModelModel

Presented byPresented by

Faith Vaughn RN, BSN, MSNFaith Vaughn RN, BSN, MSN

Overview of The ModelOverview of The Model

Relevance of the Model to Relevance of the Model to Community/Aggregate Population Care Community/Aggregate Population Care

Relevant for all health care providers, and Relevant for all health care providers, and educators, in a diverse environmental educators, in a diverse environmental contexts.contexts.

Guide the development of assessment tools, Guide the development of assessment tools, planning strategies, and group interventionsplanning strategies, and group interventions

Can guide data collectionCan guide data collection Valuable resource for the study of cultural Valuable resource for the study of cultural

practicespractices

Definition of the ConceptsDefinition of the Concepts

Global society: Includes the ability for Global society: Includes the ability for people to travel around the world and to people to travel around the world and to interact with diverse societiesinteract with diverse societies

Community: Is a group of people having a Community: Is a group of people having a common interest or identity and living in a common interest or identity and living in a specified localityspecified locality

Family: Is two or more people who are Family: Is two or more people who are emotionally involved with each otheremotionally involved with each other

Person: Is a bio-psychosociocultural human Person: Is a bio-psychosociocultural human being who is constantly adaptingbeing who is constantly adapting

Relationship of the Major ConceptsRelationship of the Major Concepts

Family roles and organization: can affect Family roles and organization: can affect health care decisionshealth care decisions

Economic and political conditions: may Economic and political conditions: may affect one’s reason for migrationaffect one’s reason for migration

Education: is usually interrelated with Education: is usually interrelated with employment choicesemployment choices

Sociopolitical and socioeconomic conditions: Sociopolitical and socioeconomic conditions: influence individual behavioral responses to influence individual behavioral responses to health and illnesshealth and illness

Application/ScenarioApplication/Scenario A teenage mother brings her 3 year old son to the clinic, A teenage mother brings her 3 year old son to the clinic,

accompanied by her parents. She c/o her son having a accompanied by her parents. She c/o her son having a bothersome persistent dry cough for the past 3 months. Within bothersome persistent dry cough for the past 3 months. Within the past year, he has been coughing and wheezing every time he the past year, he has been coughing and wheezing every time he gets a cold. gets a cold.

He was diagnosed with mild persistent asthma. The physician He was diagnosed with mild persistent asthma. The physician ordered Flovent 44mcg 2 puffs BID, (increase to 4 puffs BID in ordered Flovent 44mcg 2 puffs BID, (increase to 4 puffs BID in yellow zones X2 weeks), and albuterol 2-4 puffs as needed for yellow zones X2 weeks), and albuterol 2-4 puffs as needed for asthma symptoms and prior to exercise.asthma symptoms and prior to exercise.

Both parents revealed smoking 1-2 packs of cigarettes a day Both parents revealed smoking 1-2 packs of cigarettes a day x 2yrs, and has limited knowledge of its link with asthmax 2yrs, and has limited knowledge of its link with asthma

Purnell’s Model for Cultural CompetencePurnell’s Model for Cultural Competence CommunicationCommunication

Family roles and organizationFamily roles and organization

EducationEducation

High-risk behaviorsHigh-risk behaviors

Health care practicesHealth care practices

Health care practitionersHealth care practitioners

ObjectivesObjectives

Clinician can utilize communication skills to:Clinician can utilize communication skills to:

Identify family concerns Identify family concerns

Improve teaching effectivenessImprove teaching effectiveness

Promote patient self-confidencePromote patient self-confidence

Disparity ConsiderationsDisparity Considerations

Work with each family to develop an action plan Work with each family to develop an action plan that takes into consideration: that takes into consideration:

The families cultural, ethnic, and socioeconomic The families cultural, ethnic, and socioeconomic background background

The asthma regimen neededThe asthma regimen needed The families ability to implement the plan, The families ability to implement the plan,

physically, socially and economicallyphysically, socially and economically The families high-risk behaviors that may The families high-risk behaviors that may

sabotage the plansabotage the plan

Communication Tips for Explaining AsthmaCommunication Tips for Explaining Asthma

Make it simple and use pictures of airways Make it simple and use pictures of airways

Use the “fist” example, asking parent/patient to Use the “fist” example, asking parent/patient to do it with you. do it with you.

Convey the dynamic Convey the dynamic

of open/shut airwaysof open/shut airways

InterventionsInterventions Provide written instructions in client’s preferred languageProvide written instructions in client’s preferred language

Implement some of their cultural practices into the plan of careImplement 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 Provide explanations for all Rx and OTC products at family in teaching. Emphasize not to share child’s treatment with otherstreatment with others

Educational level appropriate to client/family. Emphasize to call 911, if there’s no improvement in Educational level appropriate to client/family. Emphasize to call 911, if there’s no improvement in wheezing or breathingwheezing or breathing

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

Seek help from primary MD, regarding FDA approved prescriptions. Contact local smoke cessation Seek help from primary MD, regarding FDA approved prescriptions. Contact local smoke cessation

programs. programs. Baptist Health (202-7069), or Dept. of Health (825-5055)Baptist Health (202-7069), or Dept. of Health (825-5055)

Teachable MomentsTeachable Moments

Office visitsOffice visits Checking in Checking in RoomingRooming Phone callsPhone calls Grocery StoreGrocery Store Health fairsHealth fairs MentoringMentoring

Parents can ask…Parents can ask… Does my child need a "quick-relief inhaler" more than Does my child need a "quick-relief inhaler" more than TWO TIMES A WEEK?TWO TIMES A WEEK?

Does my child wake up at night with asthma more than TWO Does my child wake up at night with asthma more than TWO TIMES A MONTH?TIMES A MONTH?

Do we refill the "quick-relief inhaler" more than TWO TIMES A Do we refill the "quick-relief inhaler" more than TWO TIMES A YEAR?YEAR?

Do I smoke EARLY IN THE MORNING or EVENING?Do I smoke EARLY IN THE MORNING or EVENING?

If yes, the asthma OR SMOKING may not be control

ReferencesReferences

Association for the Advancement of Health Education,Association for the Advancement of Health Education,

Cultural Awareness and sensitivity: Guidelines forCultural Awareness and sensitivity: Guidelines for

Health Educators.Health Educators. Campinha-Bacote, J. (1999). Campinha-Bacote, J. (1999). The process of culturalThe process of cultural

competence in the delivery of health care services: competence in the delivery of health care services:

A culturally competent Model of care A culturally competent Model of care (3(3rdrd ed.). ed.).

Cincinnati, OH: Transcultural C.A.R.E. Associates.Cincinnati, OH: Transcultural C.A.R.E. Associates. Diversity in the workplace (1996).Washington DC: Diversity in the workplace (1996).Washington DC:

Veterans Health Association Management Support Veterans Health Association Management Support

Office.Office. Purnell, L., & Paulanka, B. (1998). Purnell, L., & Paulanka, B. (1998). Transcultural healthTranscultural health

care: A culturally competent approach. care: A culturally competent approach. Philadelphia:Philadelphia:

F. A. Davis.F. A. Davis.