Purnell

Purnell's Model

Purnell's model is a circle with the outer ring representing global society. Global society is "world communications and politics; conflicts and warfare; natural disasters and famines; international exchanges in business, commerce, and information technology; advances in the health sciences; space exploration; and the increased ability for people to travel around the world and to interact with diverse societies." (p. 9).¹¹

The second ring is labeled "Community" and is defined as "a group of people having a common interest or identity and living in a specified locality." (p. 9).¹¹

The third ring represents "Family" and is defined as "two or more people who are emotionally involved with each other" (p. 9).¹¹

The fourth ring represents "Person" and is defined as "a biopsychosociocultural human being who is constantly adapting" (p. 9).¹¹

In from the person ring are 12 wedges that represent cultural domains and their concepts:

Overview/heritage
Includes concepts related to:
- Country of origin
- Current residence
- The effects of the topography of country of origin and current residence on health
- Economics
- Politics
- Reasons for migration
- Education status
- Occupations ^11,^{12,
  13}
Communication
Includes concepts related to:
- Dominant language
- Dialects
- Cultural communication patterns
  - Personal space
  - Body language
  - Touch
  - Temporal relationships
  - Format for names ^11,^{12,
    13}
Family roles and organization
Includes concepts related to:
- The head of the household
- Gender roles
- Family goals and priorities
- Developmental tasks of children and adolescents
- Roles of the aged
- Roles of extended family members
- Individual and social status in the community
- Acceptance of alternative lifestyles
  - Single parenting
  - Nontraditional sexual orientations
  - Childless marriages
  - Divorce ^11,^{12,
    13}
Workforce issues
Includes concepts related to:
- Autonomy
- Acculturation
- Assimilation
- Gender roles
- Ethnic communication styles
- Individualism
- Health care practices from the country of origin. ^{11, 12, 13}
Biocultural ecology
Includes concepts related to:
- Skin color
- Body type
- Diseases that are genetic, hereditary, topographic or endemic
- How the culture metabolizes drugs^{11, 12, 13}
High-risk behavior
Includes concepts related to:
- Drug use
- Alcohol use
- Nicotine use
- Dangerous behaviors
- Use of safety equipment (seat belts, helmets)
- High risk behaviors (sexually or otherwise)
- Degree of sedentary lifestyle
- Consumption of unhealthy food ^{11, 12, 13}
Nutrition
Includes concepts related to:
- Availability of food
- Rituals and taboos associated with food
- The meaning of food to the culture
- How food is used in sickness and in health^{11, 12, 13}
Pregnancy and childbearing practices
Includes concepts related to:
- Fertility practices
- Labor and delivery practices
- Practices that are considered taboo, prescriptive or restrictive during pregnancy
- Labor and postpartum^{11,
  12, 13}
Death rituals
Includes concepts related to:
- How death is viewed
- Euthanasia
- Preparation for death
- Burial practices
- Bereavement practices ^{11, 12, 13}
Spirituality
Includes concepts related to:
- Practices that give strength and meaning of life to a individual
- Religious practices
- How prayer is used^{11, 12, 13}
Health care practices
Includes concepts related to:
- Does the culture seek preventative or acute treatment?
- Magicoreligious healthcare beliefs
- Traditional practices
- Individual responsibility for health
- Self medicating practices
- iews towards issues such as
  - Organ donation
  - Mental illness
  - Rehabilitation
- How pain is expressed
- The sick role
- Barriers to health care^{11,
  12, 13}
Health care practitioners
Includes concepts related to:
- Type of practitioners the culture uses
  - Traditional, or folk
  - Biomedical
- Does gender of the practitioner comes in to play?
- What is the status the practitioner has in this culture?^11,^{12,
  13}