Purnells Assessment Model*
Purnells model includes 12 domains to assess the ethnocultural
attributes of an individual, family, or group.
Overview, Inhabited Localities, and Topographies
- Identify the part of the world from which this cultural or ethnic group originates and
describe the climate and topography of the country.
- Identify where this group predominately resides and include approximate numbers.
- Identify major factors that motivated this group to emigrate.
- Explore economic or political factors that have influenced this groups
acculturation and professional development in America.
- Assess the educational attainment and value place on education by this ethnic group.
- Identify occupations that individuals in this group predominately seek on immigration.
- Identify the dominant language of this group.
- Identify the dialects that may interfere with communication.
- Explore the contextual speech patterns of this group. What is the usual tone and volume
- Explore the willingness of individuals to share thoughts, feelings, and ideas.
- Explore the practice and meaning of touch in their society: within the family, between
friends, with strangers, with members of the same sex, with members of the opposite sex,
and with health care providers.
- Identify personal spatial and distancing characteristics when communicating on a
one-to-one basis. Explore how distancing changes with friends versus strangers.
- Explore the use of eye contact within this group. Does avoidance of eye contact have
special meanings? How does eye contact vary among family, friends, and strangers? Does eye
contact change among socioeconomic groups?
- Explore the meaning of various facial expressions. Do specific facial expressions have
special meaning? Do persons seem to smile a lot? How are emotions displayed or not
displayed in facial expressions?
- Are there acceptable ways of standing and greeting outsiders?
- Explore temporal relationships in this group. Are individuals primarily past, present,
or future-oriented? How do individuals see the context of past, present, and future?
- Identify how differences in interpretation of social versus clock time are perceived.
- Explore how time factors are interpreted by this group. Are individuals expected to be
punctual in terms of jobs, appointments, and social engagements?
- Explore the format for a persons name.
- How does one expect to be greeted by strangers and health-care practitioners?
Family Roles and Organization
- Identify the perceived head of the household. How does this change during different
developmental aspects of life?
- Describe gender-related roles of men and women in the family system.
- Identify prescriptive, restrictive, and taboo behaviors for children.
- Identify prescriptive, restrictive, and taboo behaviors for adolescents.
- Describe family goals and priorities emphasized in this culture.
- Explore developmental tasks in this group.
- Explore the status and role of the aged in the family.
- Explore the roles and importance of extended family members.
- Describe how one gains social status in this cultural system. Is there a caste system?
- Describe how alternative lifestyles and nontraditional families such as single parents,
blended families, communal families, same-sex families, etc., are viewed by this society.
- Identify specific workforce issues affected by immigration, e.g., education.
- Describe specific multicultural considerations when working with this culturally diverse
individual or group in the workforce.
- Explore factors influencing patterns of acculturation in this cultural group.
- Explore native health-care practices and their influence in the workforce.
- Identify cultural issues related to professional autonomy, superior or subordinate
control, religious issues, and gender in the workforce.
- Identify language barriers with concrete interpretations of the language.
- Identify the skin color and physical variations for this group.
- Explore any special problems or concerns the skin color may pose for health care
- Identify biologic variations in body habitus or structure.
- Identify specific risk factors for individuals related to the topography or climate.
- Identify any hereditary or genetic diseases or conditions that are common with this
- Identify any endemic diseases specific to this cultural or ethnic group.
- Identify any diseases or health conditions for which this group has increased
- Identify specific variations in drug metabolism, drug interactions, and related side
High Risk Behaviors
- Identify specific high-risk behaviors common among this group.
- Explore behaviors related to the use of alcohol, tobacco, and recreational drugs and
other substances among this group.
- Identify the typical health-seeking behaviors in this group.
- Assess the level of physical activity in their lifestyle.
- Assess the use of safety measures such as seat belts and helmets.
- Explore the meaning of food to this group.
- Identify foods, preparation practices, and major ingredients commonly used by this
- Identify specific food rituals.
- Identify dietary practices used to promote health or treat illness in this cultural
- Identify enzyme deficiencies or food intolerance commonly experienced by this group.
- Identify large-scale or significant nutritional deficiencies experienced by this group.
- Identify native food limitations in America that may cause special health difficulties.
Pregnancy and Child Bearing Practices
- Explore cultural views and practices related to fertility control.
- Identify cultural practices and view toward pregnancy.
- Identify prescriptive, restrictive, and taboo practices related to pregnancy such as
foods, exercise, intercourse, and avoidance of weather-related conditions.
- Identify prescriptive, restrictive, and taboo practices related to the birthing process
such as reactions during labor, presence of men, position for delivery, preferred types of
health care practitioners, or place of delivery.
- Identify prescriptive, restrictive, and taboo practices related to the post partum
periods such as bathing, cord care, exercise, foods, and roles of men.
- Identify culturally specific death rituals and expectations.
- Explain the purpose of death rituals and mourning practices.
- What are specific burial practices, such as cremation?
- Identify the meaning of death, dying, and afterlife.
- Identify the influences of the dominant religion of this group on health-care practices.
- Explore the use of prayer, meditation, and other activities or symbols that help
individuals reach fulfillment.
- Explore what gives meaning to life for individuals.
- Identify the individual's sources of strength.
- Explore the relationship between spiritual beliefs and health practices.
Health Care Practices
- Identify predominant beliefs that influence health-care practices.
- Describe the influences of health promotion and prevention practices.
- Describe the focus of acute-care practice (curative or fatalistic).
- Explore who assumes responsibility for health care in this culture.
- Explore behaviors associated with the use of over-the-counter medications.
- Explore the combinations of magicoreligious beliefs, folklore, and traditional beliefs
that influence health care behaviors.
- Identify barriers to health care such as language, economics, and geography for this
- Explore cultural beliefs and responses to pain that influences interventions. Does
pain have a special meaning?
- Describe beliefs and views about mental illness in this culture.
- Differentiate between the perceptions of mentally and physically handicapped in this
- Describe cultural beliefs and practices related to chronicity and rehabilitation.
- Identify cultural perceptions of the sick role in this group.
- Describe the acceptance of blood transfusions, organ donation, and transplantation among
Health Care Practitioners
- Explore the roles of traditional, folklore, and magicoreligious practitioners and their
influence on health practitioners.
- Describe the acceptance of health-care practitioners with this group.
- Identify the status of health-care providers in this culture.
- Describe how different health-care practitioners view each other.
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