Topic 3 World View on Cultural and Spiritual Competence

Topic 3 DQ 2

World View on Cultural and Spiritual Competence and The Role Of Advanced Practice Nurse In Providing Spiritual and Cultural Care

In my worldview, I believe in the sociocultural scientific literature and its application to human health. Reducing and eventually eliminating the detrimental impacts of health inequalities necessitates cultural change. The notion of worldview is vital for health inequities education because it serves to alter the culture of health care workers toward a more self-reflective, modest, and open-minded stance over time (Sadat Hoseini et al., 2019).

Topic 3 World View on Cultural and Spiritual Competence

My worldview influences how I interpret the physical, emotional, and spiritual components of my patients’ life. This relates to the patient’s belief system on the nature of God, mankind, and existence, as well as what the patient desires in terms of therapy and what consoles the patient (Sadat Hoseini et al., 2019). This includes the patient’s spiritual and cultural background. God, humans, ethics, knowledge, and truth are all part of a cultural and spiritual worldview.

My duty as an APRN in cultural and spiritual competency is to contribute to my patients’ health and well-being. Spiritual well-being is linked to a variety of favorable outcomes, including increased tolerance of the mental and physical strains of sickness, less pain, tension, and negative feelings, and a reduced risk of both depression and suicidal thoughts (Harrad et al., 2019).

Patients who receive proper spiritual care are happier with their hospital care and therapy, and their chances of recovery improve while readmissions decrease. As an APRN, I may aid in the integration of spirituality and culture into patient care and satisfaction by including components such as a higher power, feelings of closeness with the patient, helping the patient to find a sense of meaning in life, and relationships (Harrad et al., 2019).

APRNs in healthcare systems collaborate to offer culturally competent care to patients so that they can receive quality treatment and be happy with it. The quality of interactions between patients and health professionals improves cultural and spiritual competence (Swihart et al., 2021).

Learning the various cultural practices and beliefs of diverse patients is critical for an APRN, and collaborating with a diverse group of health professionals from various ethnic, cultural, and religious backgrounds improves the quality of patient-health professional interrelationships and is associated with higher contentment in the healthcare provider and patient.

According to Swihart et al. (2021), African Americans, Asian Americans, Latinos, and Muslims experience compromised quality of their care due to their ethnicity or color, as well as a health care provider’s lack of cultural understanding.

References for Topic 3 World View on Cultural and Spiritual Competence

  • Harrad, R., Cosentino, C., Keasley, R., & Sulla, F. (2019). Spiritual care in nursing: an overview of the measures used to assess spiritual care provision and related factors amongst nurses. Acta Bio-Medica : Atenei Parmensis90(4-S), 44–55.
  • Sadat Hoseini, A. S., Razaghi, N., Khosro Panah, A. H., & Dehghan Nayeri, N. (2019). A concept analysis of spiritual health. Journal of Religion and Health58(4), 1025–1046.
  • Swihart, D. L., Yarrarapu, S. N. S., & Martin, R. L. (2021). Cultural religious competence in clinical practice. In StatPearls [Internet]. StatPearls Publishing.

Diversity in Healthcare Essay Sample

The concept of culture in healthcare is increasingly gaining relevance. According to Tucker et al. (2017), culture is defined as the patterns of behaviors and thoughts that distinguish a particular social group from others. Culture entails parameters such as knowledge, beliefs, morals, arts, customs and laws (Tucker et al., 2017). To enable a culturally sensitive and competent healthcare practice, healthcare providers must ensure that they transcend beyond their culture bound assumptions.

Apparently, due to the aspect of multiculturalism, the concept of culturally sensitive care is pertinent. The impetus for the need of a culturally sensitive care includes the many diverse communities and origins that prefer to preserve their cultures rather than being assimilated. Therefore, it is mandatory for healthcare workers to acquire cultural competence in a bid to reduce healthcare disparities. The purpose of this writing is to explain the relevance of cultural sensitivity in healthcare using the Purnell’s model of culture.

Culturally Sensitive Care and its Application in Healthcare

Most of the times, the words cultural sensitivity and cultural competence are incorrectly used interchangeably. Tucker et al. (2017) delineate the difference as follows: while cultural sensitive healthcare is the system that takes care of the feelings and attitudes of a people with a common distinguishing characteristic such as religion or a socioeconomic status, cultural competence refers to gaining an understanding of culturally diverse patient groups. The difference is however not profound in healthcare, since practicing a culturally sensitive care requires culturally competent healthcare workers.

Cultural sensitivity is undoubtedly significant in healthcare. Tucker et al (2017) relates cultural sensitivity with patient outcomes and satisfaction. In their explanation, lack of knowledge and awareness impacts patients’ response to medications. Knowledge being a parameter of culture, nurses are obliged to educate patients on the importance of drug adherence.

Lack of knowledge and awareness concerning drug adherence therefore causes less medication compliance which in turn have a negative impact on patient outcomes (Ray, 2016; Tucker et al., 2017). Additionally, patient centered cultural sensitivity enables engagement in health promotion activities which positively and directly improves patient outcomes such as blood pressure and glucose levels.

Purnell’s Theory and Organizational Framework

The theory was proposed by Purnell and Paulanka and is represented in the form of a model. The model is broadly utilized in the pedagogy of intercultural competence, mostly within the nursing practice. However, it can also be used by other professions besides nursing. This is important especially in the contemporary nursing practice which requires an inter-professional collaboration (Purnell, 2018).

The model is in the form of a circle with different rims representing metaparadigms in nursing practice. The outer circle represents the global society and its effect on the culture of a population. An example includes technological advancement and impact on civilization (Purnell, 2018). The second circle represents the community and the divergent ethics and values of its population.

The third rim represents the family while the inner rim represents the person’s sense of self, ideas, values and beliefs (Purnell, 2018). Further, there are 12 pie-shaped wedges in the interior of the circle that depicts the different cultural domains, and a black circle at the center of the model representing unknown phenomena. The objective of the model is to provide an explanation of various occurrences and situations that influence an individual’s culture.

The theory is relevant to transcultural healthcare in various ways. The healthcare workers use the model to provide a culturally competent care to patients (Purnell, 2018). Further, the model is applied in learning and teaching of nursing students. For example, it is used to fabricate a culturally sensitive curriculum for undergraduate nurses (Purnell, 2018). Additionally, in the administration, the model is used in training of employees.

For instance, administrators and employees are required to collaborate with each other irrespective of the cultural backgrounds of their fellows (Purnell, 2018). The application of the model in employee training ultimately leads to formation of an organizational culture that recognizes and respects an individual’s culture and dignity. Moreover, in a bid to maintain the ethical standards in research (consent seeking and information gathering); multiple individuals have used the model.

Purnell’s 12-Domains of Culture

As aforementioned, the model is divided into 12-domains that are interrelated. The first domain is the overview or heritage. The domain relays concepts related to origin, residence, economics and politics (Purnell, 2018). The second domain (communication) relays concepts related to language and dialect. Multiple shreds of evidence underpin that language barriers significantly affect patient-nurse therapeutic relationships.

The third domain reflects concepts about family roles and organization. In this domain, the head of the household, gender roles and priorities are some of its concepts. The fourth domain includes the workforce issues and its effect on the individual and health (Purnell, 2018). Bio-cultural ecology which is the fifth domain reflects the biological variations among a diverse population that impacts their culture. The sixth domain includes the high risk behaviors such as tobacco smoking and alcohol drinking. The behaviors exist among all culture; however, the degree and their impact significantly vary.

Nutrition and its concepts such as the meaning of foods, common foods and rituals make the seventh domain. Further, pregnancy and childbearing is the eighth domain. Various communities have diverse beliefs and perceptions regarding pregnancy. For example, in my community, it was initially believed that miscarriage is a sign of a bad omen. However, with the increasing awareness and availability of knowledge, people have gradually accepted the scientific basis of miscarriage and abortion. Additional domains include death rituals, spirituality, healthcare practices and healthcare providers (Purnell, 2018).

Application of Purnell’s Model to increase Cultural Competence as a Healthcare Provider

To effectively practice nursing, a nurse must acquire cultural competence. This is essential since healthcare providers deal with patients and colleagues from various cultural and ethnic backgrounds. The Purnell model for cultural competence enables nurses acquire knowledge and information relevant to diverse cultures (Purnel, 2018; Ray, 2016; Shepherd et al., 2019).

A culturally competent nurse is able to determine various needs of a patient and decide on appropriate approach mechanisms. Additionally, the model represents different outlooks of the world and their impact on the culture of patients. The various outlooks include impact of the global society, community, family and personal issues on health (Purnell, 2018). Other than the nurse-patient relationship, the model also impacts nurse-nurse relationship. The ability of healthcare workers to coexist harmoniously and practice without disunity implies cultural competence and sensitivity.


The concept of culture in healthcare is pertinent. Healthcare providers are required to acquire cultural competence before they begin practice. Therefore, it is crucial to fabricate a culturally sensitive educational curriculum in nursing pedagogy (Jongen, McCalman & Bainbridge, 2018). The Purnell model for cultural competence relays the information concerning the components and the domains of cultures.

The model has been used by nurses and other professions to provide a cultural competent care (Jongen et al., 2018). Areas where the model is increasingly used include nursing practice, learning and teaching, administration and research. Even though the model informs a culturally competent care, other scholars view its visual complexity as a limitation. This does not undermine its significance in healthcare but calls for a modification to a simpler yet a more elaborative model that serves the same purpose.


  • Jongen, C., McCalman, J., & Bainbridge, R. (2018). Health workforce cultural competency interventions: a systematic scoping review. BMC Health Services Research, 18(1).
  • Purnell, L. (2018). Update: The Purnell Theory and Model for Culturally Competent Health Care. Journal Of Transcultural Nursing, 30(2), 98-105.
  • Ray, M. (2016). Transcultural Caring Dynamics in Nursing Healthcare (2nd edition). Philadelphia: F.A. Davis Company.
  • Shepherd, S., Willis-Esqueda, C., Newton, D., Sivasubramaniam, D., & Paradies, Y. (2019). The challenge of cultural competence in the workplace: perspectives of healthcare providers. BMC Health Services Research, 19(1).
  • Tucker, C., Arthur, T., Roncoroni, J., Wall, W., & Sanchez, J. (2013). Patient-Centered, Culturally Sensitive Health Care. American Journal Of Lifestyle Medicine, 9(1), 63-77.