Discuss the Pregnancy construct of Purnell’s model as it relates to your selected culture and address each of the sub-constructs list below: o    Fertility practices o    Views toward pregnancy o    Pregnancy beliefs o    Birthing o    Post-partum (including child rearing)

MHS 502 SLP#3 Cultural Diversity of Health science

Module 3 – SLP
Cultural Context in Health Sciences, Pregnancy, Nutrition, and Risk Behaviors
Background: In this module you will continue to explore different aspects of the culture that you selected in Module 1. This module, as evidence of your progress, you will submit a paper addressing the constructs of Purnell’s model listed below. Subheadings should be used that address each of the papers requirements.
1.    Discuss the Pregnancy construct of Purnell’s model as it relates to your selected culture and address each of the sub-constructs list below:
o    Fertility practices
o    Views toward pregnancy
o    Pregnancy beliefs
o    Birthing
o    Post-partum (including child rearing)
2.    Discuss the Nutrition construct of Purnell’s model as it relates to your selected culture and address each of the sub-constructs list below:
o    Meaning of food
o    Common foods
o    Rituals
o    Deficiencies
o    Limitations
o    Health Promotion
3.    Discuss the High-Risk behaviors construct of Purnell’s model as it relates to your selected culture and address each of the sub-constructs list below:
o    Tobacco
o    Alcohol
o    Recreational drugs
o    Physical activity
o    Safety
SLP Assignment Expectations
Use information from your module readings/articles as well as appropriate research to support your selection.
Length: The SLP assignment should be 3-5 pages long (double-spaced).
References: At least three references must be included from academic sources (e.g., peer-reviewed journal articles). Required Reading is included. Quoted materials should not exceed 10% of the total paper (since the focus of these assignments is critical thinking). Use your own words and build on the ideas of others. Materials copied verbatim from external sources must be enclosed in quotation marks. In-text citations are required as well as a list of references at the end of the assignment. (APA format is recommended.)
Organization: Subheadings should be used to organize your paper according to the questions.
Format: APA format is recommended for this assignment.
Grammar and Spelling: While no points are deducted for minor errors, assignments are expected to adhere to standard guidelines of grammar, spelling, punctuation, and sentence syntax. Points may be deducted if grammar and spelling impact clarity.
Your assignment will not be graded until you have submitted an Originality Report with a score <20%. Papers not meeting this requirement by the end of the session will receive a score of 0 (grade of F).
The following items will be assessed in particular:
•    Achievement of learning objectives for SLP assignment.
•    Relevance – All content is connected to the question.
•    Precision – Specific question is addressed. Statements, facts, and statistics are specific and accurate.
•    Depth of discussion – Points that lead to deeper issues are presented and integrated.
•    Breadth – Multiple perspectives and references, and multiple issues/factors are considered.
•    Evidence – Points are well supported with facts, statistics, and references.
•    Logic – Discussion makes sense; conclusions are logically supported by premises, statements, or factual information.
•    Clarity – Writing is concise and understandable, and contains sufficient detail or examples.
•    Objectivity – Avoids the use of first person and subjective bias.
Additional Resources
Link to the Purnell Model of cultural competence: Purnell Model of Cultural Competence
Your response should be based on reliable and scholarly material, such as peer-reviewed articles, white papers, technical papers, etc.. Do not include information from non-scholarly materials such as Wikis, encyclopedias, www.freearticles.com (or similar websites).

Module 3 – Background
Cultural Context in Health Sciences, Pregnancy, Nutrition, and Risk Behaviors
Case Background
Robinson, Callister, Berry, and Dearing, (2008) suggest that the phenomenon of patient centered care (PCC) is a measure of the quality of health care and that promoting PCC activities will improve adherence and encourage patient responsibility. They present a global perspective of patient-centered care (PCC) that reveals key vantage points of this phenomenon. Their work suggests that the healthcare field views PCC through the various perspectives.
Robinson, Callister, Berry, and Dearing, (2008) assert that PCC is a partnership between practitioners, patients, and their families to ensure that decisions respect patient’s wants, needs, and preferences that has several perspectives. The economic perspective recognizes patients’ ability to make informed healthcare choices that balance cost, quality, convenience, and other services characteristics. The clinical perspective is noted to integrate the patient perspective and preferences while involving the patient in decision making and self-care. The authors notes that the patient perspective includes respect, courtesy, competence, efficiency, patient involvement indecisions, time for care, availability/accessibility, information, exploring patient’s needs, and communication.
Flach et al. (2004) sought to examine the relationship between PCC and the provision of preventive services, and they theorized that PCC is related to prevention care delivery. The work by these authors implies that dimensions within PCC are most closely related to adapting to individuals in and improving and supporting patients improves the delivery of care. Unlike the global perspective provided by Robinson and her colleagues, Flach and his colleagues provide an organizational/clinical perspective of PCC used by the Veterans Health Administration including the following domains: access to care, incorporating patient preferences, patient education, visit coordination, overall coordination of care, courtesy of care, continuity of care, and emotional support.
A major finding by Flach et al. (2004) is that improved communication specifically continuity of care and emotional support are associated with improved preventive care delivery. The remaining dimensions of PCC include the following: access to care, incorporating patient preferences, patient education, visit coordination, overall coordination of care, courtesy of care were not found to be associated with the delivery of preventive care. This literature supports the idea that improving communication and emotional support augments provider ability to receive, interpret, and respond to the patient (thus adapting) has the potential to improve the delivery of care.
The goal of PCC is to develop individualized treatment based on an understanding of the physiological, environmental, and psychosocial contexts within which each person’s illnesses or dysfunctions occur (Robinson et al., 2008; Flach et al., 2004; Galland, 2006). This literature illustrates PCC as the idea perspective for the delivery of culturally competent care.
Session Long Project Background
Sub-constructs of this domain include:
•    Fertility practices
•    Views toward pregnancy
•    Pregnancy beliefs
•    Birthing
•    Post-partum (including child rearing)
Each culture has individual thoughts and beliefs regarding pregnancy, family size and views about childbearing and child-rearing. In some cultures, pregnancy outside of marriage is considered shameful, whereas this practice does not carry the same stigma in other societies. Fertility practices (depending upon country and culture) range from “superstitions” to high-tech laboratory methods of conception.
Birthing practices also vary by culture. Many cultures view childbirth as quite a natural experience and women deliver children at home attended by a female family member of a trained or untrained midwife. Western medicine has transformed the birth experience into a “medical procedure”. For many women who go into active labor, their first lament is “get me to the hospital”. Not so long ago in the United States, men were forbidden by the health care establishment to accompany the laboring woman during child birth.
Depending upon culture, different beliefs are held with respect as to how a child should be raised. Some societies have concepts of gender inequality deeply engrained (usually manifested in terms of female children not being considered “worth as much” as a male child). In these societies, female children may be denied food, education or health care because they are viewed as a liability to the family (a liability in that she must be married and the father may have to pay a dowry in order for the male to marry her). In some nations of the world (specifically some Third World nations), the atrocity of infanticide (of female infants) occurs.
Sub-constructs of this domain include:
•    Meaning of food
•    Common foods
•    Rituals
•    Deficiencies
•    Limitations
•    Health Promotion
Food plays a central role in virtually every culture. To see an example of this, you don’t have to look much farther than your own family. What meals are prepared at important or significant times? Whether it’s turkey for Thanksgiving or cake at a wedding or birthday celebration, different cultures do have some degree of unifying theme in terms of common foods and special meals. The following link will provide you with some Ethnic and cultural resources.
In some nations of the world, procurement of food is not as easy as a stroll to the local supermarket. Poverty and famine are realities in many countries resulting in nutritional deficiencies. Malnutrition is also a problem in many developed countries. Obesity is becoming a major problem here in the United States for a multiplicity of reasons including increased sedentary activity associated with computer use and poverty (poor people tend to purchase foods that are cheaper which have higher processed sugar content and lower nutritive value).
A comprehensive study of culture demands that we consider the role and challenges associated with food.
High-Risk Behaviors
Sub-constructs of this domain include:
•    Tobacco
•    Alcohol
•    Recreational drugs
•    Physical activity
•    Safety
Risk-taking behaviors are those behaviors that put an individual at risk for disease, injury or even death. Examples of this can be seen in every culture. In some parts of the world, prostitution is an important part of the local economy. This behavior, however, is associated with pregnancy and sexually transmitted diseases.
Tobacco use, alcohol and recreational drug use are other examples of risk taking behaviors. Recreational drug use continues to be a major problem in many parts of the world. Lack of physical activity, coupled with a sedentary lifestyle has resulted in obesity and increased risk of heart disease and diabetes for many cultural groups.
This module’s background reading will consider some of these concepts.
Required Reading
Primm, A. B., Osher, F. C. & Gomez, M. B. (2005, October). Race and ethnicity, mental health services and criminal competence in the criminal justice system: Are we ready to change? Community mental health journal, 41(5), 557-569.
Purnell, L. (2005). The Purnell model for cultural competence [Electronic version].Journal of multicultural nursing & health, 11(2), 7-15.
Sheth, S. S. (2006). Missing female births in India [Electronic version]. The Lancet, 367(9506), 185-186.
U.S. Department of Agriculture (2006, August 23).Ethic and cultural resources. Retrieved from http://fnic.nal.usda.gov/professional-and-career-resources/ethnic-and-cultural-resources
Denison, D., & Mishra, A. (1989). Organizational Culture and Organizational Effectiveness: A Theory and Some Preliminary Empirical Evidence. Academy of Management Proceedings.Retrieved from http://www.denisonconsulting.com/sites/default/files/documents/resources/denison-1989-preliminary-evidence_0.pdf
Recommended Reading
Robinson, J., Callister, L., Berry, J., & Dearing, K. (2008). Patient-centered care and adherence: definitions and applications to improve outcomes. Journal Of The American Academy Of Nurse Practitioners, 20(12), 600-607.doi:10.1111/j.1745-7599.2008.00360.x
Omeri, A. (2008) Pathways of Cultural Awareness.Advances in Contemporary Transcultural Nursing, 28:ix-xi. Retrieved from
Samandari, G., Speizer, I. (2010). Adolescent Sexual Behavior and Reproductive Outcomes in Central America: Trends over the Past Two Decades. International Perspective on Sexual and Reproductive Health, 36(1), 26.

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