19-01-12

Selection of a Conceptual Model/Framework for Guiding Research Interve

The Internet Journal of Advanced Nursing Practice ISSN: 1523-6064

Selection of a Conceptual Model/Framework for Guiding Research Interventions

Angela Coope B a h ai e Doc o al Candida e, Uni e i of To on o, Manage , P blic Heal h N ing

Citation: A.C. B a h ai e: Selec ion of a Concep al Model/F ame o k fo G iding Re ea ch In e en ion . The In e ne Jo nal of Ad anced N Ke w ords: c l e, c l ing P ac ice. 2003 Vol me 6 N mbe 1 al compe ence, heo , concep al model /f ame o k , c i e ia, e ea ch in e en ion

Abstract
Concep al f ame o k o model a e e ea che ed o g ide e ea ch ed fo die , n ing p ac ice and ed ca ional p og am , b l of a c i ical e ie i n fe of ha e de c ibed he c i e ia elec ing a concep al f ame o k fo g iding he de ign of an

ed ca ional in e en ion. Thi pape p e en model of c l hei c l al compe ence fo hei kill . C i e ia

he c i e ia fo app ai ing concep al model , e

he e model and applica ion of a model in de igning a e ea ch in e en ion. The in e iga o ha c i icall app ai ed i i abili o g ide he de elopmen of an in e en ion o a a e: Comp ehen i ene e (c l ili , and pe pec i e on c l e in efining e al compe ence ed o app ai e he model ac ion, clinical of con en , logical al li e ac Campinha-Baco e' e i p o ide di ec ion

cong ence, concep al cla i , le el of ab (1999) model of c l al compe ence i

e pe ien ial-phenomenological pe pec i e). Se e al of he model fo ed ca ion, p ac ice and e ea ch a ell a mee

me h ee o mo e c i e ia, b

elec ed o g ide he de elopmen of he in e en ion beca all he afo emen ioned c i e ia.

Introduction
Mo nde a heo e ea ch die ha e an e plici o implici heo , hich de c ibe , e plain , p edic o con ol he phenomenon ac han (B n & hich o i d . Theo ie a e linked o concep al model and f ame o k ; and a heo he ea a concep al model i mo e ab

ma be de i ed f om a model, he f ame o k i de i ed ded c i el f om he heo d ; and 2) a emp o e plain ho befo e elec ing one. In o de l n of a c i ical e ie he in e en ion

G o e , 2001). Theo ie a e impo an o in e en ion e al a ion e ea ch beca in e en ion and he de ign and cond c of he fac o facili a e o inhibi he effec i ene f ame o k a ailable of he in e en ion. The e i

e: 1) he g ide he de elopmen of he o k and heo ie

a need o e al a e diffe en of he li e a

i hin a opical a ea of in e e

o make an info med deci ion in e. Thi pape p e en

elec ing a concep al model, he a ho ha cond c ed a comp ehen i e e ie c i e ia fo app ai ing concep al model /f ame o k , e ing a model o de ign an ed ca ional in e en ion o a i

of he e model and he impo ance of al compe ence kill .

e in efining hei c l

Description of a Case Stud

P io o di c ing he c i e ia fo e al a ing he concep al model , he ill be offe ed o 140 egi e ed n hich a e deli e ed in fi e al concep ; c) C l o-ho ie e ill de c ibe a ca e ion , p o ided d of he e ea ch in So he n al in e en ion. The in e en ion e f om o P blic Heal h Depa men

On a io. I ha fi e componen , compe ence; b) C l e al a a ene

eekl fo fi e con ec i e boo e

eek . The e a e: a) An in od c ion o an c l ion i gi en o pa icipan

and an o e ie ion .

of Campinha-Baco e' model of c l al enco n e . A one-ho

al kno ledge; d) C l

al kill; and e) C l

a one mon h follo ing he e e al compe ence (1998) a

Campinha-Baco e' model of c l componen a c l al

ed o g ide he de ign of he in e en ion. The model ell a he choice of con en inco po a ed in o he of Campinhaal he ill al al a a ene ) i comp i ed of ill di c

make e plici he goal of each componen in he in e en ion a of he p og am. Fo e ample, he fi elf-a e men e e ci e and a of c l Baco e' model and an in od c ion o an c l a a ene p oce cond c and cha ac e i ic

componen of he in e en ion incl de and o e ie hich

al concep . The econd componen (c l im la ed game (Ba Fa Ba Fa),

ill enhance pa icipan ' c l i ion a ell a appl

al de i e. In he hi d componen (c l

al kno ledge), pa icipan

con en on biological a ia ion incl ding gene ic condi ion , a ia ion in d g me aboli m, and n e fo de eloping c l im la ed c l al a e al compe ence o ca e men on pee a al enco n e ), he Amba i e hem in die . In he fo h componen (c l he concep of ca ing, ill e plo e c o -c l e ponden and c l ell a di c e ponden

al kill), pa icipan

hich i an a pec of c l al diffe ence oc o -c l

de i e. In componen fi e (c l comm nica ion a ell a ole pla

in non- e bal al diffe ence ell a

1/9

ado game. Thi game e po e ill inc ea e hei c l

in non- e bal comm nica ion. I al o a i a ion. Th o gh hi in e en ion, n

ispub.com/

an fe ing lea ning f om he im la ed game o he clinical a ea o al a a ene al kno ledge a

/selection-of-a-conceptual-model-framework-for-guiding-res

19-01-12

Selection of a Conceptual Model/Framework for Guiding Research Interve

, A , ) , .T . L ,C -B ' (1998, 2002) , .T -

, ( )

, , ( ,

.F ,

. A / S (C , , : 1) A -B

, 2002); 2) C (L ( ), , 1995; C -B , 1999). T . 3) D '

' (T ' 1995; J ( T , , 1993); 7) )

; 4) &G ' , 1998); 5) (L , 1995; P , 1994); 6) ' (T . &G , 1998; D &Z (L , , 1995).

C i e ia fo E al a ing he Concep al Model /F ame o k in Gene al and C l Compe ence Specific

T , , , , , ). F ) . T . A , . E (F , , L (F , 1995). C .I . C , (F
ispub.com/

al

: C , ' (1995) , ( , ( ,

' , , , .T F ' (1995): C

.C , 1995). F , .A , . , ' . I , ,

.A , , 1995).

, , ,

/selection-of-a-conceptual-model-framework-for-guiding-res

2/9

19-01-12

Selection of a Conceptual Model/Framework for Guiding Research Interve

Le e ab ae C a ab

f ab ac i di ec ac e

ac i a ge f ea f he

efe c

he e e c ee ce . F e , c

i e ab

b ce

hich c ac c hi f ae h

ce ce

a e e e e ed i a c ae h e ha a e ea de e . i ab e i c de g a d he d f

ce

a i e e

de . Le e

ac . Ab ified i e, he c ce

i i ed b ab e (O

ace a d i Wa e & c ei ai g ide i e ,

ab e. Si i a h e he

c ee c a e ca e a

e ha a e di ec a

A a , 1995). Whe c he ab ii efe a c ide ed ide i g ef .

a ,a a a idd e a ge de he ea

i e he c

c ee e e

ecific fac a idea

he ea Ci ica a a

ac e e i c de he a c i icia icabi i

he e ica c

a d e e a ce f he e i he de ee he he e de c e : The c i ica

ac ice (Sida i, 2000). Tha i , he hei ac ice. The de ' abi i di i ,i i e e a , a d he ee he e c

de i i i f e ce c

beca

a d he i a i he e he ha di i

a ha d a d g ide de i e ia he

ai i ac ice. If he

be a d e i g

The a ie a c ie i e

c ie i e: C .I he c ie he i

be de c ibed i a i e ac de a de hich

ec i e ach he c e

c e

a c gica e e

e e ce ha c i icia 'c e i

de . T ha e e a d de

di i c ei a e a e hi

ec i e a e ci ed i a ed de be

he hei e e

e ie ia - he

ec i e (D che & Za a , 1995). Acc di g edge a c gai e he c ie ' e ach, c i icia

D che a di g f

a d Za a (1995), he c hei c ie a d ha ' i ai .C

a i e ac a b c ibe

a i e ac a ac i i

b i c ea i g hei a i e ac a a de e i e a i e ac e i ah fac ac ica i a g ibi i a ge

edge f he c ie ha he

edge i a a a di

edgeab e ab

e he (T a g & Ge ge, 1998). ach i c de: 1) he e , 4) c i icia f e e i i g e e c ac i i ec e f c ie c a e i e a e e , 2) he e ac i i a e i e a c ie i i hi g e a e, a hei e a d e ea f

Cha ac e i ic ei 5) he c ie i iai ge e a i a i c h i di id a i di id a i . i a

f he c edge, 3) c e be ee i ed i ee hei

ecific ech i he ac i i

(D che & Za a , 1995). Adhe e ce ec g i e a d ac e ec diffe e a i e ac

he e cha ac e i ic e e c

ch a , he a d e h ha

e , he i

i g i di id a , fai e ha ec

edge i di id a diffe e ce e (T a g & Ge ge, 1998). F ee e f h ec e ach abe

e , a d fai e ee e

ec g i e ha i di id a eed . Addi i

i e a i e diffe e

e , i e a i e a d ada e a he ha f c

a , he c

A e a i e , he e edge b eache fe fe i i a c f hi /he c aee c f he i e a bi g

e ie ia - he e e a e aged edge i ai ce . The c ie e, a d ea

e f

gica a ii a d e a

ach ad e . Th i

ca e he e

ha

he c i icia fe e '

d e i a gica a edge he a d

a e cei e

e he c ie

ei a

e f h

, he hea hca e e ie ia - he he c ie e, he c ie edge a d i e

he c ie . I a e c ac i i e e. F bi g eed . e e

ach, hea hca e a d he e, g f f hi /he c

e d hei he c a d

. B h he c ie e , e ide i

e a

bi g

e ce i a

hi e he c i icia ee he c ie ' e i e e ; ac e he i gica e e ac i i

edge f he hea h ca e i h each

di ea e a d e

ha e hei

ge he he de e

ag eeab e g a a d a a f he e e ie ia - he e, 3) e c e ac i i

Cha ac e i ic i ici 5) ce Adhe e ce diffe e ce c e ha be

ec i e i c de: 1) he c ec a i a a d 6) e ha c ie a i e e f hei

ac i i

e a

ea e , 2) he i e f he f f 'c

ai ac i i ac i i

a d e, e.

f he i e a i ed c - ie ed ech i i hi g e ;a d

f i di id a i e e a be efi edge e a ic a d a

e, 4) ai e f c i ica

a dc i

ed b

e f-e a i a i ee e hei c ie

he e cha ac e i ic ee hei

ch a : Ac

edgi g a d

ec i g i di id a di e e e e . i hi a c

i e a i e diffe e c e a e a

ec i e eed ; c

ei d

cha gi g; he e i

e a ia i

ee c

ec g i e he

Re ie
Si de

of Si Concep al Model /F ame o k Ba ed on he C i e ia

fc a c e e e ce f a e e: C ec i e f c e (1992), C he e i ied e e c i ica ehe i e e e. M de , Ba de beca a f c , De e he f de e ai ed i f e , de a gica c de e e ea ch i e hich ce de a he ed a c ii f ab ia e e he ac i , ed ca i a i e e i d . The c i e ia

g ide he de e de /f a e c i ica LaF de e ii de e

ispub.com/

g e ce, c

a ca i , e e

ii

a d e e

e ie ed i c ded: Ca ide a hi e ( ica e ,

i ha-Bac e (1998, 2002), P e cia de ch ec i e (Ca gi c a c ch

e (1998, 2002), e e ce ( gi de a e

b i e a d F ed be e

i , a d I acc (1989), Wi

(1999), a d G ee (1995, 1982). The e ,a d (LaF ); ha e c i ica e , a d Wi ), e ) ha e

e ie e ha ch

ee 1989-1999); ha e a a ie e ea ch. N ed f he ha e de e

a d ca be a ed e f he

e ha e de e

ed h ee f he e a .), a d

i ha-Bac e, P

S cia W

de (G ee , C

b i e &F

de .
3/9

/selection-of-a-conceptual-model-framework-for-guiding-res

19-01-12

Selection of a Conceptual Model/Framework for Guiding Research Interve

All of these models define cultural competence as a process and are applicable to practice. According to Campinha-Bacote (1998), cultural competence is defined as a process in w hich the healthcare provider continuously strives to achieve the ability to effectively w ork w ithin the cultural context of a client/individual, or family or community (1999, p. 203). Similarly, Purnell (2002) defines cultural competence as adapting care in a manner that is consistent w ith the client's culture and is therefore a conscious process and nonlinear. Cross et al. define cultural competence as those professionals to w ork effectively in cross-cultural situations (1989, p ii). LaFromboise and Foster (1992) describe a cross-culturally competent psychologist as being able to display skill, self confidence, and w illingness to be flexible in responding to the needs of clients from diverse cultures. Alternatively, Green (1995, 1982) describes cultural competence as an evolving process on a continuum, w here individuals and organisations move tow ard cultural competence, but the process is never completed. Lastly, Wills (1999), does not define cultural competence but perceives it as a seven-step progression tow ard the achievement of cultural competence. a set of congruent behaviours, attitudes, and policies that come together in a system, agency, or among professionals and enable that system, agency, or

C i ical App ai al of he Model

Purnell's model (1998, 2002) is comprehensive in content, very abstract, has logical congruence, conceptual clarity, demonstrates clinical utility and espouses the experiential-phenomenological perspective (see Table 1). It provides a comprehensive, systematic and concise framew ork to assist health care professionals in providing individualised, culturally competent and appropriate care to clients. It can be used in practice to assess individuals, a family, community or society. The model's philosophical claim is explicit and the model reflects more than one contrasting w orld view . Additionally, it is easy to apply and is relevant to any culture or setting. It has been used in staff development and academic settings in many countries. Lastly, the model w as used to guide ethnographic, ethnomethodological and constitutive ethnographical research studies (Purnell, 2002). Campinha-Bacote's model is comprehensive in content, has a high level of abstraction, conceptual clarity, and logical congruence as w ell as demonstrates clinical utility (Table 1). The model advocates the experiential-phenomenological perspective of culture. Nurse educators can use the model to teach nurses how to deliver culturally competent nursing care by incorporating all its constructs in and education program. The model's philosophical claim is explicit and it reflects more than one contrasting w orld view . For example, it reflects more than one field of know ledge (skill acquisition, transcultural nursing, medical anthropology, and multicultural counselling), w hich are combined in a consistent manner (Campinha-Bacote, 2002). Furthermore, the sources of know ledge are congruent w ith nursing w orld view . Lastly, this model has provided direction for empirical research using pre-test post-test designs and the development of interventions.

ispub.com/

/selection-of-a-conceptual-model-framework-for-guiding-res

4/9

19-01-12

Selection of a Conceptual Model/Framework for Guiding Research Interve

Table 1: C i i

e of Model

ispub.com/

/selection-of-a-conceptual-model-framework-for-guiding-res

5/9

19-01-12

Selection of a Conceptual Model/Framework for Guiding Research Interve

ispub.com/

/selection-of-a-conceptual-model-framework-for-guiding-res

6/9

19-01-12

Selection of a Conceptual Model/Framework for Guiding Research Interve

The ne

model o be di c

ed i LaF omboi e and Fo e ' model (1992). Thi model i comp ehen i e in con en , ha a and logical cong ence i h demon a ed clinical ili (Table 1). al li e ac of c l

mode a e le el of ab

ac ion, ha concep al cla i

Limi a ion of hi model a e: 1) i ha no been e ed empi icall , and 2) ha adop ed ce ain a pec app oach (T ang & Geo ge, 1998). Co demon c l e al.' model (1989) i ili comp ehen i e in con en , ha

logical cong ence, and concep al cla i

ell a o gain ha

a e clinical

(Table 1). I emb ace bo h he e pe ien ial-phenomenological and c l of hi model a e: 1) i e po e

al li e ac pe pec i e ppo e

(T ang & Geo ge, 1998). Al ho gh he model ha mode a e le el of ab al compe ence. O he limi a ion p ac i ione empi icall b and o gani a ion ha e e pe c l c l

ac ion, i p o ide g ideline on ho a dominan po i ion ha p e

al kno ledge of hei clien . Thi e pec a ion i a ion. model ha

n eali ic, a p ac i ione

doe no ha e kno ledge of e e

e ha indi id al

ill enco n e in p ac ice. 2) Thi model ha no been e ed

g ided p ac ice, ed ca ion and admini ed i Will'

The fif h model o be di c cong ence (Table 1). I a lea ne and a ia ion p o ide di ec ion fo ppo

model (1999). Thi

concep al cla i , clinical eb e

ili , and logical

he e pe ien ial-phenomenological pe pec i e of c l

ecogni ing he p ac i ione conc e e, 2) i doe no

i hin a c l

e and g o p . Limi a ion of he model a e: 1) i i

e ea ch, ed ca ion, and admini al compe ence.

a ion, 3) i ha no been e ed empi icall , and 4) he de elope of

he model doe no define c l

ispub.com/

/selection-of-a-conceptual-model-framework-for-guiding-res

7/9

19-01-12

Selection of a Conceptual Model/Framework for Guiding Research Interve

,G

'

(1995, 1982) (T 1). L

, : 1)

, .C (C -B , 2002). 2) I

, T . C , : C -B P

3)

/ , ). S . M . , C ,

:C ( . H -B ' , ,

Ra ionale fo Selec ing Campinha-Baco e' Concep al Model

A ,C / ' ' . B . T . I . F , , ) . I . , , ( , , . F , , , C -B ' .F , .A , .T , -B ' .I ( ) .I

Co e pondence o
A C B 149 C S W ,O , L1N 5M3 E : . @ .

Refe ence
B C P C J C C C C C D F :A F G B J
ispub.com/

, N. & G C -B & B. J. P -B T -B -B E , N. & S :I , T. L., B , L. & Z ,

, S. (2001). T . -A . I T : F. A. D , 13 (3) 181-184 . -B .J , J., Y , T., & L N , P. (1997). T ( , B., D CASSP T , L. H. (1995). T , R., F , C., & M H , R. D .J , K. W. & I A . 70-79) (J. D , M. R. (1989). T C ,G , D. (1999). A T , 27 (2), 59-64. N , M. (1996). T C . , J. (1998). A , E ). P , J.(2002). T N , J. & C

, : A

,&

(4

). T

,O

W. B. S

. (L. D. :A .

, 10(3) 291-292. .J . I , U ). W C B T (3 :A N , 12(1) 48-55. E ).P . (2 .N : F. A. D E ). T P C :A , 18 (4) 30,

8/9

, DC: A D C

A . .F

N .M P

34, 389-399. , N., B , J. (1995). A , J. (1995, 1982). C . , L. (1993). U , '

/selection-of-a-conceptual-model-framework-for-guiding-res

19-01-12

Selection of a Conceptual Model/Framework for Guiding Research Interve

32, 37-38, 41- 43. LaFromboise, T. & Foster, S. (1992). Cross-cultural training: Scientist-practitioner model and methods. The Counseling Psychologist, 20, (3) 472-489. Leininger, M. (1995). Transcultural nursing: Concepts, theories, research, and practices (2 nd ed). New York: Mc Graw Hill. MacAvoy, S. & Troth Lippman, D. (2001). Teaching culturally competent care: Nursing students experience in rural Applachia. Journal of Transcultural Nursing, 12, (3) 221- 227. Olszew ski Walker, L. & Coalson Avant, K. (1995). Strategies for theory construction in nursing (3 rd Ed). Norw alk, CT: Appleton & Lange. Patcher, L. (1994). Culture and clinical care: Folk illness, beliefs and behaviours and their implications for health care delivery. Journal of American Medical Association, 27 (9) 690-694. Purnell, L. D. & Paulanka, B. J. (1998). Purnell's model for cultural competence. In Transcultural health care: A culturally competent approach (L.D. Purnell & B.J. Paulanka, eds). Philadelphia: F. A. Davis Company. Purnell, L. D. (2002). The Purnell's model for cultural competence. Journal of Transcultural Nursing, 13(3) 193-196. Sidani, S. (2000, September). Intervention theory, validity and clinical utility. Notes presented in Course: Evaluating Interventions in Clinical Settings, University of Toronto, Ontario. Spector, R. E. (1995). Cultural concepts of w omen's health and health-promoting behaviours. Journal of Gynaecologic and Neonatal Nursing, 24 (3) 241-245. Tsang, A. & George, U.(1998). Tow ard an integrated framew ork for cross-cultural social w ork practice. Canadian Social Work Review , 15 (1) 73-93. Wills, W. O. (1999). Culturally competent nursing care during the perinatal period. Journal of Perinatal and Neonatal Nursing, 13 (3) 45-59. Generated at: Thu, 19 Jan 2012 01:13:20 -0600 (000015ae) interventions.html http://w w w .ispub.com:80/journal/the-internet-journal-of-

advanced-nursing-practice/volume-6-number-1/selection-of-a-conceptual-model-framew ork-for-guiding-research-

ispub.com/

/selection-of-a-conceptual-model-framework-for-guiding-res

9/9