Cultural competence among nurses and its influencing factors: A cross-sectional study

Cultural competence and associated factors among nurses working in public hospitals of South Wollo zone, Northeast Ethiopia: a multi-center cross-sectional study

BACKGROUND

Enhancing cultural competence stands as a cornerstone in the realm of clinical nursing. Consequently, nurses engaging with culturally diverse communities encounter significant challenges. In Ethiopia, nurses providing care often prioritize physical well-being, the therapeutic journey, and medical interventions, while overlooking the critical cultural dimensions of patient care. Therefore, this study aims to assess the level of cultural competence and its determining factors among nurses employed in public hospitals located in the South Wollo Zone of northeastern Ethiopia.

METHODS

A multicenter, institution-based cross-sectional study was conducted, involving 629 nurses employed in public hospitals across northeastern Ethiopia. Participants were selected using a simple random sampling method. Data were gathered using a structured, self-administered English version of the Nurse Cultural Competence Scale Questionnaire (NCCSQ), and subsequently entered into Epi-data 4.6 for analysis. Statistical analysis was performed using SPSS version 26, employing multiple linear regression analysis to identify determining factors.

RESULT

The participants' overall mean score for cultural competence was 3.198 [95% CI: 3.161, 3.234]. Specifically, factors such as being a female nurse (β = 0.089, CI: 0.019-0.159), having a diploma level of education (β = -0.084, CI: -0.101 to -0.007), having 11-20 years of work experience (β = 0.412, CI: 0.090-0.815), a 1:15 nurse-to-patient ratio (β = 0.081, CI: 0.010-0.162), experience with caring for culturally and ethnically diverse patients (β = 0.362, CI: 0.248-0.476), comprehensive hospital level (β = 0.699, CI: 0.496-0.903), and attending cultural training (β = 0.002, CI: 0.234-0.931) were predictors of the mean score for cultural competence.

CONCLUSION

In this study, the level of cultural competence was found to be at a moderate level and need more effort. Factors such as gender, years of work experience, nurse-to-patient ratio, experience in caring for culturally and ethnically diverse patients, hospital level, educational attainment, attendance of cultural training, and the presence of a feedback system for cultural competence were identified as predictors of cultural competence level. Sharing experiences from higher-level hospitals to lower-level ones and strengthening cultural competence training sessions for nurses can significantly enhance cultural competence within clinical settings.

Self-reported cultural competence among Czech and Slovakian nurses: A comparative correlation study

AIM

This study aimed to compare the level of cultural competence among nurses working in clinical practice in Slovakia and the Czech Republic.

BACKGROUND

Demographic changes have greatly affected the health sector in Slovakia and the Czech Republic. By identifying the level of nurses' cultural competence, many of the complications encountered in caring for patients from different cultures can be avoided. However, few studies have explored the cultural competence of nurses in clinical practice in these countries.

METHOD

This study was cross-sectional, descriptive, and comparative. It followed the STROBE checklist and used the Cultural Competence Assessment Tool questionnaire to collect data. Descriptive and inferential statistical tests were utilized for data analysis, using SASD 1.5.8 and IBM SPSS Statistics version 28.0.0.

RESULTS

The sample comprised 424 nurses, with 202 from the Czech Republic and 222 from Slovakia, primarily female. Most nurses in both countries have not received cultural diversity training. Nevertheless, nurses in both countries indicate the necessity of conducting a cultural impact assessment of patients' health. Cultural diversity training significantly increases the level of cultural competence in nurses.

DISCUSSION

Lower cultural competence scores can negatively impact nursing care for patients from different cultures, leading to additional cultural challenges.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The findings highlight the need for enhanced cultural competence among nurses. Nurses need to learn and utilize cultural information to help maximize healthcare for patients from different cultures. By providing nurses with cultural knowledge and skills, they will be able to deliver more effective and culturally competent care to patients from varied cultural backgrounds.

Status and influencing factors of undergraduate midwifery students' core competencies: A cross sectional study

INTRODUCTION

Midwifery undergraduate students' core competencies directly affect the quality of midwifery services and overall quality of midwifery teams. However, limited research has explored the core competencies of undergraduate midwifery students in China.

OBJECTIVES

This study aimed to describe the level of core competencies among undergraduate midwifery students in China and investigated possible associated factors.

DESIGN

This was a cross-sectional descriptive study.

SETTINGS AND PARTICIPANTS

The study population comprised third- and fourth-year undergraduate midwifery students at Zunyi Medical University in Guizhou Province in southwest China (n = 207, response rate 94.1 %).

METHODS

Data were collected using an online survey that included a general information questionnaire, a general self-efficacy scale, and a core competencies self-assessment questionnaire for midwifery undergraduates. Data were statistically analyzed using SPSS 18.0. Pearson's correlation analysis was used to explore the relationship between self-efficacy and the core competencies. Stepwise multiple linear regression was used to explore influencing factors.

RESULTS

The total score for the core competencies among midwifery undergraduates was 118.46 (8.97). The highest mean score was for professional attitude, 4.21 (0.43), and the lowest was for professional skills, 3.70 (0.30). We found a positive association between self-efficacy and core competencies (r = 0.251, P < 0.01). Grade (β = 0.261, P < 0.01), scholarship (β = -0.231, P < 0.01), work intention (β = -0.135, P < 0.05), and self-efficacy (β = 0.207, P < 0.01) significantly influenced undergraduate midwifery students' core competencies (R2 = 0.189, adjusted R2 = 0.173, F = 11.775, P < 0.001).

CONCLUSIONS

Undergraduate midwifery students showed moderate core competencies, indicating room for improvement. Fourth-grade midwifery students had higher core competencies than third-grade students. Additionally, scholarship, work intention, and self-efficacy were significant influencing factors. Midwifery educators should examine students' core competencies and explore targeted interventions, particularly for those with low self-efficacy and core competencies.

The Development and Validation of an Intercultural Nursing Educator Profile Using the Delphi Method

INTRODUCTION

Educators require focused training to foster the development of intercultural competence in nurses. Training programs for educators need to be based on a comprehensive profile with a focus on intercultural learning. This study aims to define and validate a profile of the Intercultural Nursing Educator (INE).

METHOD

The Delphi method was used with an iterative, multi-stage process to transform opinions into group consensus. A total of 46 European, African, and American experts from the nursing and intercultural field participated. Inclusion criteria required English at a level of B2, expertise in the field of intercultural competence, experience in teaching intercultural competence in the nursing context, and publications focused on intercultural topics.

RESULTS

The INE profile was developed and all 126 competencies were validated.

DISCUSSION AND CONCLUSION

The profile is freely available on the project website and provides the basis for curricula, training programs and assessment of the required competences.

Cultural competence and associated factors among nurses working in public health institutions in the Assosa zone, Benishangul Gumuz regional state, Ethiopia, 2022

BACKGROUND

Cultural competence is one of the principal foundations of clinical nursing. In Ethiopia, nurses in nursing care still focus more on physical needs, the healing process, and treatment and less on the cultural aspects of the patient.

OBJECTIVE

This study aims to assess the cultural competence and associated factors among nurses working in public health institutions found in the Assosa Zone, West Ethiopia, in 2022.

METHODS

An institution-based cross-sectional study design was conducted on 362 nurses who were selected by simple random sampling. Data was collected using a structured, self-administered English version of the Nurse Cultural Competence Scale Questionnaire for Nurses. The data were entered into Epi Data version 3.1 and exported to SPSS version 25. Linear regression analysis was used to identify factors statistically significantly associated with the cultural competence of nurses at a p-value < 0.05.

RESULT

Overall The mean score of cultural competence of participants was 113 (CI, 111.7-115.7), with a mean item score of 3.2 (CI, 3.15-3.26). Nurse-to-patient ratio (B;.93, CI;.59_1.3), experience with previously working in a primary hospital than the current health institution (B; -11.1, CI; -18_-4.2), and experience with previously working in a health center than the current health institution (B; -11.5, C;-18.5_-4.8), being diploma education level (B; -23.2, CL;-32_-14.8), being BSC education level (B;-20.3, CI;-28_-12.3), and the presence of a feedback system in a health facility (B; 13.5, CI; 9.5_17.5) were identified as predicted factors of cultural competences.

CONCLUSION

The overall mean score of the cultural competencies of the participants was moderate. To improve the cultural competence of nurses, it is typically necessary to provide educational opportunities to raise their educational level and establish a feedback system in all health institutions across the nation.

Construction and application on the training course of information literacy for clinical nurses

DESIGN

A two-round Delphi survey was conducted to seek opinions from experts about the index system for the evaluation of training courses of clinical nursing staff's information literacy. Besides, a non-randomized controlled experimental study was adopted to check the application effect of the training courses.

AIMS

This study intended to construct a training course of information literacy for clinical nurses, train nurses in order to improve their information literacy level and provide theoretical reference for the training of information literacy courses for clinical nurses.

METHODS

Two rounds of Delphi study were conducted for the study among 26 clinical medical and nursing experts as well as educational experts from 5 different provinces and cities in China. From July 2022 to October 2022, a total of 84 clinical nurses from two hospitals were selected by the convenience sampling method, of which the nurses in one hospital were the control group and the nurses in the other hospital were the observation group. 42 nurses in the observation group were trained by the constructed information literacy training course. Questionnaire evaluation was used to compare the differences in the level of information literacy of nurses and the training effect between the two groups.

RESULTS

The results of the Delphi consultation showed that the expert's judgment coefficient was 0.958, the expert's familiarity was 0.946, and the expert's authority coefficient was 0.952. Finally, a training course of information literacy for clinical nurses with 4 course categories and 45 specific course contents was formed. Among them, nursing information awareness included 7 courses, nursing information knowledge 15 courses, nursing information ability 19 courses, and nursing information ethics 4 courses. The results of the empirical study showed that the information literacy level of the nurses in the observation group after the training of the information literacy course was improved, and the scores in nursing information awareness, nursing information knowledge, nursing information ability, and information ethics were significantly higher than those in the control group after training (P < 0.05).

CONCLUSIONS

The constructed information literacy training courses for clinical nurses were clearly targeted and systematic. Empirical research showed that the course contents were scientific and reasonable, which could provide reference for the training of clinical nurses' information literacy.

The moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence in Korean public health nurses

BACKGROUND

In an increasingly multicultural society, cultural competence and transcultural self-efficacy of public health nurses is important for providing culturally congruent care for client from diverse cultural background. To improv this, it is needed tailored and effective educational program based on the cultural competence educational needs. This study investigated the moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence.

METHODS

This cross-sectional study recruited 217 public health nurses in Korea using convenience sampling from August 2018 to January 2019. A direct questionnaire was used to collect data. Study variables were analyzed using descriptive statistics, correlation, and the Hayes PROCESS macro (Model 1) moderation model.

RESULTS

The mean scores for transcultural self-efficacy, cultural competence educational needs, and cultural competence were 62.33 ± 11.08, 58.19 ± 15.08, and 97.96 ± 17.09, respectively. Transcultural self-efficacy and cultural competence educational needs were positively associated with cultural competence. In the tested model, cultural competence educational needs had a conditional moderating effect on the relationship between transcultural self-efficacy and cultural competence. The positive association between transcultural self-efficacy and cultural competence was significant at low, medium, and high levels of cultural competence educational needs and stronger for those with high needs.

CONCLUSIONS

Cultural competence educational needs may be an important determinant of cultural competence among public health nurses. To effectively increase cultural competence, transcultural self-efficacy should be increased by education programs tailored by cultural competence educational needs.

Cultural competence among nursing students and nurses working in acute care settings: a cross-sectional study

BACKGROUND

The increasing cultural diversity in healthcare in European countries, including Austria, has highlighted the need to enhance nurses' cultural competence. Assessing cultural competence and identifying relevant influencing factors can help to improve culturally competent care. The aim of this study was to assess the cultural competence of nurses and nursing students working in Austrian acute care settings and to identify influencing factors using the Cultural Competence Assessment scale.

METHODS

A cross-sectional design was used. Data collection was carried out in March 2021 with nurses and nursing students in the last year of their studies who were working in Austrian acute care settings. Descriptive analysis was applied to display the general characteristics of the study participants and the levels of their overall cultural competence. A multiple linear regression analysis was conducted to analyze the influencing factors of cultural competence.

RESULTS

The nurses' cultural competence level was moderate to high (mean = 3.89; SD = .48). Their age, educational level, cultural diversity training and self-perceived cultural competence significantly influenced the level (F (6, 875) = 18.971, p < .0000, adj. R2 = 1.09).

CONCLUSIONS

Providing culturally competent healthcare services for culturally diverse patients is essential for all healthcare professionals, and especially for nurses who spend the most time with patients. Effective interventions, such as educational training, need to be implemented in order to deliver culturally competent care and potentially reduce disparities in healthcare and improve patient outcomes.

Beyond challenges and enrichment: a qualitative account of cross-cultural experiences of nursing patients with an ethnic minority background in Norway

BACKGROUND

Substantial mass migrations to the Scandinavian countries have made them heterogeneous and multicultural societies. Migration has also influenced the workforce, especially the healthcare system that has had to accommodate a culturally diverse population. This qualitative study aimed to explore nurses' experiences in caring for patients with an ethnic minority background.

METHODS

Focus group interviews with a total of 21 nurses were conducted. Thematic analysis was performed on the transcribed and translated interviews.

RESULTS

The findings of this study revealed three major themes: various experiences concerning language barriers and the use of interpreters, the impact of religious and cultural values, and caring for patients with an ethnic minority background is professionally interesting but demanding.

CONCLUSIONS

Caring for culturally diverse patients offers both challenges and opportunities to enhance cultural competence and cultural sensitivity among nurses. Various culturally divergent needs of patients such as family visits, food preferences, expression of pain, and gender sensitivity are interlinked and depend on effective communication during encounters with nurses and the healthcare system at large.

Student nurses' spiritual care competence and attitude: An online survey

AIMS

This study aimed to assess student nurses' competence and attitude toward spiritual care and analysed the associated factors.

DESIGN

Cross-sectional study using an online survey.

METHODS

From April 14 to June 14, 2018, a convenience sample of 938 student nurses were recruited from six schools of Nursing in Hunan Province, China. Data were collected by using the Chinese versions of the Spiritual Care Competence Scale (C-SCCS) and the Spiritual Care Attitude Scale (C-SCAS).

RESULTS

The average total score on the C-SCCS was 21.42 (±4.27) out of 30 and the C-SCAS was 58.03 (±9.90) out of 75. Factors such as liking the nursing profession, attending a spiritual care course, participation in classroom learning or expert lecture, and supporting continuous and systematic training were the strongest predictors of higher spiritual care competence and attitude. A better attitude about spiritual care was a relatively moderate and significant predictor of higher spiritual care competence.

Methods of increasing cultural competence in nurses working in clinical practice: A scoping review of literature 2011–2021

Aim

Training for the development of cultural competence is often not part of the professional training of nurses within the European Economic Area. Demographic changes in society and the cultural diversity of patients require nurses and other medical staff to provide the highest quality healthcare to patients from different cultural backgrounds. Therefore, nurses must acquire the necessary cultural knowledge, skills, and attitudes as part of their training and professional development to provide culturally competent care to achieve this objective.

Objective

This review aims to summarize existing methods of developing cultural competence in nurses working in clinical practice.

Design

A scoping review of the literature.

Method

The following databases were used: PubMed, ScienceDirect, ERIH Plus, and Web of Science using keywords; study dates were from 2011 to 2021.

Results

The analysis included six studies that met the selection criteria. The studies were categorized as face-to-face, simulations, and online education learning methods.

Conclusion

Educational training for cultural competence is necessary for today’s nursing. The training content should include real examples from practice, additional time for self-study using modules, and an assessment of personal attitudes toward cultural differences.

Nurses' experiences of providing transcultural nursing care to minority patients in Yunnan province: A descriptive qualitative study

Cultural competency is essential for providing transcultural nursing care. This qualitative study explores nurses' experiences of providing transcultural nursing care to patients from ethnic minority in Yunnan province, China, with the aim of supplementing and enriching previous quantitative research. Yunnan is home to 25 ethnic minorities with the highest proportion (33.1%) of people from ethnic minorities in China. A descriptive qualitative method was used to describe the experiences of 12 nurses. Data were collected in October 2020 through semistructured interviews and analyzed using conventional content analysis methods. Three themes were generated, including limitations of resources to provide transcultural nursing care, challenges in providing transcultural nursing care, and concerns about the quality of nursing care. The results suggest that there is scope for improving cultural competence of nurses in Yunnan through education that would enable them to provide high-quality transcultural nursing care. Training topics could include transcultural knowledge, cultural sensitivity, minority languages, and immersive multicultural experiences. Other suggested improvements include a resource room for transcultural care, the accommodation of religious and dietary needs, and dedicated staff who lead transcultural care in hospitals.