Organisational and staff-related effects on cultural competence in the hospital setting: a cross-sectional online survey of nursing and medical staff.
BMC Health Serv Res 2022;
22:644. [PMID:
35568939 PMCID:
PMC9107243 DOI:
10.1186/s12913-022-07947-x]
[Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 04/13/2022] [Indexed: 11/11/2022] Open
Abstract
Background
Cultural competence is considered a core qualification for dealing with socio-cultural diversity and balancing disparities in health care.
Objectives
To explore features supporting and inhibiting cultural competence in the hospital at both organisational and staff levels.
Design
Cross-sectional online survey in the form of a full census from May to November 2018.
Setting
Two organisations that run a total of 22 hospitals in Germany.
Participants
Eight hundred nursing and medical professionals [nurses: n = 557; doctors: n = 243].
Methods
Using the Short Form Cultural Intelligence SCALE (SFCQ), cultural competence was measured and its relation to potential influencing factors at staff level and organisational level examined, using bivariate (t-Test, one-way ANOVA, Pearson and Spearman correlations) and multivariate (multiple linear regression) approaches. Model 1 examined features at organisational level, Model 2 at individual level and Model 3 included organisational and individual features.
Results
The mean cultural competence measured was 3.49 [min.: 1.3; max.: 5.0]. In the bivariate and isolated multivariate models [Models 1 and 2], factors on both organisational and individual levels were significantly related to the hospital staff’s cultural competence. The multivariate overview [Model 3], however, revealed that individual features at staff level were the statistically relevant predictors. Positive influencing features included staff’s assessment of the importance of cultural competence in their professional context [B: 0.368, 95% confidence interval 0.307; 0.429], participation in competence training [B: 0.193; 95% confidence interval 0.112; 0.276] and having a migration background [B: 0.175; 95% confidence interval 0.074; 0.278], while negative features included length of medical service [B: -0.004; 95% confidence interval -0.007; -0.001].
Conclusions
The development and practice of cultural competence appear to be determined less by organisational features and more on the level of individual actors. In addition to staff development, adequate organisational structures and an economic incentive system are required to promote sociocultural diversity in hospitals.
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