NRSE 4570 M2 Sharifi 2019 Cultural competence in nursing
Background: Cultural competence is one of the principal foundations of. It has not yet been clearly defined and analysed and there are different views regarding this issue. Objective: Analyzing the concept of cultural competence in nursing. Design: A concept analysis. Data Sources: The literature was searched using electronic databases including PubMed, ScienceDirect, Scopus, ProQuest, Google Scholar, CINAHL, Wiley, Ovid, Magiran, and SID with no date limitation. Any quantitative or qualitative studies published in English or Persian, which were focused on cultural competence in nursing were included in the study. Review methods: Walker and Avant’s strategy for concept analysis was used. The attributes, antecedents, consequences, and uses of the concept were identified. Results: A total of 43 articles were included. The six defining attributes of cultural competence were cultural awareness, cultural knowledge, cultural sensitivity, cultural skill, cultural proficiency, and dynamicity. Antecedents included cultural diversity, cultural encounter and interaction, cultural desire, cultural humility, general humanistic competencies, educational preparation, and organizational support. The consequences of cultural were also identified: those related to care receivers, those related to care providers, and health-related consequences. Conclusion: A theoretical definition and a conceptual model of cultural competence were developed. The attributes, antecedents, and consequences of cultural competence identified in this study can be used in nursing education, research, and managerial and organizational planning.
© 2019 Published by Elsevier Ltd.
What is already known about the topic? � Reduction in health care inequalities, enhancing patients’ trust in healthcare systems and cultural safety are among the main
Contents lists available at ScienceDirect
International Journal of
journal homepage: www.elsevier.com/ijns
� Cultural competence is one of the principal foundations of clinical nursing.
� Cultural competence is affected by the immediate financial, political, social, historical, and cultural context.
� There are many different definitions of cultural competence.
What this paper adds
� Cultural competence is the dynamic process of acquiring the ability to provide effective, safe, and quality care to the patients through considering their different cultural aspects.
* Corresponding author. E-mail addresses: firstname.lastname@example.org (N. Sharifi), email@example.com
(M. Adib-Hajbaghery), firstname.lastname@example.org (M. Najafi).
http://dx.doi.org/10.1016/j.ijnurstu.2019.103386 0020-7489/© 2019 Published by Elsevier Ltd.
consequences of cultural competence. � The system and healthcare organizations have significant roles in improving nurses’ cultural competence.
Globalization and international migrations have caused cultural diversity in societies and hence, nurses in different societies have patients with different cultures and different cultural needs (Alizadeh and Chavan, 2016; Sharma et al., 2009). Cultural diversity can be a major barrier to effective care delivery. Nurses’ lack of knowledge and skills about how to effectively deal with patients from different cultures may impair their relationships with them and result in inequality in care delivery. Consequently, cultural competence has become an international demand (Alizadeh and Chavan, 2016; Taylor, 2005).
Box 1. Electronic search strategy in PubMed.
Cultural competency [Title/Abstract] AND nursing[Title/
Culturally competent care [Title/Abstract] AND nursing[Title/
Transcultural nursing [Title/Abstract].
2 N. Sharifi et al. / International Journal of Nursing Studies 99 (2019) 103386
The importance of cultural competence in nursing was recognised two decades ago. Then, many studies were carried out and several nursing theories were developed to address this concept. Nonetheless, many ambiguities still surround this concept (Cai, 2016; Suh, 2004). The term cultural competence consists of the words culture and competence. Some studies focused on the word competence and defined cultural competence as a spectrum or a process, while some studies focused on the word culture and referred to the methods for developing cultural competence. For instance, Campinha-Bacote (2002) focused on the word compe- tence and defined cultural competence as a process which encompasses the five components of cultural awareness, cultural knowledge, cultural skill, cultural encounter, and desire On the other hand, Leininger (2002) defined cultural competence based on the different dimensions of culture, including values, health beliefs, religion, and philosophy. Some studies also interchangeably used cultural congruence, culturally congruent care, culturally competent care, and congruent care to refer to the cultural competence concept (Andrews and Boyle, 2008).