Assessment of cultural competence among nurses

Mohammad Reza Bastami, Toktam Kianian, Milad Borji, Mehdi Amirkhani, Saman Saber



Introduction: Culture influences different aspects of human life and plays a major role in shaping one’s behavior, beliefs, and health values. Nursing is an occupation which is associated with a lot of cultural diversity since each patient is culturally different from another, and nurses have to be capable of communicating effectively with different cultures and understanding patients’ values, beliefs and health function (cultural competence) to know their patients’ needs, decide over the appropriate nursing care for the patients, and know how to change these measures if necessary so that the patients’ health improvement is ensured. Nurses’ cultural competence, therefore, is a matter of necessity to communicate effectively with the patients and to improve their health. Hence, the present study was conducted to determine cultural competence among nurses in hospitals of Ilam University of Medical Sciences.


Methods: This descriptive cross-sectional comparative study was carried out on nurses working at the hospitals of Ilam University of Medical Sciences in 2014. The total number of the nurses in Ilam was 260, out of whom 215 nurses were selected by convenience sampling. The main inclusion criteria were: the nurses needed to hold an undergraduate and graduate degree, to work at the hospitals of Ilam University of Medical Sciences, and to have at least two years of work experience. The study was conducted in all three hospitals of Ilam University of Medical Sciences. Data collection was performed through individual characteristics forms and cultural competence questionnaires using a self-assessment method. Individual characteristics forms included such information as age, education and work history; and cultural competence questionnaires contained 51 questions in four dimensions of cultural care knowledge, attitudes towards cultural care, preparedness for cultural care, and cultural competence in nursing care. To implement the research, research objectives were fully described for the nurses, and they were assured that the questionnaires were completely anonymous, and that the results of the questionnaire had no impact on their evaluation. The nurses were asked to accurately complete the questionnaires in their free time and return it to the researcher. The researcher was present there to address the nurses’ questions. Once completed, the questionnaires were collected. Using SPSS statistical software (version 18), the data were analyzed running the descriptive indicators (to determine the prevalence and the mean scores of the participants' cultural competence), independent samples t-test (to evaluate the different cultural competence scores based on gender and education), and Spearman correlation coefficient (to investigate the relationship between working experience and cultural competence). The significance level was set as > 0.05.


Ethical Considerations: Informed consent was obtained from the participants for attending and conducting research, after complete description of the research objectives and assuring that the information is completely confidential and has no effect on their professional evaluation process.


Results: Of 215 nurses participating in the study, 55.81% were women holding a bachelor's degree (95. 34%) with 2-5 years of work experience. The mean score of the nurses’ cultural competence was at the medium level (115.03 ± 25.56). The results indicated that the mean score of cultural competence as for the dimension of preparedness for cultural care had the highest level (50.16 ± 13.16); while the attitudes towards cultural care had the lowest level (12.69 ± 2.50). In addition, there was a significant difference between cultural competence scores of men and women (P= 0.001) in a way that the cultural competence was higher with women than with men. There was also a significant relationship between cultural competence and work history (P= 0.040): the longer the work history, the higher cultural competence.


Discussion and Conclusion: Based on the results of the present study, the mean score of the nurses’ cultural competence was at the medium level. Strengthening the nursing workforce as the primary healthcare provider is of paramount importance in terms of cultural competence, particularly in such dimensions as attitudes towards cultural care and preparedness for cultural care, taking into account the fact that most of the nurses presented low levels of these two dimensions. Given that Iranian society historically has a multi-ethnical-cultural, linguistic, and religious context, the nurses in clinical areas are dealing with people with different cultural backgrounds. According to the results of the present study, reinforcement of such an important skill will be essential in promoting public health. It is therefore recommended that some planning be done to add some courses to nursing education programs, and that some workshops be held to increase cultural competency among the nurses. Likewise, it is recommend that this study be conducted with a larger sample size. Considering that the number of female nurses is often greater than the number of male nurses, it is also suggested that the researchers make sure to check for gender matching before initiating the study.


Please cite this article as: Bastami MR, Kianian T, Borji M, Amirkhani M, Saber S. Assessment of cultural competence among nurses . Med Ethics J 2016; 10(36): 65-72.


Culture; Cultural Competence; Nurses; Ilam

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