A Concept Analysis of Cultural Nursing Competence

Geum Hee Jeong; Hye-Sook Park; Kyung Won Kim; Young Hee Kim; Sun Hee Lee; Hyun-Kyoung Kim

doi:10.4069/kjwhn.2016.22.2.86

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Jeong, Park, Kim, Kim, Lee, and Kim: A Concept Analysis of Cultural Nursing Competence

Original Article

Korean Journal of Women Health Nursing 2016; 22(2): 86-95.

Published online: 28 June 2016

DOI: https://doi.org/10.4069/kjwhn.2016.22.2.86

A Concept Analysis of Cultural Nursing Competence

Geum Hee Jeong¹, Hye-Sook Park², Kyung Won Kim³, Young Hee Kim⁴, Sun Hee Lee⁵, Hyun-Kyoung Kim⁶

¹Division of Nursing, Hallym University, Chuncheon, Korea.

²Department of Nursing, Dongyang University, Yeongju, Korea.

³Department of Nursing, Daegu Haany University, Daegu, Korea.

⁴Department of Nursing, Dongguk University, Gyeongju, Korea.

⁵Department of Nursing Science, Gimcheon University, Gimcheon, Korea.

⁶Department of Nursing, Doowon Technical University, Anseong, Korea.

Corresponding author: Kim, Hyun-Kyoung. Department of Nursing, Doowon Technical University, 678 Jangwon-ri, Juksan-myeon, Anseong 17520, Korea. Tel: +82-31-8056-7314, Fax: +82-31-8056-7269, leomommy@hanmail.net

Received 27 April 2016 Revised 15 June 2016 Accepted 15 June 2016

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to conduct a concept analysis of cultural nursing competence.

Methods

Cultural nursing competence was analyzed using Rodgers' evolutionary concept development method. A literature search using the keywords "cultural nursing competence", "intercultural nursing competence", "cultural nursing", "cultural health nursing", and "cultural competence" was conducted in PubMed, CINAHL, ERIC, and RISS on material published before 2015. Database and bibliographic searches yielded 35 records.

Results

Cultural nursing competence comprised cognitive, affective, and behavioral domains. The critical attributes of the concept were sensitivity, equality, and activity. The analysis identified the following dimensions: awareness, openness, and coherence. The consequences of cultural nursing competence were personal satisfaction and social justice. The definition contained competence on both an individual and social level.

Conclusion

Cultural competency enhances quality of care by narrowing health disparities and increasing client satisfaction. The concept analysis of cultural nursing competence may offer an acceptable framework which can be used to develop psychometric tools of this concept and provide guidelines in nursing practice.

Keywords: Cultural competence, Psychometrics, Concept analysis

Figures and Tables

Figure 1

Flow of study analysis through the different phases of the literature review.

Figure 2

Antecedents, affecting factors, and consequences of cultural nursing competency.

Table 1

Concept Analysis of the Reviewed Research Papers (N=35)

No	First author (year)	Definition	Antecedents	Affecting factors	Attributes	Consequences	Related/surrogate term
1	Clair (1999)	Overcome ethnocentrism	Conflict	Experience	Self-efficacy, relativism	Perspective transformation	Cultural transformation, cultural relativism
2	Clark (2000)	Integrity of knowledge, skill, attitude	Mixture	Experience, education	Positivity, openness	Decision making, care quality, responsibility	Unclear
3	Garcia (2001)	Assessment of mutual effect	Supremacy	Race, disease	Community health, media	Understanding, acknowledgement	Unclear
4	Kollar (2002)	Unclear	Population	Opportunity	Knowledge, perception, growth	Development of global perspective	Global competency
5	Fester (2003)	Unclear	Diversity	Language, protocol	Contact, relationship	Patient outcome	Unclear
6	Thobaben (2003)	Unclear	Diversity	System, language	Leadership, understanding, respect	Health promotion	Unclear
7	Flowers (2004)	Unclear	Population	Acculturation, assimilation	Awareness, knowledge, skill, encounter, desire	Trust, correct nursing intervention	Unclear
8	Lim (2004)	Cultural congruent qualified care	Prejudice, resistance	Race, need	Cognition, practice, affection	Effective, proficient care	Transcultural care, transcultural self-efficacy
9	Suh (2004)	Achieving ability to work	Minority	Unclear	Ability, openness, flexibility	Patient outcome	Unclear
10	Chenowethm (2006)	Set of behavior, attitude, policy	Conflict, Diversity	Education, religion, value	Awareness, respect, knowledge	Care quality, equality	Cultural sensitivity, cultural consciousness
11	Cowan (2006)	Sensitivity toward different group	Expansion of global citizen	Gender, class, race	Communication, action, value, belief	Unclear	Culturally congruent nursing care
12	Evans (2006)	Set of values, principle, behaviors	Inequality	Race, language	Insight, behavior, perception	Cooperation	Cultural sensitivity
13	Mohammadi (2007)	Identification of cultural diverse need	Cultural conflict	Healthcare system	Desire, sensitivity	Innovative healthcare system	Cultural individualization
14	Siantz (2007)	Unclear	Inequality	Law, war	Leadership, Partnership	System, quality, benefit	Unclear
15	Yasmin (2007)	Professional competency	Inequality	Training, experience	Knowledge, skill, sensitivity	Responsive care	Responsive intercultural nursing
16	Xu (2007)	The highest quality care for all	Globalization	Training, education	Unclear	Eliminate disparity	Unclear
17	Zander (2007)	Combination of insight, knowledge, skill	Cultural incapacity	Education, desire	Awareness, knowledge, skill	Equality, care	Unclear
18	Capell (2008)	Ability to understand & work effectively	Inapplicability	Policy, diversity	Awareness, knowledge, skill, encounter, desire	Health outcome, relationship	Unclear
19	Engebretson (2008)	Growth process	Inequality, disagreement	Ethics, law, rule, education	Knowledge, skill, attitude	Suitable care, evidence based care	Cultural proficiency
20	Pergert (2008)	Cultural congruent care	Relation, inequality	Immigration, health status	Relationship. bridging	Moral care	Bridging obstacles to transcultural care
21	Aponte (2009)	Ongoing process in cultural context	Population	Service	Awareness, knowledge, skill, encounter, desire	Problem solving	Unclear
22	Edwards (2009)	Unclear	Population	Service, research, education,	Application, evaluation	Competency	Unclear
23	Koprucu (2009)	Perceptive competency	Global need, cosmopolitanism	Curriculum, system	Belief, value, behavior, communication	Global citizen	Unclear
24	Son (2009)	Interaction competency	Multiculture	Program, theory, experience	Awareness, attitude, knowledge, skill	Care quality	Unclear
25	Gebru (2010)	Meaningful care	Diversity, content deficit	Feeling, thought, action	Awareness, application	Cultural congruent	Cultural sensitivity, Cultural safety practice
26	Kamaka (2010)	Congruent behavior, attitude, policy	Globalization	Education, training	Immersion, attention	Alternative medicine	Cultural sensitivity, Cultural immersion
27	Onorati (2010)	Reflection of diversity	Global convergence	Education, social welfare system	Knowledge, communication, perception	Human relationship	Transcultural sensitivity
28	Schumacher (2010)	Unclear	Immigration	Need, belief	Knowledge, maintenance	Cultural congruent care	Transcultural nursing
29	Wilson (2010)	Nursing intervention with openness	Disparity	Desire, evaluation, communication	Awareness, knowledge, skill	Care quality, positive mental health	Cultural brokering
30	Tuttas (2011)	True collaboration with stranger	Increase strangers	Belief, value, norm	Converting, adjustment	Optimal health outcome	Enculturation
31	Dudas (2012)	Meet need of changing society	Population	Language, motivation	Awareness, communication	Organizational benefit	Culturally concordant care, culturally attuned care
32	Epner (2012)	Patient centered care	Dynamic society	Sex, age, politics, status	Communication, intimacy, understanding	Patient centeredness	Patient centered competency
33	Perng (2012)	Dynamic ongoing proces	Globalization	Multi-culture	Nonjudgement, openness, flexibility, ability	Equality, patient satisfaction	Cultural sensitivity, cultural capacity
34	Rew (2012)	Unclear	Difference, diversity	Service, difference	Tolerance, communication, understanding	Holistic nursing	Unclear
35	Isaacson (2014)	Diverse of care Minority, vulnerability	Minority, vulnerability	Education	Advocation, attention, reflection	Patient safety	Cultural humility

Table 2

Attributes of Cultural Nursing Competency

Domains	Attributes	Features	Dimensions
Cognition	Sensitivity	Knowing	Awareness
		Understanding
		Tailoring
		Desire
		Reflection
Affection	Equality	Respect	Openness
		Diversity
		Humility
		Acceptance
		Tolerance
Behavior	Activity	Encounter	Coherence
		Approach
		Communication
		Mediating
		Practice

Notes

This research was performed by women health interest group in Sigma Theta Tau International Honor Society of Nursing.

Summary Statement

▪ What is already known about this topic?

While several studies have applied cultural competence into nursing, there was lack of studies analyzing a concept of cultural nursing competence.

▪ What this paper adds?

The attributes of cultural nursing competence are sensitivity, equality, and activity. The cultural nursing competency is defined as understanding and respecting client's culture and providing care to be congruent with their culture. Cultural nursing competence bring about increasing client's satisfaction and improving care quality.

▪ Implications for practice, education and/or policy

The concept analysis of cultural nursing competence may offer an acceptable framework which can be used to develop psychometric tools of this concept and provide guidelines in nursing practice.

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