Cultural competence in nursing refers to a nurse’s capacity to understand, respect, and support patients from diverse cultural backgrounds. It requires a combination of education and skills that enable nurses to provide care in a way that meets their patients’ social and cultural needs.
Explore cultural competence in nursing, its importance, examples, related careers, strategies, trends, necessary skills, and tips for implementation. Learn more about how nurses with cultural competence can contribute to improved patient outcomes, higher patient satisfaction, and the delivery of effective, respectful health care.
Social Factors Affect Health Outcomes
The social determinants of health (SDOH) are the conditions in which people are born, grow, live, work, and age that affect their health outcomes. These determinants are shaped by the distribution of money, power, and resources at the global, national, and local levels, and they have a significant impact on health disparities and inequities among communities.
The World Health Organization (WHO) identifies several key social determinants of health:
- Financial and Economic Stability: This includes factors such as employment, income, expenses, debt, medical bills, and support. Economic stability affects an individual’s ability to afford necessities such as housing, food, and health care, which in turn influences their health outcomes.
- Education: Educational opportunities, literacy, early childhood education, vocational training, and higher education are all components of this determinant. Attaining higher levels of education is linked to better health outcomes due to its connection to increased health literacy and improved access to resources.
- Community Context: This includes social support networks, community engagement, discrimination, social cohesion, and exposure to violence. Strong social connections and supportive communities contribute to better mental and physical health.
- Neighborhood and Built Environment: This includes the quality of housing, access to nutritious foods, transportation options, air and water quality, and neighborhood safety. The environment in which people live can significantly influence their health behaviors and overall well-being.
Each of these determinants can affect a person’s health outcomes. By focusing on the SDOH, policymakers and health care providers can work toward reducing health disparities and improving the overall health of certain populations.
Why Cultural Competence Matters
Nurses with cultural competence can help address and reduce health disparities by ensuring that all their patients receive appropriate and effective care. When they acknowledge the SDOH and strive to provide care that considers these factors, they promote health equity.
Health Disparities
Although Americans’ health has improved overall in recent years, “disparities continue in the incidence of illness and death among African Americans, Latino/Hispanic Americans, Native Americans, Asian Americans, Alaska Natives, and Pacific Islanders, as compared with the U.S. population as a whole,” according to the Centers for Disease Control and Intervention (CDC).
In addition to racial and ethnic health disparities , as just described, there are also linguistic health disparities in the U.S. For example, the Hispanic population in the U.S. is increasing at a rate three times faster than the overall U.S. population. Approximately 14% of Americans speak Spanish at home, but only 6% of the nursing workforce is Hispanic, according to PBS.
To understand, study, and address health disparities across racial, ethnic, linguistic, social, and geographic groups, the field of nursing can develop a workforce that is trained in the social determinants of health, and raise public awareness about them.
Health care and human service organizations are increasingly acknowledging the importance of improving services for culturally and linguistically diverse groups. Delivering the appropriate health care services to these populations requires cultural competence.
Defining Cultural Competence in Nursing
Cultural competence in nursing refers to the ability of nurses to deliver services that are respectful of and responsive to the cultural and linguistic needs of their patients. It involves understanding the cultural factors that influence their patients’ health behaviors, beliefs, and outcomes.
The CDC defines cultural competence as “a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.” This definition suggests that cultural competence can occur at the individual nurse level and the macro level of a health care organization’s norms and policies.
Culture
Culture encompasses the integrated patterns of human behavior, including the language, thoughts, communication styles, actions, customs, beliefs, values, and institutions associated with racial, ethnic, religious, or social groups.
Nurses have an ethical duty to provide equitable care to all patients, regardless of their cultural background. Nurses trained in cultural competence help fulfill this responsibility by ensuring that care is inclusive and respectful.
A patient’s culture significantly influences how they communicate and interpret health information. Being aware of cultural differences in communication styles, language preferences, and nonverbal cues helps nurses communicate more effectively, thereby reducing misunderstandings and building trust.
Competence
Competence in this context means having the ability to operate effectively both as an individual and within the health care organization in a way that is consistent with the cultural beliefs, behaviors, and needs of the people and communities being served.
It involves the integration of knowledge, skills, and attitudes that enable nurses to understand and appropriately respond to the cultural needs, practices, and differences of their patients. This competence ensures that nurses can provide care that is both effective and respectful.
Cultural Competence vs. Cultural Knowledge
Cultural competence is the ability to function effectively in various cultural settings and adapt practices to engage with different cultural groups. In contrast, cultural knowledge, cultural sensitivity, and cultural awareness involve recognizing cultural similarities and differences, without specifically focusing on taking action or making structural changes to address them.
Key Components of Cultural Competence in Nursing
Cultural competence in nursing encompasses several key components. The primary components are awareness, knowledge, and skills.
Awareness: Recognizing One’s Own Cultural Influences and Biases
Awareness is the foundational component of cultural competence. Nurses must be aware of how their cultural background influences their perceptions, attitudes, and interactions with patients.
- Self-Reflection: Nurses should regularly reflect on their personal experiences, values, and cultural influences. This reflection can help them identify any of their unconscious biases or stereotypical views that may affect the care they provide to patients.
- Acknowledging Biases: Recognizing and acknowledging their personal biases is crucial for nurses. Biases can lead to prejudiced attitudes and behaviors, which can negatively impact their interactions with their patients and their patients’ health outcomes.
- Cultural Humility: Awareness also involves practicing cultural humility, which means recognizing the limits of one’s knowledge and being open to learning from others. It requires an ongoing commitment to self-evaluation and self-critique.
Knowledge: Understanding Different Cultural Practices and Worldviews
Knowledge is the next critical component of cultural competence. It involves learning about and understanding the diverse cultural practices, health beliefs, and worldviews of the patients nurses serve. This knowledge enables nurses to provide care that is respectful and aligned with their patients’ cultural values.
- Cultural Practices: Nurses should be familiar with the cultural practices of the people in the communities they serve, including their dietary customs, religious practices, and traditional healing methods. This understanding helps in creating care plans that respect these practices.
- Health Beliefs: People with different cultural backgrounds have different beliefs about health, illness, and healing. Understanding these beliefs can help nurses communicate more effectively with their patients and develop culturally appropriate interventions for them.
- Language Proficiency: While fluency in multiple languages is not always possible, understanding common phrases or medical terminology in patients’ languages can both enhance a nurse’s communication with these patients and the patients’ trust in the nurse.
Skills: Developing the Ability to Communicate and Interact Effectively With People From Different Cultures
Skills related to cultural competence involve the practical application of awareness and knowledge. These skills enable nurses to communicate and interact effectively with patients from diverse cultural backgrounds.
- Effective Communication: Nurses need to develop strong communication skills that include active listening, empathy, and the ability to convey information clearly and respectfully. This includes using plain language and avoiding medical jargon.
- Cultural Sensitivity: Being culturally sensitive means recognizing and respecting patients’ cultural differences and adapting the care they receive accordingly. This involves being aware of patients’ cultural norms related to personal space, eye contact, and body language.
- Adaptability: Nurses need to be adaptable and willing to modify their approach based on the cultural background of each patient. This flexibility can enhance patients’ comfort and cooperation.