Page 185 - S. Ličen, I. Karnjuš, & M. Prosen (Eds.). (2019). Women, migrations and health: Ensuring transcultural healthcare. Koper, University of Primorska Press.
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Cultural Competence in Nursing
Discussion
There is a deficit of studies on changes in nurses’ knowledge and behaviour
in the area of cultural competence and subsequent impacts on patient out-
comes. The four reviewed studies focused on different types of intervention,
different targeted groups in various settings and measured dissimilar out-
comes. This heterogeneity in intervention strategies and how they are imple-
mented makes it difficult to offer empirical evidence on their effectiveness
on the quality of care for patients from culturally diverse groups. However,
despite some methodological limitations of the four studies included, this
review contains the available evidence on interventions used with the aim
to improve cultural competence among nurses working with patients from
culturally diverse groups.
It has been shown that various forms of cultural training improve the cul-
tural competence of nurses (Govere & Govere, 2016). The general focus of cul-
tural competence interventions has been on educating and training nurses,
like other healthcare workers, in the knowledge, attitudes and skills needed
to effectively respond to socio-cultural issues arising in clinical encounters
(Betancourt et al., 2003). Cultural competence training can include: under-
standing the central role of culture in all lives and how it shapes behaviour;
respect and acceptance of cultural differences; learning to effectively utilise
culturally adapted and culturally specific practices; and, continuous devel-
opment of healthcare employees’ awareness of personal cultural influences
and prejudices (Jongen, McCalman, & Bainbridge, 2018; Warren, 2002).
Intervention strategies in the reviewed studies showed some evidence
of their effectiveness, although there is limited research revealing a posi-
tive relationship between cultural competency training and improved pa-
tient outcomes. While cultural competency training is an important compo-
nent of an overall framework for cultural competence, it is generally insuf-
ficient to merely change health professionals’ behaviour if we wish to influ-
ence patient-related outcomes such as patient satisfaction, adherence and
health outcomes (Beach et al., 2005; Lie, Lee-Rey, Gomez, Bereknyei, & Brad-
dock, 2011). Improving patient-related outcomes based on cultural compe-
tency training requires structural changes at the level of the organisation
(Betancourt et al., 2003; Clifford, McCalman, Bainbridge, & Tsey, 2015). Fur-
ther, building up the cultural competence of healthcare professionals and
organisations may be one of the best strategies for narrowing healthcare
disparities. Although there is some evidence that organisations which have
integrated cultural competency standards into policies and practices influ-
183
Discussion
There is a deficit of studies on changes in nurses’ knowledge and behaviour
in the area of cultural competence and subsequent impacts on patient out-
comes. The four reviewed studies focused on different types of intervention,
different targeted groups in various settings and measured dissimilar out-
comes. This heterogeneity in intervention strategies and how they are imple-
mented makes it difficult to offer empirical evidence on their effectiveness
on the quality of care for patients from culturally diverse groups. However,
despite some methodological limitations of the four studies included, this
review contains the available evidence on interventions used with the aim
to improve cultural competence among nurses working with patients from
culturally diverse groups.
It has been shown that various forms of cultural training improve the cul-
tural competence of nurses (Govere & Govere, 2016). The general focus of cul-
tural competence interventions has been on educating and training nurses,
like other healthcare workers, in the knowledge, attitudes and skills needed
to effectively respond to socio-cultural issues arising in clinical encounters
(Betancourt et al., 2003). Cultural competence training can include: under-
standing the central role of culture in all lives and how it shapes behaviour;
respect and acceptance of cultural differences; learning to effectively utilise
culturally adapted and culturally specific practices; and, continuous devel-
opment of healthcare employees’ awareness of personal cultural influences
and prejudices (Jongen, McCalman, & Bainbridge, 2018; Warren, 2002).
Intervention strategies in the reviewed studies showed some evidence
of their effectiveness, although there is limited research revealing a posi-
tive relationship between cultural competency training and improved pa-
tient outcomes. While cultural competency training is an important compo-
nent of an overall framework for cultural competence, it is generally insuf-
ficient to merely change health professionals’ behaviour if we wish to influ-
ence patient-related outcomes such as patient satisfaction, adherence and
health outcomes (Beach et al., 2005; Lie, Lee-Rey, Gomez, Bereknyei, & Brad-
dock, 2011). Improving patient-related outcomes based on cultural compe-
tency training requires structural changes at the level of the organisation
(Betancourt et al., 2003; Clifford, McCalman, Bainbridge, & Tsey, 2015). Fur-
ther, building up the cultural competence of healthcare professionals and
organisations may be one of the best strategies for narrowing healthcare
disparities. Although there is some evidence that organisations which have
integrated cultural competency standards into policies and practices influ-
183
