Original researchEvaluation of nursing students’ perceptions of their cultural care competency: A mixed method study in Taiwan
Introduction
Globalization and growing cultural diversity among client populations challenge nurses’ practice and nursing education worldwide. In Taiwan, transnational marriages are the major source of immigration, and this phenomenon has become a tremendous challenge for nurses (Chang et al., 2013). According to the household registration data (Ministry of the Interior, 2018), the total Taiwanese population was 23,571,497 at the end of April 2018. Of the total population, 533,159 (2.3%) were immigrants, including foreigners and foreign spouses, of which 354,982 (66.6%) were from Mainland China, Macao, and Hong Kong. Immigrants from other countries, predominantly in Southeast Asia, numbered 178,177 (33.4%).
New immigrant women, who are usually very young and married to men with a low socio-economic status, often experience difficulties in dealing with issues pertaining to life adaptation, communication, and family continuity owing to the significant differences from their original cultures (Hsieh and Wang, 2008; Yang and Wang, 2003). Moreover, new female immigrants are often expected to bear children soon after their marriage in keeping with Taiwanese traditional ideas of continuing the family line (Chou et al., 2006). Thus, pediatric healthcare professionals commonly encounter the childcare issues of immigrant women in Taiwan (Chen et al., 2008).
Culture can be an elusive and nebulous concept, but it generally encompasses all aspects of the ways people live, including beliefs, values, actions, interactions with other, customs, institutions, and group affiliations, whether racial, ethnic, religious, or social (Bourque Bearskin, 2011; Epner and Baile, 2012). Immigrants’ native languages and cultures affect their health beliefs and care practices. Thus, cultural competence is essential for health care professionals committed to providing the best possible care to all of their patients regardless of background (Nguyen, 2008). The need providing culturally competent care to people of diverse cultures has become apparent in educational and health service programs established to meet the needs of immigrants (Leininger and McFarland, 2002).
Section snippets
Background
Culturally appropriate or culturally competent care is a critical component of patient-centered care for health care providers (Kamrul et al., 2014) in the current context of global diversity. Scholars' understanding of cultural competency changes as the world changes. Thus, cultural competency has come to have a variety of definitions. “Cultural competence” is a term attributed to Leininger, who encouraged its implementation by nurses working in multicultural settings (Bourque Bearskin, 2011).
Development and implementation of the embedded cultural competency in child and adolescent care (ECC-CAC) course
A preliminary literature review was conducted via a panel discussion with pediatric experts to determine the cultural perceptions that are vital to child and adolescent care with immigrant mother caregivers.
Thus, it was determined that the ECC-CAC should help develop nursing students who are knowledgeable, sensitive, and competent to provide effective care for children and adolescents with different or similar cultures. Subsequently, an outline was developed for the ECC-CAC course based on the
Quantitative results
Fifty nursing students enrolled in the ECC-CAC course. Forty-eight (96%) completed the pre- and post-tests. They were female and ranged in age from 20 to 24 years. A comparison of the participants' SP-CCC in the ECC-CAC course at the pre- and post-tests revealed a significant improvement (Table 3). The mean total score on the post-evaluation was 101.00 ± 3.48, which was significantly higher than the pre-evaluation score (88.28 ± 12.54) (t = 7.15, p < 0.001). On the post-test, students’ scores
Discussion
This study aimed to evaluate the extent to which an ECC-CAC course could increase perceptions of cultural care competency among Taiwanese nursing students. Cultural care competencies, including knowledge, attitude, and skills, were embedded into the core child and adolescent healthcare course using multiple learning strategies. Both quantitative and qualitative analyses confirmed that the course improved students’ perception of CCC. The findings confirm those of other studies (Elminowski, 2015;
Conclusion
Cultural care education embedded in child and adolescent nursing education is effective for improving students’ perception of their cultural care competency as an alternative to the current approaches to cultural education. Apart from didactic teaching, multidimensional teaching strategies incorporated with locally and culturally relevant issues were applied in the ECC-CAC course in this study. These strategies encouraged students to think reflexively and to develop empathy and the desire to
Role of the funding source
This study was supported by a grant from Ministry of Science and Technology, Taiwan (NSC101-2511-S-255-004), and Chang Gung Memorial Hospital at Chiayi (BMRP824).
The funding body had no involvement in the design of the study and collection, analysis and interpretation of data and in writing of this manuscript.
Ethical approval
This study was approved by the Institutional Review Board of the Chang Gung Memorial Hospital (102–2360B). The participants were given information about the study indicated their consent to participate by signing a written consent form.
Declaration of competing interest
The authors declare that they have no conflict of interest.
Acknowledgements
We would like to thank the participants sharing their experiences.
References (41)
A developmental approach to training for intercultural sensitivity
Int. J. Intercult. Relat.
(1986)Cultural competence in psychiatric mental health nursing. A conceptual model
Nurs. Clin. N. Am.
(1994)- et al.
Evaluation of the case method in nursing education
Nurse Educ. Pract.
(2014) - et al.
eSimulation: a novel approach to enhancing cultural competence within a health care organisation
Nurse Educ. Pract.
(2015) A critical lens on culture in nursing practice
Nurs. Ethics
(2011)The process of cultural competence in the delivery of healthcare services: a model of care
J. Transcult. Nurs.
(2002)- et al.
Cultural sensitivity and related factors among community health nurses
J. Nurs. Res.
(2013) - et al.
The maternal and child healthcare needs of new immigrants in Taipei
J. Nurs. Res.
(2008) - et al.
The pregnancy and labor experience of Southeast asian women in transnational marriages
J. Evidence-based Nurs.
(2006) Educational Research: Planning, Conducting, and Evaluating Quantitative and Qualitative Research
(2012)
Cultural competence in pediatrics: health care provider knowledge, awareness, and skills
Int. J. Environ. Res. Public Health
Putting the altruism back into altruism: the evolution of empathy
Annu. Rev. Psychol.
Cultural competence training for primary care nurse practitioners: an intervention to increase culturally competent care
J. Cult. Divers.
Cultural safety and providing care to Aboriginal patients in the emergency department
Can. J. Emerg. Med.
Cultural competence in rural nursing education: are we there yet?
Nurs. Educ. Perspect.
Cultural competence: an evolutionary concept analysis
Nurs. Educ. Perspect.
Developing and implementing a cultural awarness workshop for nurse practitioners
J. Cult. Divers.
Patient-centered care: the key to cultural competence
Ann. Oncol.
Cultural safety assessment of an urban Canadian hospital
J. Cult. Divers.
Transcultural self-efficacy perceptions of baccalaureate nursing students
J. Transcult. Nurs. : Off. J. Transcult. Nurs. Soc.
Cited by (10)
Effect of compassion competence on cultural competence in student nurses: Mediating effect of professional nursing values
2022, Journal of Professional NursingCitation Excerpt :In particular, medical professionals have difficulty in providing medical services considering the diverse health beliefs, biological differences, and health problems of multicultural patients, as well as their cultural specificity (Cho Chung et al., 2017; Govender et al., 2017). Culturally competent nursing care integrates specific knowledge, attitudes, and skills that guarantee appropriate care to diverse patient populations (Liang et al., 2019). In this context, health care services that reflect and accommodate cultural specificities increase patient-to-practitioner communication, patient satisfaction, and health status (Park & Yoo, 2019; Tang et al., 2019; Weech-Maldonado et al., 2012).
Addressing the effects of transcultural nursing education on nursing students’ cultural competence: A systematic review
2021, Nurse Education in PracticeCitation Excerpt :Muir-Cochrane et al. (2018) used the “Kiersma-Chen Empathy Scale (REF)”, the “Mental Health Nursing Clinical Confidence Scale”, and “The Cultural Competence Questionnaire (theory of planned behavior–(TPB)–CCQ)” combined with FGs and interviews (n = 21). Liang et al. (2019) also combined focus group interviews (n = 10) with a questionnaire, the “Self-perceived Cultural Care Competence” (SP-CCC) instrument (Table 3). Allen et al. (2013) combined theoretical and practical learning environments using different methods and audio-visual material to prompt discussion and debate.
A virtual training program for improving cultural competence among academic nurse educators
2023, BMC Medical EducationCultural competence of nursing students at a public university in Colombia
2023, Revista Cuidarte