Cultural Competence in Care of Patients from Diverse Cultural Backgrounds : Experiences of Nursing Students in Gauteng Province, South Africa

Abstract: Background: The society is rapidly changing in a demographic matter. As a result of this nurses are required to be equipped with the right skills and knowledge to approach a more diverse patient group. Hence, the health care is dependent on cultural competent nurses, without them the health care is vulnerable. Previous studies show that nurses are faced with great challenges when it comes to encounters with patients from different cultural backgrounds and that they lack the essential cultural knowledge which effects the quality and standard of care. This means high demands on the nursing curricula to integrate guidelines for cultural competence and educate future nurses in order to make them more prepared for their future profession. Aim: To explore nursing students experiences of practicing cultural competence in care of patients from diverse cultural backgrounds, a qualitative study in Gauteng province, South Africa.  Method: The chosen method was qualitative. Eight individual semi-structured interviews were conducted and analyzed with inspiration from Burnard’s (1996) four-step content analysis. Findings: The findings showed the main-category: beneficial components in cultural competent care, with three sub-categories: positive attitudes and adapting of care, gaining knowledge from cultural encounters with patients and existing contextual insights of own culture and other cultures. The beneficial components included the positive attitudes of the participants and their ability to adapt the care around cultural challenges. Gaining knowledge from cultural encounters with patients and having existing contextual insights of own culture facilitated the encounters with patients. Findings also showed the main-category: barriers in providing a cultural competent care with three sub-categories: disrupted communication, limited levels of cultural knowledge and lack of trust. Disrupted communication was mostly due to the language barrier, a huge problem as important information was left out and the system of getting interpreters faulted. The limited levels of cultural knowledge were based on limited knowledge about different cultures. Lack of trust originated from patients’ strong cultural belief while disbelieving in the westernized health care which resulted in a non-trusting relationship between health care personnel and patients.  Conclusion: There were several barriers as well as facilitators, though the barriers were more dominating in character. Therefore, more education is needed so nursing students feel empowered and more secure when encountering patients from different cultures. Continuing education is also needed for registered nurses as well as prospective and further research is required in order to obtain the best resources for implementation of cultural competence.