A STUDY OF THE CULTURAL COMPETENCE OF NURSES WORKINGIN MULTICULTURAL HEALTHCARE ORGANISATIONS WITHIN THEKINGDOM OF SAUDI ARABIA

Manal Al-Wahbi, George Kernohan, Carol Curran

Research output: Contribution to journalArticle

Abstract

In Saudi Arabia nursing care is provided by both Saudi and foreign nurses. Foreign nurses make up66.4% of the total nursing workforce. As a result the workforce is multicultural and more than 40languages are spoken. This paper identifies and addresses the cultural competence experience ofregistered nurses in 5 hospitals in Jeddah city. It explores the relationship between educationalexperience and the nurses' experience and ability to deliver culturally competent nursing care. Thisqualitative study used the Three Dimensional Puzzle Model of culturally congruent care as aframework. An interview guide with a piloted list of questions developed from the 4 theory constructsdescribed in the puzzle model was followed. Semi structured interviews were used for qualitative datacollection. Sixteen interviews were carried out in 4 hospitals in the western region of Saudi Arabia.Five different themes emerged: culture diversity, culture awareness and knowledge, culture attitude andsensitivity, language facilitation and organizational support. Results showed that there were gaps incultural competency in the multicultural nursing workforce in Saudi Arabia and that leaders in healthcare should be aware of and address these issues. In conclusion this study makes an importantcontribution to new knowledge in the fieldof cultural diversity for both the patient and the nurse inSaudi Arabia.
LanguageEnglish
Pages325-342
JournalHumanities and Social Sciences Review
Volume3
Issue number4
Publication statusPublished - 20 Dec 2014

Fingerprint

Cultural Competency
Saudi Arabia
International Nurses
Nurses
Organizations
Interviews
Nursing Care
Delivery of Health Care
Arabia
Nursing
Cultural Diversity
Aptitude
Language
Culturally Competent Care

Keywords

  • Cultural diversity
  • Cultural awareness
  • Culture sensitivity
  • Culture competence
  • Multicultural health care organization
  • Saudi Arabia

Cite this

@article{f126effc4d8e40f3b217b30c332faf68,
title = "A STUDY OF THE CULTURAL COMPETENCE OF NURSES WORKINGIN MULTICULTURAL HEALTHCARE ORGANISATIONS WITHIN THEKINGDOM OF SAUDI ARABIA",
abstract = "In Saudi Arabia nursing care is provided by both Saudi and foreign nurses. Foreign nurses make up66.4{\%} of the total nursing workforce. As a result the workforce is multicultural and more than 40languages are spoken. This paper identifies and addresses the cultural competence experience ofregistered nurses in 5 hospitals in Jeddah city. It explores the relationship between educationalexperience and the nurses' experience and ability to deliver culturally competent nursing care. Thisqualitative study used the Three Dimensional Puzzle Model of culturally congruent care as aframework. An interview guide with a piloted list of questions developed from the 4 theory constructsdescribed in the puzzle model was followed. Semi structured interviews were used for qualitative datacollection. Sixteen interviews were carried out in 4 hospitals in the western region of Saudi Arabia.Five different themes emerged: culture diversity, culture awareness and knowledge, culture attitude andsensitivity, language facilitation and organizational support. Results showed that there were gaps incultural competency in the multicultural nursing workforce in Saudi Arabia and that leaders in healthcare should be aware of and address these issues. In conclusion this study makes an importantcontribution to new knowledge in the fieldof cultural diversity for both the patient and the nurse inSaudi Arabia.",
keywords = "Cultural diversity, Cultural awareness, Culture sensitivity, Culture competence, Multicultural health care organization, Saudi Arabia",
author = "Manal Al-Wahbi and George Kernohan and Carol Curran",
note = "Websites 1. Ministry of Health. 2011. Ministry statistics and indicators: statistics book [pdf] available at� http://www.moh. gov.sa/Ministry/Statistics/Book/Pages/default.aspx�[accessed 1 October 2012]. Last Update: March 06, 2014. 2. Office of Minority Health.US.Department of Health and Human Services. 2013. The National CLAS Standards [online] Available at �http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=15�[accessed 12 December 2013]. Last Update: March 05, 2013. 3. United Nations. 2013. Department of Economic and Social Affairs. World Population Prospects: The 2012 Revision [online] available at �http://esa.un.org/unpd/wpp/Documentation/pdf/WPP2012_Volume-IIDemographic-Profiles.pdf� [Accessed 23. January 2014]. 4. United Nations. 2006. Department of Economic and Social Affairs. Population Division: United Nations expert group meeting on international migration and development in the Arab region. Arab versus Asian migrant workers in the GCC countries [online] available at�http://www.un.org/esa/population/meetings/ EGM_Ittmig_Arab/P02_Kapiszewski.pdf� [Accessed 23 March 2012]. 5. World Health Organization. 2011. Country Cooperation Strategy for WHO and SaudiArabia 2006-2011 [online] available at� http://www.who.int/countryfocus/cooperation_strategy/ccs_sau_en.pdf�[accessed 02 November 2011]. Reference text: 1. Adejumo, O. 1999. Divergent backgrounds, unified goals: continuing education program for multinational nurses in a hospital in the Middle East. Journal of continuing education in nursing, 30 (2), 79-83. 2. Attride-Stirling, J. 2001.Thematic networks: an analytic tool for qualitative research. Qualitative Research, 1 (3), 385-405. 3. Almalki, M., FitzGerald, G. and Clark, M. 2011. The nursing profession in Saudi Arabia: an overview. International nursing review, 58 (3), 304-311. 4. Andrews, M., Backstrand, J.R., Boyle, J.S., Campinha-Bacote, J., Davidhizar, R.E., Doutrich, D., Echevarria, M., Newman Giger, J., Glittenberg, J., Holtz, C., Jeffreys, M.R., Katz, J.R., McFarland, M.R., McNeal, G.J., Pacquiao, D.F., Papadopoulos, I., Purnell, L., Ray, M.A., Sobralske, M.C., Spector, R., Yoder, M.K. and Zoucha, R. 2010. Chapter 3: Theoretical Basis for Transcultural Care. Journal of Transcultural Nursing, 21 (4 suppl), 53S-136S. 5. Andrews, M. and Friesen, L. 2011.Finding electronically available information on cultural competence in health care.Online Journal of Cultural Competence in Nursing and Healthcare, 1 (4), 27-43. 6. Bryman, A. 2012. Social Research Methods. 4th ed. Oxford: Oxford University Press. 7. Cary, A. Brown and Mieke Busman. 2003. Expatriate health-care workers and maintenance of standards of practice factors affecting service delivery in Saudi Arabia. International Journal of Health Care Quality Assurance, 16 (7), 347 – 353. 8. Cowan, D.T. and Norman, I. 2006. Cultural Competence in Nursing: New Meanings. Journal of Transcultural Nursing, 17 (1), 82-88. 9. Crigger, N.J. and Holcomb, L. 2007. Practical Strategies for Providing Culturally Sensitive, Ethical Care in Developing Nations. Journal of Transcultural Nursing, 18 (1), 70-76. 10. Dudas, K., I. 2012. CULTURAL COMPETENCE: An Evolutionary Concept Analysis. Nursing Education Perspectives, 33 (5), 317-321. 11. Englund, A.D. and Rydstr{\"o}m, I. 2012. “I have to Turn Myself Inside Out”. Clinical nursing research, 21 (2), 224-242. 12. Graneheim, U.H. and Lundman, B. 2004. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today, 24 (2), 105-112. 13. Leininger, M. and McFarland, M. 2002.Transcultural nursing concepts, theories, and practices. New York: McGraw- Hill. 14. Lister, P. 1999. A taxonomy for developing cultural competence. Nurse education today, 19 (4), 313-318. 15. Loftin, C., Hartin, V., Branson, M. and Reyes, H. 2013. Measures of cultural competence in nurses: an integrative review. Scientific World Journal, 2013 289101-289101. 16. Luna, L. 1998. Culturally Competent Health Care: A Challenge for Nurses in Saudi Arabia. Journal of Transcultural Nursing, 9 (2), 8-14. 17. Maitra B (2005) Culture and the mental health of children: The cutting edge of expertise. In Timimi S &Maitra B (Eds) Critical Voices in Child and Adolescent Mental Health.Free Association Books, London. 18. Mohammadreza, H., Monireh, A., Taghi, A., Armaki and Eisa, M. 2012. Communication strategies for nurses facing culturally diverse patients [Farsi].Payesh Health Monitor, 11 (5), 2p. 19. Rebekah, E. Carey. 2011. Cultural Competence Assessment of Baccalaureate Nursing Students: An Integrative Review of the Literature. International Journal of Humanities and Social Science, 1 (9), 258-266. 20. Ryan, G.W. 1999. Measuring the typicality of text: Using multiple coders for more than just reliability and validity checks. Human Organization, 58 (3), 313–322. 21. Ryan, G.W. and Bernard, H.R. 2003. Techniques to Identify Themes.Field Methods, 15 (1), 85-109. 22. Schim, S.M., Doorenbos, A.Z., Miller, J. and Benkert, R. 2003. Development of a cultural competence assessment instrument.Journal of nursing measurement, 11 (1), 29-40. 23. Schim, S.M., Doorenbos, A., Benkert, R. and Miller, J. 2007. Culturally Congruent Care.Journal of Transcultural Nursing, 18 (2), 103-110. 24. Schim, S.M. and Doorenbos, A.Z. 2010. A three-dimensional model of cultural congruence: framework for intervention. Journal of Social Work in End-Of-Life & Palliative Care, 6 (3-4), 256-270. 25. Smith, L.S. 1998. Concept analysis: cultural competence. Journal of cultural diversity, 5 (1), 4-10. 26. Suh, E.E. 2004. The Model of Cultural Competence Through an Evolutionary Concept Analysis. Journal of Transcultural Nursing, 15 (2), 93-102. 27. Taylor, R.A. and Alfred, M.V. 2010. Nurses’ Perceptions of the Organizational Supports Needed for the Delivery of Culturally Competent Care. Western journal of nursing research, 32 (5), 591-609. 28. Tumulty, G. 2001.Professional Development of Nursing in Saudi Arabia.Journal of Nursing Scholarship, 33 (3), 285-290. 29. Zakari, N., Al Khamis, N. and Hamadi, H. 2010. Conflict and professionalism: perceptions among nurses in Saudi Arabia. International nursing review, 57 (3), 297-304. 30. Wiebe, A. and Young, B. 2011. Parent perspectives from a neonatal intensive care unit: a missing piece of the culturally congruent care puzzle. Journal Of Transcultural Nursing: Official Journal Of The Transcultural Nursing Society / Transcultural Nursing Society, 22 (1), 77-82. 31. Wilson-Stronks, A. and Galvez, E. 2007. Hospitals, language, and culture: A snapshot of the nation: Exploring Cultural and Linguistic Services in the Nation’s Hospitals A Report of Findings. [online] available at. �http://www.jointcommission.org/assets/1/6/hlc_paper.pdf � [accessed 13 March 2012]. 32. Wu, H. and Volker, D.L. 2009. The use of theory in qualitative approaches to research: application in end-oflife studies. Journal of advanced nursing, 65 (12), 2719-2732.",
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month = "12",
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language = "English",
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pages = "325--342",
journal = "Humanities and Social Sciences Review",
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T1 - A STUDY OF THE CULTURAL COMPETENCE OF NURSES WORKINGIN MULTICULTURAL HEALTHCARE ORGANISATIONS WITHIN THEKINGDOM OF SAUDI ARABIA

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AU - Kernohan, George

AU - Curran, Carol

N1 - Websites 1. Ministry of Health. 2011. Ministry statistics and indicators: statistics book [pdf] available at� http://www.moh. gov.sa/Ministry/Statistics/Book/Pages/default.aspx�[accessed 1 October 2012]. Last Update: March 06, 2014. 2. Office of Minority Health.US.Department of Health and Human Services. 2013. The National CLAS Standards [online] Available at �http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=15�[accessed 12 December 2013]. Last Update: March 05, 2013. 3. United Nations. 2013. Department of Economic and Social Affairs. World Population Prospects: The 2012 Revision [online] available at �http://esa.un.org/unpd/wpp/Documentation/pdf/WPP2012_Volume-IIDemographic-Profiles.pdf� [Accessed 23. January 2014]. 4. United Nations. 2006. Department of Economic and Social Affairs. Population Division: United Nations expert group meeting on international migration and development in the Arab region. Arab versus Asian migrant workers in the GCC countries [online] available at�http://www.un.org/esa/population/meetings/ EGM_Ittmig_Arab/P02_Kapiszewski.pdf� [Accessed 23 March 2012]. 5. World Health Organization. 2011. Country Cooperation Strategy for WHO and SaudiArabia 2006-2011 [online] available at� http://www.who.int/countryfocus/cooperation_strategy/ccs_sau_en.pdf�[accessed 02 November 2011]. Reference text: 1. Adejumo, O. 1999. Divergent backgrounds, unified goals: continuing education program for multinational nurses in a hospital in the Middle East. Journal of continuing education in nursing, 30 (2), 79-83. 2. Attride-Stirling, J. 2001.Thematic networks: an analytic tool for qualitative research. Qualitative Research, 1 (3), 385-405. 3. Almalki, M., FitzGerald, G. and Clark, M. 2011. The nursing profession in Saudi Arabia: an overview. International nursing review, 58 (3), 304-311. 4. Andrews, M., Backstrand, J.R., Boyle, J.S., Campinha-Bacote, J., Davidhizar, R.E., Doutrich, D., Echevarria, M., Newman Giger, J., Glittenberg, J., Holtz, C., Jeffreys, M.R., Katz, J.R., McFarland, M.R., McNeal, G.J., Pacquiao, D.F., Papadopoulos, I., Purnell, L., Ray, M.A., Sobralske, M.C., Spector, R., Yoder, M.K. and Zoucha, R. 2010. Chapter 3: Theoretical Basis for Transcultural Care. Journal of Transcultural Nursing, 21 (4 suppl), 53S-136S. 5. Andrews, M. and Friesen, L. 2011.Finding electronically available information on cultural competence in health care.Online Journal of Cultural Competence in Nursing and Healthcare, 1 (4), 27-43. 6. Bryman, A. 2012. Social Research Methods. 4th ed. Oxford: Oxford University Press. 7. Cary, A. Brown and Mieke Busman. 2003. Expatriate health-care workers and maintenance of standards of practice factors affecting service delivery in Saudi Arabia. International Journal of Health Care Quality Assurance, 16 (7), 347 – 353. 8. Cowan, D.T. and Norman, I. 2006. Cultural Competence in Nursing: New Meanings. Journal of Transcultural Nursing, 17 (1), 82-88. 9. Crigger, N.J. and Holcomb, L. 2007. Practical Strategies for Providing Culturally Sensitive, Ethical Care in Developing Nations. Journal of Transcultural Nursing, 18 (1), 70-76. 10. Dudas, K., I. 2012. CULTURAL COMPETENCE: An Evolutionary Concept Analysis. Nursing Education Perspectives, 33 (5), 317-321. 11. Englund, A.D. and Rydström, I. 2012. “I have to Turn Myself Inside Out”. Clinical nursing research, 21 (2), 224-242. 12. Graneheim, U.H. and Lundman, B. 2004. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today, 24 (2), 105-112. 13. Leininger, M. and McFarland, M. 2002.Transcultural nursing concepts, theories, and practices. New York: McGraw- Hill. 14. Lister, P. 1999. A taxonomy for developing cultural competence. Nurse education today, 19 (4), 313-318. 15. Loftin, C., Hartin, V., Branson, M. and Reyes, H. 2013. Measures of cultural competence in nurses: an integrative review. Scientific World Journal, 2013 289101-289101. 16. Luna, L. 1998. Culturally Competent Health Care: A Challenge for Nurses in Saudi Arabia. Journal of Transcultural Nursing, 9 (2), 8-14. 17. Maitra B (2005) Culture and the mental health of children: The cutting edge of expertise. In Timimi S &Maitra B (Eds) Critical Voices in Child and Adolescent Mental Health.Free Association Books, London. 18. Mohammadreza, H., Monireh, A., Taghi, A., Armaki and Eisa, M. 2012. Communication strategies for nurses facing culturally diverse patients [Farsi].Payesh Health Monitor, 11 (5), 2p. 19. Rebekah, E. Carey. 2011. Cultural Competence Assessment of Baccalaureate Nursing Students: An Integrative Review of the Literature. International Journal of Humanities and Social Science, 1 (9), 258-266. 20. Ryan, G.W. 1999. Measuring the typicality of text: Using multiple coders for more than just reliability and validity checks. Human Organization, 58 (3), 313–322. 21. Ryan, G.W. and Bernard, H.R. 2003. Techniques to Identify Themes.Field Methods, 15 (1), 85-109. 22. Schim, S.M., Doorenbos, A.Z., Miller, J. and Benkert, R. 2003. Development of a cultural competence assessment instrument.Journal of nursing measurement, 11 (1), 29-40. 23. Schim, S.M., Doorenbos, A., Benkert, R. and Miller, J. 2007. Culturally Congruent Care.Journal of Transcultural Nursing, 18 (2), 103-110. 24. Schim, S.M. and Doorenbos, A.Z. 2010. A three-dimensional model of cultural congruence: framework for intervention. Journal of Social Work in End-Of-Life & Palliative Care, 6 (3-4), 256-270. 25. Smith, L.S. 1998. Concept analysis: cultural competence. Journal of cultural diversity, 5 (1), 4-10. 26. Suh, E.E. 2004. The Model of Cultural Competence Through an Evolutionary Concept Analysis. Journal of Transcultural Nursing, 15 (2), 93-102. 27. Taylor, R.A. and Alfred, M.V. 2010. Nurses’ Perceptions of the Organizational Supports Needed for the Delivery of Culturally Competent Care. Western journal of nursing research, 32 (5), 591-609. 28. Tumulty, G. 2001.Professional Development of Nursing in Saudi Arabia.Journal of Nursing Scholarship, 33 (3), 285-290. 29. Zakari, N., Al Khamis, N. and Hamadi, H. 2010. Conflict and professionalism: perceptions among nurses in Saudi Arabia. International nursing review, 57 (3), 297-304. 30. Wiebe, A. and Young, B. 2011. Parent perspectives from a neonatal intensive care unit: a missing piece of the culturally congruent care puzzle. Journal Of Transcultural Nursing: Official Journal Of The Transcultural Nursing Society / Transcultural Nursing Society, 22 (1), 77-82. 31. Wilson-Stronks, A. and Galvez, E. 2007. Hospitals, language, and culture: A snapshot of the nation: Exploring Cultural and Linguistic Services in the Nation’s Hospitals A Report of Findings. [online] available at. �http://www.jointcommission.org/assets/1/6/hlc_paper.pdf � [accessed 13 March 2012]. 32. Wu, H. and Volker, D.L. 2009. The use of theory in qualitative approaches to research: application in end-oflife studies. Journal of advanced nursing, 65 (12), 2719-2732.

PY - 2014/12/20

Y1 - 2014/12/20

N2 - In Saudi Arabia nursing care is provided by both Saudi and foreign nurses. Foreign nurses make up66.4% of the total nursing workforce. As a result the workforce is multicultural and more than 40languages are spoken. This paper identifies and addresses the cultural competence experience ofregistered nurses in 5 hospitals in Jeddah city. It explores the relationship between educationalexperience and the nurses' experience and ability to deliver culturally competent nursing care. Thisqualitative study used the Three Dimensional Puzzle Model of culturally congruent care as aframework. An interview guide with a piloted list of questions developed from the 4 theory constructsdescribed in the puzzle model was followed. Semi structured interviews were used for qualitative datacollection. Sixteen interviews were carried out in 4 hospitals in the western region of Saudi Arabia.Five different themes emerged: culture diversity, culture awareness and knowledge, culture attitude andsensitivity, language facilitation and organizational support. Results showed that there were gaps incultural competency in the multicultural nursing workforce in Saudi Arabia and that leaders in healthcare should be aware of and address these issues. In conclusion this study makes an importantcontribution to new knowledge in the fieldof cultural diversity for both the patient and the nurse inSaudi Arabia.

AB - In Saudi Arabia nursing care is provided by both Saudi and foreign nurses. Foreign nurses make up66.4% of the total nursing workforce. As a result the workforce is multicultural and more than 40languages are spoken. This paper identifies and addresses the cultural competence experience ofregistered nurses in 5 hospitals in Jeddah city. It explores the relationship between educationalexperience and the nurses' experience and ability to deliver culturally competent nursing care. Thisqualitative study used the Three Dimensional Puzzle Model of culturally congruent care as aframework. An interview guide with a piloted list of questions developed from the 4 theory constructsdescribed in the puzzle model was followed. Semi structured interviews were used for qualitative datacollection. Sixteen interviews were carried out in 4 hospitals in the western region of Saudi Arabia.Five different themes emerged: culture diversity, culture awareness and knowledge, culture attitude andsensitivity, language facilitation and organizational support. Results showed that there were gaps incultural competency in the multicultural nursing workforce in Saudi Arabia and that leaders in healthcare should be aware of and address these issues. In conclusion this study makes an importantcontribution to new knowledge in the fieldof cultural diversity for both the patient and the nurse inSaudi Arabia.

KW - Cultural diversity

KW - Cultural awareness

KW - Culture sensitivity

KW - Culture competence

KW - Multicultural health care organization

KW - Saudi Arabia

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M3 - Article

VL - 3

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EP - 342

JO - Humanities and Social Sciences Review

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