A multilevel investigation of cultural competence among South Korean clinical nurses.

ABSTRACT

BACKGROUND: There is lack of empirical evidence on whether organisational variables affect the cultural competence of nurses. AIM: This study aimed to investigate individual and organisational characteristics associated with South Korean clinical nurses' cultural competence. METHODS: A descriptive cross-sectional research design was used. A convenient sample of 401 clinical nurses from 21 hospitals in South Korea was recruited between November 2015 and February 2016. Multilevel modelling was used to estimate the effects of individual- and organisation-level predictors. Data were analysed using the nlme package in R. RESULTS: Multilevel modelling indicated that professionalism (ß = 0.02, p < 0.001) and foreign language fluency (ß = 0.25, p = 0.012) were significant individual-level predictors. Education on foreign patient care was marginally significant at p = 0.069. At the organisational level, nurse-to-patient ratio (ß = 0.37, p = 0.038) and organisational cultural competence (ß = 0.02, p < 0.001) were significant predictors. In addition, hospital ownership and work environment were marginally significant at p = 0.054 and p = 0.050, respectively. Furthermore, there was a significant cross-level interaction between professionalism and hospital ownership (ß = 0.03, p = 0.003). CONCLUSION: To provide culturally competent care, nurse leaders should recognise the importance of organisational-level factors, such as nurse staffing and organisational cultural competence, and create an environment that is inclusive of diverse patients, as well as promote professionalism among individual nurses.