Developing a Conceptual Framework for Cultural Competence in Healthcare: Looking at Antecedents and Consequences

Abstract

Introduction: Cultural Competence (CC) is a continuous endeavor to develop the capacity to deliver care by health professionals to interact with people from various cultural backgrounds. Being a culturally competent health practitioner in a culturally diverse society is a challenging prerequisite. Hence, for developing a conceptual framework for CC, it is essential to identify the antecedents and consequences. Objective: To identify and synthesize available evidence on antecedents and consequences to develop a conceptual framework for cultural competency. Methods: A narrative review of the literature was performed on four databases; Google Scholar, Science Direct, PubMed, and Web of Science to identify the publications between 2000 and 2022. Results: Forty-three articles were eligible from the initial search of 4804 studies. Of these,81.4% and 18.6% were contributed to nurses and healthcare workers respectively. Dimensions of CC care; cultural awareness, cultural sensitivity, cultural desire, and encounters. Antecedents are included under four domains; Cognitive (Cultural knowledge, skills, understanding), Affective (cultural diversity including demographic factors). Behavioral (cultural proficiency, humility, and respect subsisted), Environmental (organizational infrastructure, service support, and healthcare policy guidelines). Upon the available evidence, consequences were categorized into three variables as; client related variables (enhancing patient’s quality of life, holistic care, patient satisfaction), healthcare professional related variables (development of cultural skills, professional growth, communication, and improving nursing practice), and health system related variables (positive organizational outcome, cost-effectiveness, and effective treatment). Conclusions: Ensuring precise deployment of CC provides a positive outcome for both healthcare professional and the client and directly influence the quality of the healthcare system. A comprehensive approach to the assessment of CC and implementation in healthcare practice, education, administration, and research of strategies to enhance cultural competence is vital to promoting culturally congruent healthcare practices. The model could provide a framework for health educators to create significant patient safety and organizational culture curriculum.