A STRUCTURAL EQUATION MODELING OF CULTURAL COMPETENCE AMONG THAI NURSES

Abstract

Cultural competence is essential to the nursing profession. It is the nurses’ ability to deliver nursing practice and communication effectively and appropriately with people from different cultural backgrounds. This cross-sectional model-testing design aimed to test a hypothesized model of nurse cultural competence. Multi-stage random sampling was used to recruit 470 participants who had worked as registered nurses for at least 6 months. Participants were from eight hospitals, both private and public, in the four provinces in Thailand most popular with foreign tourists. Data collection was carried out from July to December 2020. Research instruments were the Cultural Competence Scale for Clinical Nurses, the Generalized Ethnocentrism Scale, the Multicultural Experiences Questionnaire, the Subscale of Cultural Competence Assessment Instrument, and the Goal Adjustment Scale. Their Cronbach alpha reliability ranged from 0.80 to 0.92. Descriptive statistics and Structural Equation Modeling were used to analyze the data.

The results revealed that the modification of the hypothesized model fit the data well (χ2 = 32.860, df = 21, p = .048, CMIN/ df = 1.565, GFI = .984, CFI = .988, and RMSEA = .035). Organizational cultural competence support had direct and indirect effects on nurses’ cultural competence through adaptation (β = .16, and β = .15, p < .05). Ethnocentric attitude and multicultural experience had indirect effects through adaptation (β = -.09, and β = .31, p < .05). Adaptation had a direct effect on nurses’ cultural competence (β = .62, p < .05). Ethnocentric attitude, multicultural experience, organizational cultural competence support, and adaptation accounted for 49.0% of the variance in predicting nurses’ cultural competence. These findings suggest that this causal model of nurse cultural competence fits the empirical data. An intervention to promote organizational cultural competence support and adaptation should be developed and implemented among Thai nurses to achieve optimal cultural competence.

-