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Appl Nurs Res. 2019 Feb;45:6-11. doi: 10.1016/j.apnr.2018.11.001. Epub 2018 Nov 7.

Exploring the experiences of cultural competence among clinical nurses in Taiwan.

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Department of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan.
Department of Cosmetics, Chang Gung University of Science and Technology, Taiwan.
Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, and Assistant research fellow, Department of Internal Medicine, Chang Gung Memorial Hospital, Taiwan. Electronic address:



To generate a descriptive theory framework regarding the experiences of the cultural competencies among clinical nurses in Taiwan.


With the advances in, and the easy accessibility to health care services, frontline nurses require a higher cultural competence to perceive and satisfy the needs of the culturally diverse patients.


A qualitative approach using a grounded theory was applied. There were 30 nurses recruited by purposive sampling.


'Unprepared when encountering different cultures' was the core theme for describing and guiding the process of examining the nurses' experiences with a cultural competence. 'Awareness of value differences' was identified as the antecedent condition. The nurses revealed that they have had difficulty implementing their nursing work and seeking resources that represented situations in which interactive behavioral characteristics appeared to improve their cultural competencies. The nurses managing different cultural situations ultimately learned to tolerate the different cultures and to give patients culturally appropriate care, which thereby enhanced the care quality.


This study highlights the multiple layers of cultural competence experienced by the nurses and the understanding of cultural diversity among patients and caregivers. These results will assist the healthcare providers by offering references for clinical healthcare based on the patients' subjectively different cultural perspectives. Medical organizations should design an in-service educational program/instructions concerning culture to help strengthen the nursing specialists' relevant cultural competencies, to meet the individual patients' cultural care needs, and thereby boost the clinical care quality.


Cultural competence; Grounded theory; Nurses

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