Cultural Competence Nursing Care and Its Associated Factors Among Nurses in Northern Ethiopia: A Mixed Method Study Design

Background: Cultural competence comprises understanding the values, beliefs, traditions, and customs of diverse groups. Nurses working with a culturally diverse population are fronting challenges principally due to the coexistence of multicultural and multiethnic societies. Objective: To assess cultural competency nursing care and its associated factors among nurses working in Amhara Regional State Referral Hospitals, Ethiopia, 2021. Methods: Institution-based mixed method study design was conducted at selected referral hospitals in Amhara Regional state Ethiopia from April 1 to May 30, 2021. A simple random sampling technique was used to select 543 participants for quantitative and purposive sampling for qualitative study. Data were collected using a self-administered Nurse Cultural Competence Scale Questionnaire, and semi-structured questions for in-depth inter-views. Data were entered into Epi data version 4.6 and exported to SPSS version 25 analysis. Descriptive statistics independent t-test and one-way analysis of variance with multiple linear regression analysis were used for data analysis. Qualitative data were analyzed using thematic analysis using open code software. Results: A total of 543 participants were involved in this study making a response rate of 95.02% and seven participants for qualitative until data saturation was involved. More than half (54.5%) were female. The overall cultural competence nursing care of mean score was 3.39 (0.61) out of a total possible score ranging from 1 to 5 which indicates a moderate level of cultural competency. The language barriers, lack of organizational support, cultural difference, and health care provider-related factors were the main identified themes in qualitative results. Conclusion and Recommendation: The overall cultural competence was at a moderate level, among four subscales cultural sensitivity was the highest. The language barrier and lack of training were the major barriers to culturally competent nursing care.