Nursing students' cultural competence in caring for older people in a multicultural and developing region

Background. Health disparities exist among different cultural groups in a multicultural society. Older people from minority groups usually face greater challenges in accessing and utilizing healthcare services due to language barriers, low levels of health literacy and cognitive impairment. Objectives: The aims of this study were to measure nursing students cultural competence in the context of caring for older people from diverse cultural backgrounds and explore associated factors affecting their cultural competence in order to inform curriculum design in Xinjiang, China. Design: A cross-sectional study design. Settings: The study was undertaken in the School of Nursing, Xinjiang Medical University, Xinjiang Uygur Autonomous Region, China. Participants: Students enrolled in a 4-year Bachelor of Nursing Program. Methods: Students' cultural competence was measured using a validated Chinese version of Cross-cultural Care Questionnaire. Data were collected using a self-administered survey. Results: The number of students in the survey was 677. Of those students, 59.5% of them were from an ethnic group other than Han Chinese. A higher proportion of students from ethnic groups, other than Han Chinese, were able to fluently speak a language other than Chinese and used this language in their study and daily lives. Nursing students demonstrated low scores in knowledge, skills and encounters subscales for cultural competence, but had a relatively high score in awareness across all academic years. Findings from students' responses to open-ended questions reveal the need to integrate cross-cultural care and gerontological care into the nursing curricula and support students to apply gerontological knowledge to practice in clinical placements. Conclusions: Nursing students enrolled in a 4-year Bachelor degree program in a multicultural and less developed region demonstrated lower scores on cultural competence and recognized the need to develop crosscultural and gerontological competencies.