Cultural Awareness in Nursing: Concept Analysis Using Rodgers’ Evolutionary Approach

Background: The necessity of nurses’ cultural awareness in the caring process has been emphasized; however, there is a need to define this concept clearly; so the aim of this study was to clarify the cultural awareness concept in the nursing context. Methods: in this qualitative study, a concept analysis using 6-steps Rodgers’s evolutionary method (Determining the intended concept and the related terms, selecting the appropriate domain for data gathering, determine attributes, antecedents, and consequences of the concept, data analysis, stating examples and generate a hypothesis) was adopted based on thematic analysis. The articles published in English and Persian language from 2005 to 2019 were searched and then analyzed. Results: The 6 attributes of cultural awareness include “being a prerequisite to cultural competence, a dynamic and progressive process; having learning potential; being multidimensional; and including self-awareness and awareness about the service user”. Antecedents for cultural awareness consist of global diversity, cultural teaching, developing cultural skills, cultural immersion, and organizations supporting cultural awareness, and researches. Cultural competence or effectiveness, constructive intercultural interaction, and improvement of health outcomes are the consequences of cultural awareness. A definition of cultural awareness was proposed. Conclusion: In today's global diversity, providing suitable infrastructure (including cultural teaching, development, immersion, and researches) can lead to cultural awareness that is a dynamic multidimensional process of self and service user awareness that causes constructive intercultural interaction, cultural competence, and improvement of health outcomes. So, it is suggested to providing the infrastructures and do more studies related to the development of this concept.

[1]  P. Reid,et al.  Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition , 2019, International Journal for Equity in Health.

[2]  E. Hadziabdic,et al.  "Cultural awareness requires more than theoretical education" - Nursing students' experiences. , 2019, Nurse education in practice.

[3]  Joseph S. Gallegos,et al.  The Need for Advancement in the Conceptualization of Cultural Competence , 2018 .

[4]  M. McFarland,et al.  Leininger's transcultural nursing : concepts, theories, research & practice , 2018 .

[5]  A. Mesoudi Migration, acculturation, and the maintenance of between-group cultural variation , 2017, bioRxiv.

[6]  Eddy Li,et al.  Overcoming Communication Barriers to Healthcare for Culturally and Linguistically Diverse Patients , 2017 .

[7]  W. Kunaviktikul,et al.  Identifying the essential components of cultural competence in a Chinese nursing context: A qualitative study , 2017, Nursing & health sciences.

[8]  A. Green,et al.  Residents' Attitude, Knowledge, and Perceived Preparedness Toward Caring for Patients from Diverse Sociocultural Backgrounds , 2017, Health equity.

[9]  K. Bariyyah,et al.  Students multicultural awareness , 2016 .

[10]  D. Cai A concept analysis of cultural competence , 2016 .

[11]  William H. Lonneman Teaching Strategies to Increase Cultural Awareness in Nursing Students , 2015, Nurse educator.

[12]  J. Agazio,et al.  Cultural Awareness , 2015, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[13]  D. Bohman,et al.  Student exchange for nursing students: does it raise cultural awareness'? A descriptive, qualitative study. , 2014, Nurse education in practice.

[14]  Y. Paradies,et al.  Interventions to improve cultural competency in healthcare: a systematic review of reviews , 2014, BMC Health Services Research.

[15]  P. Hart,et al.  Cultural Competency Among Nurses with Undergraduate and Graduate Degrees: Implications for Nursing Education , 2014, Nursing education perspectives.

[16]  L. Rew,et al.  Cultural diversity among nursing students: reanalysis of the cultural awareness scale. , 2014, The Journal of nursing education.

[17]  Renee Martin-Thornton A correlational study on the cultural awareness among graduating associate degree nursing students , 2014 .

[18]  N. Waters The Effect of Virtual-Learning on the Cultural Awareness of Nursing Students , 2014 .

[19]  Joyce Victor-Chmil,et al.  Critical Thinking Versus Clinical Reasoning Versus Clinical Judgment: Differential Diagnosis , 2013, Nurse educator.

[20]  C. J. Thompson Improving the Educational Experience for International Clinical Nurse Specialist Students, Part II: Attending to Culturally Sensitive Communication , 2012, Clinical nurse specialist CNS.

[21]  F. Rafiee,et al.  CONCEPT ANALYSIS OF TRANSITION FROM NURSING STUDENT TO CLINICAL NURSE: RODGERS' EVOLUTIONARY CONCEPT ANALYSIS , 2012 .

[22]  R. Watson,et al.  Construct validation of the Nurse Cultural Competence Scale: a hierarchy of abilities. , 2012, Journal of clinical nursing.

[23]  R. Ingram Using Campinha-Bacote's process of cultural competence model to examine the relationship between health literacy and cultural competence. , 2012, Journal of advanced nursing.

[24]  L. Fogg,et al.  Using a Virtual Community to Enhance Cultural Awareness , 2012, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[25]  Rong Zhang,et al.  Improving Intercultural Awareness: A Challenging Task for Japan , 2012 .

[26]  Dionne Roberts,et al.  Foster cultural responsiveness on your unit. , 2011, Nursing management.

[27]  Raija Kokko Future nurses' cultural competencies: what are their learning experiences during exchange and studies abroad? A systematic literature review. , 2011, Journal of nursing management.

[28]  H. Wharrad,et al.  PROMOTING CULTURAL AWARENESS IN HEALTH CARE STUDENTS WITH THE USE OF VIRTUAL MOBILITY, COMMUNICATION TECHNOLOGIES AND AUTHENTIC CASE STUDIES , 2011 .

[29]  A. Alm Enhancing transcultural awareness in nursing education - the impact of Rainbow Intensive Program , 2011 .

[30]  Lisbeth Fagerstrøm,et al.  Rodgers' evolutionary concept analysis--a valid method for developing knowledge in nursing science. , 2010, Scandinavian journal of caring sciences.

[31]  M. Williamson,et al.  Providing culturally appropriate care: a literature review. , 2010, International journal of nursing studies.

[32]  Joseph R Betancourt,et al.  Commentary: linking cultural competence training to improved health outcomes: perspectives from the field. , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[33]  D. Wagner,et al.  Patient satisfaction with nursing care: a concept analysis within a nursing framework. , 2009, Journal of advanced nursing.

[34]  Sandra Lyniece Pugh Raising cultural awareness of second grade African American students using Mexican American children's literature , 2009 .

[35]  Bramwell Osula Cultural Awareness in Intercultural Mentoring : A Model for Enhancing Mentoring Relationships , 2009 .

[36]  Cynthia L Foronda,et al.  A Concept Analysis of Cultural Sensitivity , 2008, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[37]  L. Yoder,et al.  Improving cross-cultural awareness and skills to reduce health disparities in cancer. , 2008, Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses.

[38]  D. Drevdahl,et al.  Of Goldfish Tanks and Moonlight Tricks: Can Cultural Competency Ameliorate Health Disparities? , 2008, ANS. Advances in nursing science.

[39]  P. Jokinen,et al.  Multicultural Healthcare: A Transatlantic Project , 2007, Nurse educator.

[40]  L. Desantis,et al.  Current Approaches to Integrating Elements of Cultural Competence in Nursing Education , 2007, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[41]  Scott Eugene Hovater Developing cultural awareness: A grounded theory study of pre-service teachers' field experiences in Taiwan , 2007 .

[42]  M. Johnstone,et al.  Culture, language, and patient safety: Making the link. , 2006, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[43]  M. K. Kramer,et al.  Integrated Theory and Knowledge Development in Nursing , 2004 .

[44]  Joyceen S Boyle,et al.  Transcultural concepts in nursing care. , 1989, Journal of transcultural nursing : official journal of the Transcultural Nursing Society.

[45]  Derald Wing Sue,et al.  Counseling the Culturally Diverse: Theory and Practice , 2002 .

[46]  L. Smith Concept analysis: cultural competence. , 1998, Journal of cultural diversity.

[47]  J. Banks,et al.  Multicultural Education: Issues and Perspectives. 6th Edition. , 2006 .