Association Between Cultural Competence and Patient-Centered Communication Among Nurses in Clinical Settings: A Cross-Sectional Study

Abstract

Background: Cultural competence is essential for the workforce and quality of care, impacting patient safety, equity, and overall health system performance. This study evaluated the relationship between cultural competence and patient-centered communication across five domains to inform policy and management in emergency care settings. The goal was to evaluate domain-specific cultural competence among emergency department nurses at two tertiary hospitals in Riyadh, Saudi Arabia. Methods: A descriptive cross-sectional survey was conducted with a convenience sample of 217 nurses working in emergency departments at these hospitals. Cultural competence was assessed using the validated Healthcare Provider Cultural Competence Instrument (HPCCI), which measures awareness and sensitivity, behavior, patient-centered communication, self-assessment, and practice orientation. Descriptive statistics summarized domain scores, while t-tests and ANOVA were used to analyze differences across selected demographic and professional variables (α = 0.05). Results: Nurses showed relatively high cultural competence across several domains, with practice orientation scoring the highest (4.21 ± 0.50), and patient-centered communication the lowest (2.05 ± 0.83). Domain-level analysis revealed statistically significant differences by sex, age, years of experience, role, and education, though most effects were small to moderate. Conclusion: Emergency nurses demonstrated strengths in culturally competent practice, but patient-centered communication remains an area for improvement. Health system leaders must prioritize HPCCI-based training, ongoing professional development, and unit-level quality initiatives to foster culturally responsive, patient-centered communication and advance evidence-based workforce policies.