Cultural Competence Training and Delivery of Culturally Responsive Care Among Nurses at Msambweni County Referral Hospital, Kwale County, Kenya
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Abstract
Cultural competence training is widely recognized as a foundation for nursing care that respects patients' cultural beliefs, languages, and values, yet evidence on how training shapes practice remains limited in rural, multicultural Kenyan hospitals. This study examined the association between cultural competence training and the delivery of culturally responsive care among nurses at Msambweni County Referral Hospital (MCRH), Kwale County, Kenya. A mixed-methods design was employed, combining quantitative and qualitative approaches. Data were collected using pretested structured questionnaires from a stratified random sample of 84 nurses and key informant interviews involving seven charge nurses and the nursing officer in charge. Seventy-seven questionnaires were returned, a response rate of 91.7%. Training was measured using a nine-item Likert-type scale (Cronbach's α 0.88) covering pre-service instruction, in-service workshops, orientation, and application in daily care. Quantitative data were analyzed in SPSS version 26 using descriptive statistics, Pearson correlation, and multiple linear regression; interviews were analyzed thematically. Findings showed that formal training exposure was low overall (composite M = 2.46, SD = 0.96); only 14.3% of nurses had attended a cultural sensitivity workshop and 13.0% reported regular workplace training, yet 70.1% believed all nurses should receive such training regularly. Training was the strongest correlate of cultural competence among the variables examined (r = 0.807, p < .001) and remained an independent, statistically significant predictor in the regression model (β = 0.403, p < .001). These findings indicate that structured, practice-focused training is associated with, and may meaningfully improve, culturally responsive nursing care at MCRH; quarterly in-service training anchored in institutional policy is recommended.
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