Factors Affecting Cultural Competence of Nursing Students

  • Park, Mi-Sook (Dept. of Nursing, Korea National University of Transportation)
  • Received : 2019.04.01
  • Accepted : 2019.05.02
  • Published : 2019.05.31


This study was conducted to identify the level of cultural empathy, self-esteem, and cultural competence and factors affecting cultural competence of nursing students. Participants were 157 nursing students who were 2nd, 3rd, and 4th grade in one university located at the Chungbuk provinces. Data collected using questionnaires which consisted of general characteristics, cultural empathy, self-esteem, and cultural competence. The mean score for cultural empathy was $3.63{\pm}.34$(scores ranged from 1 to 5), The mean score for self-esteem was $2.91{\pm}.42$(scores ranged from 1 to 4). The mean score for cultural competence was $3.31{\pm}.43$(scores ranged from 1 to 5). There were significant differences between cultural competence and age(t=-2.242, p=.027), grade(F=3.473, p=.033), and fluency of foreign language(F=5.053, p=.007). There were significant correlation between cultural competence and cultural empathy(r=.49, p<.001), and self-esteem(r=.33, p<.001)), and self-esteem and cultural empathy(r=.33, p<.001). Cultural empathy and self-esteem explained 29.4% of cultural competence and major predictor variable for cultural competence was cultural empathy. In this paper, we propose various multicultural education programs in curriculum and extra curriculum that can enhance cultural empathy and self-esteem to improve cultural competence of nursing students. Especially, continuous education of cultural knowledge among cultural competence will be done.

Table 1. The Mean Score for Cultural Empathy, Self-Esteem, and Cultural Competence(N=157)

CPTSCQ_2019_v24n5_113_t0001.png 이미지

Table 2. Difference in Cultural Competence according to General Characteristics(N=157)

CPTSCQ_2019_v24n5_113_t0002.png 이미지

Table 3. Correlations among Cultural Empathy, Self- Esteem and Cultural Competence(N=157)

CPTSCQ_2019_v24n5_113_t0003.png 이미지

Table 4. Factors affecting Cultural Competence(N=157)

CPTSCQ_2019_v24n5_113_t0004.png 이미지


Supported by : Korea National University of Transportation


  1. The Ministry of Justice of Republic of Korea. Status of foreigner stayed in republic of Korea; 2017[cited 2019 April 28]. Avaliable from
  2. M. K. Cho, I. N. Shin, Y. J. Lee, J. H. Lee, E. H. Yang, H. R. Jeong, and K. M. Cha, "University Nursing Students' Empathic Ability and Cultural Competency," Perspective in Nursing Science, Vol. 12, No. 2, pp.106-114, October, 2015.
  3. Korea Institute for Health and Social Affairs.(2017, April). Health and Welfare Trends foreign patients in 2016. Seoul: Korea institute for Health and Social Affairs.
  4. N. Y. Lee, Y. S. Eo, J. and J. W. Lee, "Level of cultural competence(CC) and educational needs for cultural competence in nursing(CCN) in undergraduate nursing students," Journal of Korean Academic Society of Nursing Education, Vol 21, No. 1, pp.16-27, February, 2015.
  5. J. R. Betancourt, A. R. Green, J. E. Carrillo, and O. Ananeh-Fierempong, "Definding Cultural Competence: A Practical Framework for Addressing Racial/Ethnic Disparities in Health and Health Care," Public Health Reports, Vol. 118, No.4, pp. 293-302, July-August, 2003.
  6. J. Capell, G. Veenstra, and E. Dean, "Cultural Competence in health Care: Critical Analysis of the Construct, Its Assessment and Implications", The Journal of Theory Construction and Testing, Vol. 11, No. 1, pp.30-36, January, 2007.
  7. J. N. Giger, and R. E. Davidhizar, "Transcultural nursing," 5th ed. Lee KH, Kim KS, Kim JH, Kim YH, Park HS, Jung KH et al. Seoul: Elsevier Korea; 2011.
  8. S. O. Yang, M. S. Kwon, and S. H. Lee, " The factors affecting cultural competency of visiting nurses and community health practitioners," Journal of Korean Academic Community Health Nursing, Vol. 23, No. 3, pp.286-295, September, 2012.
  9. J. H. Kim, "A study about cultural sensitivity and stereotype about immigrant women among nursing students," Journal of Digital Convergence, Vol. 12, No. 7, pp.305-314, July, 2014.
  10. S. H, Choi, "Factors Affecting Cultural Competence of Nursing Students," Journal of the Korean Data Analysis Society, Vol.19, No.6(B), pp.3379-3390, December, 2017.
  11. S. Y. Han, "Development of a cultural competence scale for nursing students," Chonnam National University, Mater's thesis, 2014.
  12. J. M. Kim, "The relationship between emotional intelligence cultural empathy and cultural competency in nursing students," Master's thesis, Kosin University Graduate School, 2016.
  13. American Association of Colleges of Nursing(2008. August). Tool kit resources for cultural competent education for baccalaureate nurses. retrieved April 28, 2019, from
  14. K. S. Choi, H. S. Kim, S. Y. Lee, A. Dressel, L. W. Galvao, and M. H. Jun, "A study on the curriculum of global health education," The Journal of Korean Academic Society of Nursing Education, Vol. 22, No. 2, pp220-227, May, 2016.
  15. S. H. Kim, "Development of educational program for cultural competence in nursing for nursing students and its effects," Journal of Korean Academic Society of Nursing Education, Vol. 19, No. 4, pp.580-593, November, 2013.
  16. D. H. Kim, and S. E. Kim, "Cultural competence and factors influencing cultural competence in nursing students," Journal of Korean Academic Psychiatric Mental Health Nursing, Vol. 22, No. 3, pp.159-168, September, 2013
  17. M. A. Kim, and S. E. Choi, "A Literature of the studies on cultural competency of nurses and nursing students in korea,", Journal of Korean Academic Community Health Nursing, Vol.29, No.4, pp.450-466, December, 2018.
  18. S. Y. Yang, "The study on relationship between characteristics of cultural exchanges, self-efficacy, and cultural competency of nursing students," The Journal of The Korea Contents Association, Vol. 14, No. 7, pp.334-345, July, 2014.
  19. S. Y. Yang, H. N. Lim, and J. H. Lee, "The study on relationship between cultural competency and empathy of nursing students", Journal of Korean Academic Society Nursing Education, Vol. 29, No. 2, pp.183-193, May, 2013.
  20. Y. S. Bae, "A study on the relationship between cultural competence and empathy of nursing students," Journal of East-West Nursing Research, Vol. 21, No. 1, pp.52-60, May, 2015.
  21. M. S. Kim, and D. S. Shin, "Factors influencing cultural competence of nursing students," Journal of the Korean Data Analysis Society, Vol. 18, No. 6, pp.3437-3450, December, 2016.
  22. S. H. Kwon, H. K. Son, A. R. Han, Y. J. Kim, and G. H. Choi, "The factors affecting cultural competence in nursing students," Journal of the Korean Data Analysis Society, Vol. 19, No. 2, pp.1069-1081, April, 2017.
  23. D. Y. Park, and K. H. Jung, "The influence of self esteem, interpersonal relations and intercultural communicative competence on cultural competence of nursing students," The Korea Contents Association, Vol. 14, No. 11, pp.337-346, November, 2014.
  24. C. L. Jeffrey, "Empathy and competence," The Medical Journal of Australia, Vol. 188, No. 7, pp.414-416, April, 2008.
  25. A. E. Ivey, M. B. Ivey, and L. Simek-Morgan, "The empathic attitude: Individual, family and culture," In A. Ivey, M. Ivey, & L. Simek-Morgan(Eds.). Counseling and psychotherapy: A multicultural perspective(2nd ed.), pp.21-44, February, 1993.
  26. C. R. Ridley, and D. W. Lingle, "Cultural empathy in multicultural counseling: A multidimensional process model." In P. B. Pedersen, J. G. Draguns, W. J. Lonner, & J. E. Trimble(Eds.). Counseling across cultures(4th ed.), pp.21-46, December, 1995.
  27. M. Rosenberg, "Society and the adolescent self-image (Vol. 11)," Princeton University Press, Princeton, NJ. 1965.
  28. J. A. Banks, "Teaching Strategies for ethnic studies," New Jersey: Allyn & Bacon, Inc., 1984.
  29. J. Y. Lee, "The effects of self-esteem of elementary school students on multicultural acceptability, Master's thesis, Seoul National University, 2018.
  30. J. A. Lee, and Y. J. Lee, "Relationship of self-esteem and empathic ability and multicultural acceptability of elementary school," Journal of Learner-Centered Curriculum and Instruction, Vo. l6, No. 6, pp.73-91, Jun, 2016.
  31. H. J. Kim, and T. S. Lee, "The effects of students' self-esteem on multicultural acceptability at elementary school level," Journal of Learner-Centered Curriculum and Instruction, Vol. 15, No. 2, pp.479-498, February, 2015.
  32. Y. W. M. Wang, M. M. Davison, O. F Yakushko, H. B. Savoy, J. A. Tan, and J. K. Bleier, "The Scale of Ethnocultural Empathy: Development, Validation and Reliability," Journal of Counseling Psychology, Vol. 50, No. 2, pp.221-234, April, 2003.
  33. J. Y. Kim, "A study on color-blind racial attitudes and cultural competence of service providers in multicultural settings-focusing on moderating effects of cultural empathy and multicultural training-," Doctoral Dissertation, The Catholic University of Korea, 2013.
  34. B. J. Jeon, "Self-esteem: A test of its' measurability," Yonsei Research Institute, Vol. 11, No. 1, pp.107-130, 1974.
  35. E. J. Choi, "The effect of nursing students' consciousness of biomedical ethics, good death recognition, and self-esteem on the attitude toward withdrawal of life-sustaining treatment," Masters' thesis, Graduate School of Kongju National University. 2018.
  36. R. A. Caffrey, W. Neander, D. Markle, and B. Stewart, "Improving the cultural competence of nursing students: results of integrating cultural content in the curriculum and an international immersion experience," Journal of Nursing Education, Vol. 44, No. 5, pp.234-240, May, 2005.
  37. S. M. Schim, A. Z. Doorenbos, J. Miller, and R. Benkert, "Development of a cultural competence assessment instrument," Journal of Nursing Measurement, Vol. 11, No. 1, pp.29-40, March, 2003.
  38. J. S. Park, "Study on cultural competence of nurses working in general hospital," Keimyung University of Korea, Daegu, 2011.
  39. M. J. Bennet. "Developing intercultural sensitivity," In D. Landis. M. Bennett, & J. Bennett, Handbook of intercultural training, Thousands Oaks, CA:Sage. pp.166-184. 2004.