A model for the delivery of culturally competent community care
Aim. To describe the proposed Culturally Competent Community Care (CCCC) model, and the process of development and testing of the model.
Background. Community health nurses are challenged to provide culturally competent care in all types of communities. However, existing models have not provided community nurses with specific guidelines, and none attempt to explain the effects of culturally competent care on populations in community settings. Therefore, it is necessary to develop a model that is comprehensive in its description of the dimensions of culturally competent care in community-based settings and that also requires a focus on ethnic populations. The model is essential for reducing racial and ethnic health disparities.
Methods. Based on literature review and concept analysis, three constructs of the Culturally Competent Community Care Model were developed. Two of the constructs, the health care system and health outcomes, were developed based on a literature review. The main construct of the model, cultural competence, was developed after a concept analysis, following the development and testing of the Cultural Competence Scale (CCS). Interviews with eight community health nurses and a survey by five community nurse experts were conducted in order to refine and confirm the dimensions of cultural competence and its impact on health outcomes.
Conclusions. The proposed dimensions of culturally competent care are caring, cultural sensitivity, cultural knowledge, and cultural skills. This model focuses on the relationship between cultural competence and health outcomes for culturally diverse populations. The framework provides specific guidelines for community nurses in developing and assessing cultural competence and meeting the health needs of diverse communities.