Factors Predicting Cultural Competence among Nursing Personnel in the Eastern Economic Corridor of Thailand: A Cross-Sectional Study
DOI:
https://doi.org/10.60099/prijnr.2026.276733Keywords:
Cultural competence, Cultural health values, Eastern Economic Corridor, Nursing personnel, Organizational policy, ThailandAbstract
The Eastern Economic Corridor of Thailand has experienced rapid economic growth and significant immigration, which has led to greater cultural diversity and poses a challenge for healthcare. Nursing personnel require strong cultural competence to meet the diverse health needs of this population. This cross-sectional study aimed to examine the level of cultural competence and its predicting factors among nursing personnel in the Eastern Economic Corridor. The sample consisted of 353 nursing personnel, including nursing students, nursing instructors, and professional nurses, selected using simple random sampling from universities and tertiary hospitals in the Eastern region. Data were collected between March and June 2024 using four instruments: a Personal Information Form, the Nurse Cultural Competence Scale, the Cultural Health Values Questionnaire, and the Perceived Organizational Policies Regarding Cultural Care Questionnaire. Descriptive statistics and multiple regression analysis were employed to analyze the data.
The results showed that most participants (94.13%) demonstrated a relatively high level of cultural competence. Five factors significantly predicted cultural competence: cultural health values, perceived organizational policies related to cultural care, participation in cultural care meetings/training, work experience, and ability to communicate in other languages, with cultural health values being the strongest predictor. Together, these factors explained 36% of the variance in cultural competence. Since cultural competency levels are relatively high, these should be reinforced and maintained. Additionally, nurse administrators and educators should emphasize cultural health values, develop clear organizational policies, and implement structured cultural care training to strengthen nurses’ ability to provide culturally responsive care to diverse client populations in the Eastern Economic Corridor.
References
Office of the Eastern Economic Corridor Policy Committee. Manual for establishing or modifying special economic zones. 2nd rev. ed. Bangkok: Office of the Eastern Economic Corridor Policy Committee, 2021. (in Thai).
Eastern Labor Market Data Management Center. Basic labor data, Eastern region 2022. Labor Market Data Management Division, Department of Employment, Ministry of Labor; 2023. (in Thai).
Songwathana P, Chunuan S, Balthip K, Purinthrapaibal S, Hui T, Ibrahim K, et al. Cultural competence perspectives from nurses in four Asian countries: A qualitative descriptive study. J Health Sci Med Res. 2021;39(1):57-66. doi: 10.31584/jhsmr.2020767.
Wesołowska K, Hietapakka L, Elovainio M, Aalto AM, Kaihlanen AM, Heponiemi T. The association between cross-cultural competence and well-being among registered native and foreign-born nurses in Finland. PLOS One. 2018;13(12):e0208761. doi: 10.1371/journal.pone.0208761.
Williams B. Accomplishing cross cultural competence in youth development programs. J Ext. 2001;39(6):1-6. https://open.clemson.edu/joe/vol39/iss6/16
Zeleke TS, Wudu MA, Bekalu YE, Wondifraw EB, Birhanu TA, Bazie GW. Cultural competence and associated factors among nurses working in public hospitals of South Wollo zone, Northeast Ethiopia: a multi-center cross-sectional study. BMC Nurs. 2024;23:487. doi: 10.1186/s12912-024-02162-x.
Kaihlanen AM, Hietapakka L, Heponiemi T. Increasing cultural awareness: qualitative study of nurses’ perceptions about cultural competence training. BMC Nurs. 2019;18:38. doi: 10.1186/s12912-019-0363-x.
Osmancevic S, Großschädl F, Lohrmann C. Cultural competence among nursing students and nurses working in acute care settings: cross-sectional study. BMC Health Serv Res. 2023;23(1):105. doi: 10.1186/s12913-023-09103-5.
Lin HL, Guo JL, Chen HJ, Liao LL, Chang LC. Cultural competence among pre-graduate nursing students, new graduate nurses, nurse mentors, and registered nurses: A comparative descriptive study. Nurse Educ Today. 2021;97(6):104701. doi: 10.1016/j.nedt.2020.104701.
Berie KM, Salih MH, Abate HK. Cultural competence nursing care and its associated factors among nurses in Northern Ethiopia: A mixed method study design. Nurs Res Rev. 2021;11:55-67. doi: 10.2147/NRR.S342426.
Aphichaichaern N, Khamyoo A, Diaoisarae W. Cross-cultural nursing competence of professional nurses at Bangkok Eastern Hospital. J Prapaklao Nurs Coll Chanthaburi. 2020;31(1):72-80. (in Thai).
Sakaraksa P, Ditsapirom T, Prachasaraiyasaradech K. Cultural competence of third-year nursing students in maternal, infant and midwifery nursing practice 1 at Boromarajonani College of Nursing, Chonburi. J Health Center Region 9. 2025;19(2):587-599. (in Thai).
Truong M, Gibbs L, Pradel V, Morris M, Gwatirisa P, Tadic M, et al. A cultural competence organizational review for community health services: insights from a participatory approach. Health Promot Pract. 2017;18(3):466-475. DOI: 10.1177/1524839916689546
Papadopoulos R, Tilki M, Lees S. Promoting cultural competence in health care through a research-based intervention in the UK. Diversity Health Soc Care. 2004;1(2):107-115.
McFarland MR, Wehbe-Alamah HB, Faust A, Padden DL, Faust H. Leininger's Theory of Culture Care Diversity and Universality: An overview with a historical retrospective and a view toward the future. J Transcult Nurs. 2019;30(6):540-557. doi:10.1177/1043659619867134
Songwathana P, Siriphan S. Thai nurses’ cultural competency in caring for clients living in a multicultural setting. PRIJNR [internet]. 2015 Feb. 10 [cited 2025 Oct. 17];19(1):19-31. available from: https://he02.tcithaijo.org/index.php/PRIJNR/article/view/18965.
Bjarnason D, Mick J, Thompson JA, Cloyd E. Perspectives on transcultural care. Nurs Clin North Am. 2009;44(4):495-503.
Campinha-Bacote J. Promoting health equity among marginalized and vulnerable populations. Nurs Clin North Am. 2024;59(1):109-120. doi: 10.1016/j.cnur.2023.11.009.
Hirunchunha S, Sangchan H, Songwathana P, PetpichetchianW. Perception of Thai nursing students and faculty’s competence toward caring for culturally diverse clients. Thai J Nurs Council. 2009 24(1): 99-111. (in Thai).
Bukhari SAR. Sample size determination using Krejcie and Morgan table. ResearchGate. 2021. https://www.researchgate.net/publication/349118299
Perng SJ, Watson R. Construct validation of the nurse cultural competence scale: A hierarchy of abilities. J Clin Nurs. 2012;21(11-12):1678-1684. doi: 10.1111/j.1365-2702.2011.03933.x.
Alkharusi H. A descriptive analysis and interpretation of data from Likert scales in educational and psychological research. Indian J Psychol Educ. 2022;12(2):13-16. https://www.researchgate.net/publication/373096780
Jarasratphaibun Y, Dangthoern L, Siriporpaiboon T. Factors influencing cultural competence of professional nurses at Phrae Hospital. J Boromarajonani Coll Nurs Uttaradit. 2020;12(1):180-194. https://he01.tci-thaijo.org/index.php/unparticle/view/193205/165422 (in Thai).
Field A. Discovering statistics using IBM SPSS Statistics. 5th ed. London: SAGE Publications; 2018.
Treetipwanich O, Moonsart S, Kaewpan W. Factors predicting cultural competency of registered nurses: A case study at a private hospital in Bangkok. J Royal Thai Army Nurses [internet]. 2019 Dec. 30 [cited 2025 Oct. 18];20(3):185-9. available from: https://he01.tci-thaijo.org/index.php/JRTAN/article/view/233263 (in Thai).
McFarland MR, Wehbe-Alamah HB, editors. Leininger's transcultural nursing: concepts, theories, research & practice. 4th ed. New York: McGraw-Hill Education; 2018.
Cholcharoen H, Kongwattananont P, Thongbai W. Factors related to cross-cultural nursing competence of community nurse practitioners in caring for Muslim clients. J Fac Nurs Burapha Univ. 2018;26(1):69-78. (in Thai).
Wichaikhum O-A, Abhicharttibutra K, Nantsupawat A. Factors influencing Thai health workers’ attitudes toward providing health services to migrants. PRIJNR [internet]. 2024 Mar. 21 [cited 2025 Oct. 18];28(2):296-307. available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/265360
Weech-Maldonado R, Dreachslin JL, Epané JP, Gail J, Gupta S, Wainio JA. Hospital Cultural competency as a systematic organizational intervention: Key findings from the national center for healthcare leadership diversity demonstration project. Health Care Manage Rev. 2018;43(1):30-41. doi: 10.1097/HMR.0000000000000128
Liu TT, Chen MY, Chang YM, Lin MH. A preliminary study on the cultural competence of nurse practitioners and its affecting factors. Healthcare (Basel). 2022;10:678. doi: 10.3390/healthcare10040678
Urbanaviče R, Arab RAE, Austys D, Skvarčevskaja M, Istomina N. Increasing cultural awareness: qualitative study of nurses’ perceptions about cultural competence training. BMC Nurs 18, 38 (2019). doi: 10.1186/s12912-019-0363-x
Almutairi AF, McCarthy A, Gardner GE. Understanding cultural competence in a multicultural nursing workforce: registered nurses’ experience in Saudi Arabia. J Transcult Nurs. 2015;26(1):16-23. doi: 10.1177/1043659614523992
Geleta BA, Radie YT, Areri HA. Exploring cultural competence of nurses and associated barriers in Ethiopian tertiary hospitals: A qualitative study. Appl Nurs Res. 2021;62:151511. doi: 10.1016/j.apnr.2021.151511
Grinberg K, Nissim S. Cultural competence among nursing students: exploring differences across academic stages. BMC Nurs. 2025 Jun 4;24(1):640. doi: 10.1186/s12912-025-03246-y.
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