Cultural competence in practice: The example of the community nursing care of asylum applicants in Scotland

This ethnographic study used an interpretive theory of culture to investigate the principles and factors underlying the delivery of culturally competent nursing care. Initially, a theoretical view was derived from the nursing literature, which led to the development of the Five Steps Model of cultural competence (Quickfall, 2004). This model incorporates organisational values, cultural awareness, cultural sensitivity and cultural knowledge (Papadopoulos, 2006). Study methods included observation, individual face-to-face interviews and focus group interviews to consider how community nurses used cultural competence in their practice with asylum seekers and refugees. The data were analysed for their categorical content. Three major themes emerged from the study as major influences in the delivery of culturally competent care: the need for equitable service provision, the cross-cultural promotion of health as a partnership process and the importance of aiding adaptation to a new social environment. The revised model incorporates these themes.