Cultural competence models: a critical analysis

Abstract

The cultural competence models guide nurses to a culturally competent care, which is essential in our multicultural world. Considering that a culturally relevant nursing care is a sensitive, person-centered care that reflects the understanding of client’s cultural identity, the authors sought to know what has been published in this area. The starting point of this critical analysis begins on the concepts of culture and cultural competence, as well as their relationship with the conceptual designs developed by cultural competence models. The authors observed the coexistence of essentialist and constructivist perspectives of the concept of culture, which, being antagonistic, determine substantial differences in the construction of cultural competence models. The differences
also reflect the definition of cultural competence used, leading to the categorization in theoretical models and methodological models. The limitations observed in the cultural competence models are mainly related to the essentialist view of the culture, which can strengthen an ethnocentric care. As a result they are very abstract, few models have been empirically tested. Another limitation is related to the fact that most of them evaluate only the cultural competence of health professionals, not considering the clients and health. The essentialist conception of culture also emerges in the most used teaching-learning strategies. Cultural immersion is seen as a central strategy for successful training of cultural competence, seen as a continuous, dynamic and evolving process. The development of cultural competence is essential for a culturally relevant nursing care. This will reduce health inequities in culturally diverse contexts.