Cultural Competence and Cultural Intelligence of Healthcare Professionals Providing Emergency Medical Services

Abstract

Background: There are more and more foreigners in Poland who become clients of the Polish healthcare system. They use, among others, emergency medical services provided by healthcare professionals: doctors, nurses, and paramedics. Skillful care for culturally different patients requires cultural competencies and cultural intelligence to ensure good quality of care and cultural safety. The study aimed to measure and assess the cultural competencies and cultural intelligence of medical professionals working in hospital emergency departments (HEDs) and hospital emergency rooms (HERs) in Małopolska, a region in southern Poland. Methods: The following questionnaires were used in the study: the Cross-Cultural Competence Inventory (CCCI), the Cultural Intelligence Scale (CQS), and Questionnaire on Attitudes Towards Culturally Divergent People. In total, 709 medical professionals participated in the study, including 363 nurses, 223 paramedics, and 123 doctors. Results: Cultural intelligence—the overall score and the scores on the metacognitive, cognitive, motivational, and behavioral subscales were significantly higher among HED and HER doctors. Cultural competencies—the overall score and the score on the cultural adaptation subscale were also significantly higher among HED and HER doctors. The CCCI and CQS scores were influenced by selected variables: taking care of and close interactions with representatives of other cultural circles; staying outside Poland for more than a month. Doctors were the group of medical professionals that were most tolerant and most positive towards people from other cultures. Conclusions: The research results confirm the positive impact of contact of medical professionals with people from other cultures on their cultural competencies and cultural intelligence. They indicate the need for training in acquiring cultural competencies and developing cultural intelligence, especially among nurses. They demonstrate the need to raise awareness among HED and HER medical professionals about issues in intercultural care and to increase diversity efforts, especially among nurses.

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“…The validated Cultural Intelligence Scale (CQS) is a 20-item questionnaire that characterizes one’s cultural awareness according to four domains: metacognitive, cognitive, motivational, and behavioral[ 23 ]. The CQS has been validated across time, in several different populations, and in different geographic regions [ 24 – 26 ]. The four CQS domains are: Specifically, the four CQS domains are: metacognitive (4 statements), defined as the degree to which a person plans for, remains aware during, and reflects after multicultural interactions; cognitive (6 statements), defined as the level of a person’s understanding about how cultures are similar and how they are different; motivational, (5 statements), defined as the level of a person’s interest, persistence, and confidence to function in culturally diverse settings; and behavioural (5 statements), defined as the extent of a person’s flexibility and appropriate use of a broad repertoire of behaviours and skills during multicultural encounters.…”

“…The validated Cultural Intelligence Scale (CQS) is a 20-item questionnaire that characterizes one's cultural awareness according to four domains: metacognitive, cognitive, motivational, and behavioral [23]. The CQS has been validated across time, in several different populations, and in different geographic regions [24][25][26].…”

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“…Mobaraki et al define cultural competence as “a dynamic process that can be generalized and taught that improves over time with more experience and leads to effective communication with people from other cultures” [ 1 ]. To care for people of different religions, ethnic groups, countries, and races, we do not need to know each culture’s social practices, dominant beliefs, or rules; instead, in moments of vulnerability and fear, we should treat patients how we want to be treated [ 8 ]. A patient-centered approach and exhibiting respect, sensitivity, composure, partnership, honesty, understanding, curiosity, tolerance, and a positive attitude toward them are the keys to developing cultural competence that can improve patient outcomes [ 8 , 9 ].…”

“…To care for people of different religions, ethnic groups, countries, and races, we do not need to know each culture’s social practices, dominant beliefs, or rules; instead, in moments of vulnerability and fear, we should treat patients how we want to be treated [ 8 ]. A patient-centered approach and exhibiting respect, sensitivity, composure, partnership, honesty, understanding, curiosity, tolerance, and a positive attitude toward them are the keys to developing cultural competence that can improve patient outcomes [ 8 , 9 ]. The results of previous studies in Iran show that cultural competence is moderate in general nurses [ 10 ], weak in undergraduate students [ 11 ] and critical care nurses (CCNs) [ 12 ].…”

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“…Cultural knowledge deficits and feelings of ill preparedness in providing culturally responsive care among healthcare practitioners (Majda et al, 2021; Markey et al, 2018)…”