A concept of "cultural competence" among public health nurses in Japan

To clarify the conceptual structure of "cultural competence (CC)" among Japanese public health nurses (PHNs), to enhance culturally appropriate support.

A modified grounded theory approach (M-GTA) was used. A total of 11 municipal PHNs participated in this study. Data were collected through semistructured interviews. Interviews were audiotaped and transcribed. A comparative analysis was performed using M-GTA.

Five categories were identified. Japanese PHNs supported foreign residents while (1) maintaining a sincere attitude with curiosity and humility toward others regarding CC; (2) deepening their realization of issues arising from awareness of one's own and other cultures; (3) developing their knowledge about clients' cultures and the surrounding environments; and (4) mastering the skills of building a relationship with clients while creating supportive systems surrounding them. As they gained more experience in supporting foreign residents, as indicated in the above categories, their cultural competence grew, allowing them to (5) gain experience while encountering individuals without holding stereotypes and prejudice.

The concepts of CC that emerged are based on cultural humility and are cultivated through supportive activities. The concepts identified in this study can serve as educational guidelines for health nurses and other care providers in Japan.