Self-Reflection and Cultural Competence in Nursing Practice: Toward a Holistic Approach to Inclusive Care

Background: Cultural competence is a key element of holistic nursing practice in today's diverse healthcare environments. While formal education supports its development, self-reflection is a crucial mechanism for enhancing cultural awareness and inclusive care. Objectives: This study aimed to assess how nurses in Polish healthcare settings self-evaluate their cultural competence and to explore the role of self-reflection in this process. Methods: A cross-sectional study was conducted from December 2024 to February 2025 with 218 nurses in Greater Poland, using a self-developed Cultural Competence Self-Assessment Scale. Descriptive statistics, analysis of variance, and linear regression were applied. Results: Most participants rated their competence as high. However, gaps emerged in using inclusive language and responding to discriminatory behavior. Higher education and experience with culturally diverse patients were paradoxically linked to lower self-ratings, likely due to increased self-awareness, consistent with the Dunning-Kruger effect. Conclusions: The findings emphasize the value of self-reflection and inclusive communication in developing cultural competence. Although localized, the study contributes to international discourse on subjective competence assessment. It highlights the need to embed reflective practices into nursing education and supports the integration of holistic principles, particularly self-awareness and cultural responsiveness, into everyday nursing care.