Msomi Ntandoyenkosi L, Barath Suvishka
Department of Family Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Department of Speech Language Therapy, Clinical Support Services, Queen Elizabeth Hospital King's Lynn, Norfolk, United Kingdom.
J Coll Med S Afr. 2025 Jul 22;3(1):204. doi: 10.4102/jcmsa.v3i1.204. eCollection 2025.
Cultural competence is an important aspect of patient-centred care, particularly in paediatric settings, where doctors from diverse backgrounds interact with families from different cultural contexts. South Africa is a multi-cultural country, with doctors working with people whose concepts of health and healing include traditional beliefs and practices. While the importance of cultural competence is widely acknowledged, limited data exist on how doctors exercise cultural competence in a neonatal intensive care unit (NICU). This study addresses this gap by exploring doctors' perspectives on providing culturally responsive care in a rural NICU.
We conducted an exploratory qualitative study, situated within a constructivist paradigm, to explore how doctors understand and practise cultural competence. The constructivist lens guided the exploration of participants' socially constructed perspectives within their clinical contexts. Nine doctors working in the NICU of a public-sector regional hospital in KwaZulu-Natal Province, South Africa, were purposively sampled. Semi-structured interviews were conducted, and data were analysed thematically.
Five themes were generated: (1) understanding cultural competence, (2) learning cultural competence, (3) importance of clinical settings, (4) professional challenges in displaying cultural competence and (5) evaluating cultural competence. Collectively, these themes highlight the disconnect between the perceived value of cultural competence and the realities of insufficient training, inconsistent application and limited institutional support in high-pressure clinical settings.
While the doctors recognised cultural competence as integral to effective paediatric care, gaps remain in training, implementation and evaluation. Addressing these challenges through structured education may enhance culturally responsive health care delivery.
This study contributes to the growing discourse on cultural competence in health care by providing perspectives into its practical application and challenges in a South African paediatric setting.
文化能力是以人为本的医疗护理的一个重要方面，在儿科环境中尤为如此，在那里，来自不同背景的医生与来自不同文化背景的家庭互动。南非是一个多元文化的国家，医生与那些健康和治愈观念包括传统信仰和习俗的人们一起工作。虽然文化能力的重要性已得到广泛认可，但关于医生在新生儿重症监护病房（NICU）如何运用文化能力的数据却很有限。本研究通过探索医生对在农村新生儿重症监护病房提供具有文化敏感性护理的看法来填补这一空白。
我们进行了一项探索性定性研究，采用建构主义范式，以探讨医生如何理解和实践文化能力。建构主义视角指导了对参与者在其临床环境中社会建构的观点的探索。我们有目的地抽取了南非夸祖鲁-纳塔尔省一家公立地区医院新生儿重症监护病房的九名医生。进行了半结构化访谈，并对数据进行了主题分析。
产生了五个主题：（1）理解文化能力，（2）学习文化能力，（3）临床环境的重要性，（4）展示文化能力的专业挑战，以及（5）评估文化能力。总体而言，这些主题凸显了文化能力的感知价值与高压临床环境中培训不足、应用不一致和机构支持有限的现实之间的脱节。
虽然医生认识到文化能力是有效儿科护理不可或缺的一部分，但在培训、实施和评估方面仍存在差距。通过结构化教育应对这些挑战可能会加强具有文化敏感性的医疗保健服务。
本研究通过提供对其在南非儿科环境中的实际应用和挑战的见解，为关于医疗保健中文化能力的日益增多的论述做出了贡献。
