The Role of Digital Health Literacy and Cultural Intelligence in Cultural Competence of Private Hospital Nurses: Cross-Sectional Study.

BACKGROUND: As patient populations become increasingly diverse, nurses must develop cultural competence to provide effective and equitable care. OBJECTIVE: This study aims to examine the predictors of cultural competence among nurses, specifically investigating the roles of digital health literacy (DHL) and cultural intelligence, while also assessing how demographic factors, competence levels, and DHL relate to culturally competent behaviors. METHODS: A cross-sectional study was conducted with 296 nurses at a private hospital in Saudi Arabia. Data were collected using validated instruments to assess DHL, cultural intelligence, and cultural competence. Descriptive statistics, independent t tests, Pearson correlations, and hierarchical multiple linear regression analyses were performed using SPSS (IBM Corp) to evaluate the associations and predictors of cultural competence. RESULTS: In a sample of 296 nurses, cultural intelligence was observed at a moderate level, present in 35.8% (n=106) of participants. Conversely, more than half of the participants (n=158, 53.4%) exhibited low DHL. The majority of the nurses (n=195, 65.9%) demonstrated moderate cultural competence. Education was the only demographic factor significantly associated with cultural competence, with nurses holding a Bachelor of Science degree scoring higher than those with a diploma (P=.003). Furthermore, cultural intelligence and DHL each showed a strong positive correlation with cultural competence (P<.001). Hierarchical regression analyses indicated that both cultural intelligence (β=.427; P<.001) and DHL (β=.315; P<.001) were significant predictors of cultural competence, jointly explaining 47.7% of the variance (adjusted R²=0.460; P<.001). Nationality also emerged as a significant predictor (β=.105; P=.03), whereas other demographic variables were not statistically significant. Cultural intelligence accounted for the largest proportion of explained variance (ΔR²=0.375), followed by DHL (ΔR²=0.051). CONCLUSIONS: Cultural competence among nurses is predominantly influenced by cultural intelligence and DHL, rather than by most demographic variables. Consequently, enhancing DHL and cultural intelligence may strengthen culturally competent practice. It is recommended that targeted educational and professional development interventions be implemented to elevate competence and support high-quality patient care across diverse health care settings.