Investigation of Cultural Practices and Culturally Sensitive Care in Intensive Care Units: A Mixed-Methods Study.

BACKGROUND: Increasing cultural diversity in healthcare requires intensive care nurses to demonstrate cultural competence and sensitivity in order to provide care that respects the cultural values, beliefs and practices of patients and their relatives. AIMS: This study aimed to determine the levels of cultural competence and sensitivity among intensive care nurses and to examine the cultural care needs of patient relatives. STUDY DESIGN: This study employed a convergent parallel mixed-methods design integrating quantitative and qualitative research approaches. Quantitative data were collected using the Cultural Competence Scale and the Intercultural Sensitivity Scale administered to intensive care nurses. Qualitative data were obtained through semi-structured interviews conducted with patient relatives. RESULTS: In total, 215 intensive care nurses working in six different intensive care units and 30 patient relatives who had family members hospitalized in these units were included in the study. Nurses demonstrated relatively higher scores in the cultural knowledge and skills dimensions, whereas cultural sensitivity scores were comparatively lower. An increase in intercultural sensitivity scores was found to be associated with a parallel increase in cultural competence scores (r: 0.235; p = 0.001). Cultural competence accounted for a modest but statistically significant 6.5% increase in the explained variance in intercultural sensitivity and was independently associated with higher intercultural sensitivity scores (β = 0.265, p < 0.001). Six themes were identified based on the cultural needs and perceptions of care among patients' relatives: (1) culturally appropriate communication; (2) culturally patterned information needs; (3) participating in care with awareness; (4) culturally shaped boundaries of patient privacy; (5) culturally patterned expectations of attentive care; and (6) psychological support across cultural lenses. CONCLUSIONS: Integrated findings indicated that although nurses demonstrated relatively high levels of cultural competence and intercultural sensitivity, patient relatives emphasised respectful communication, attentive care and sensitivity to cultural values as key components of culturally sensitive care. RELEVANCE TO CLINICAL PRACTICE: Findings revealed unmet expectations regarding understandable information, participation in decision-making and care processes, privacy and attention to spiritual needs, suggesting a need for more individualised and participatory approaches in intensive care settings.