Significance and Background: Kenya has been experiencing an increase in cultural and ethnic diversity. As a result of cultural differences, health disparities among ethnic groups in Kenya are increasing. A component of patient centered care involves the incorporation of cultural aspects of health and illness in the delivery of nursing care. Understanding cultural competence of nursing students will provide guidance on educational needs related to cultural competence.

Purpose:. The purpose of this study was to assess nursing students’ cultural competence (CC) in the areas of cultural awareness, knowledge, sensitivity, skills, encounters and desire. Nursing students’ views on caring for culturally diverse patients and how their views relate to CC were also explored.

Design: A convergent mixed methods design was used to answer the following research questions: a) What are the levels of CC in nursing students in Kenya? b) what demographic and cultural characteristics impact the students’ level of CC? c) what are the nursing students’ views on caring for diverse patients? and d) how do the nursing students’ views on caring for diverse patients compare to or explain the nursing students’ level of CC?

Methods: A convenient sample of nursing students (N = 190) from a university in Kenya were recruited. Cultural competence was assessed using a questionnaire and interviews. Descriptive, inferential statistics, multiple regression and content analyses were used to analyze responses. Common concepts from both quantitative and qualitative data were identified.

Results: Quantitative results showed that most nursing students had a high level of CC. The highest scores were in the awareness and knowledge subscales. Skills and sensitivity were ranked lower in the subscales. Working in rural areas, private healthcare settings, having taken more continuous education units (CEUs) and lower age were associated with greater CC. Qualitative and quantitative data converged for most variables in the study. Areas of divergence explained why the scores were not at the highest possible level.

Conclusion: These findings inform stakeholders in education and healthcare about nursing students' needs for CC. Strategies to support nursing students’ ongoing competency are recommended.

Date of publication

Spring 5-2-2022

Document Type




Persistent identifier


Committee members

Dissertation Chair: Dr. Danita Alfred, Member 1: Dr. Gloria Duke, Member 2: Dr. Miriam Wagoro


Doctor of Philosophy in Nursing

Available for download on Wednesday, May 01, 2024