Development Strategies in Medical Education

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Balafkan J, Nooreddini A, Ghelichi-Ghojogh M, Anemohammadzadeh M. Association between nurses’ cultural competence and their perceptions of patient dignity in hospitals of Gonbad Kavous: A cross-sectional study. DSME 2026; 13 (1) :73-82
URL: http://dsme.hums.ac.ir/article-1-546-en.html

Introduction: Cultural competence may influence how nurses recognize and respond to patients’ culturally shaped needs and may therefore be related to perceptions of patient dignity. This study examined the association between nurses’ cultural competence and their perceptions of patient dignity in hospitals in Gonbad Kavous.
Methods: This descriptive cross-sectional study was conducted in four public hospitals in Gonbad Kavous in 1404 (2025–2026) using stratified sampling. The target sample size was 200 nurses; the results tables contained complete data for 185 participants. Data were collected using a demographic questionnaire, Moulder’s 51-item Cultural Competence Questionnaire, and the 25-item Patient Dignity Inventory (PDI). For the PDI, lower scores indicate fewer dignity-related problems and higher perceived dignity, whereas higher scores indicate greater dignity-related concerns. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA with Scheffé post-hoc comparisons, Pearson correlation, and simple linear regression at P<0.05.
Results:  The mean age of the 185 analyzed nurses was 33.13±3.25 years; 74.6% were women. The mean cultural competence score was 114.66±15.90 and the mean PDI score was 59.82 ± 15.71. PDI scores differed significantly across hospitals (P=0.001), with the highest mean score at Motahari Hospital (68.02±24.15), indicating more dignity-related concerns under the stated scoring direction. Cultural competence differed across age groups (P=0.013), with the highest mean among nurses younger than 25 years (122.38±17.87). Cultural competence was not significantly correlated with the PDI score (r=0.045, P=0.544), and the simple linear regression explained 0.2% of the variance (R²=0.002).
Discussion: No statistically significant unadjusted association was observed between nurses’ cultural competence and PDI scores. The finding should be interpreted cautiously because the study was cross-sectional, relied on self- report, and applied the dignity instrument from the nurses’ perspective. Future studies should use dignity measures validated for the intended respondent, include patients’ perspectives, and apply multivariable analyses to account for contextual factors.