Evaluation of a nurse-led education program to improve cross-cultural care for older people in aged care

Lily Dongxia Xiao, Shahid Ullah, Wendy Morey, Lesley Jeffers, Anita De Bellis, Eileen Willis, Ann Harrington, David Gillham

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Background: Cultural diversity is significant in aged care facilities. Registered nurses play a leading role in the care setting. Nurse-led education interventions to improve the cultural competence of aged care workers are in high demand. Aim: The aims of the study were to evaluate the effect of a nurse-led cross-cultural care program on cultural competence of Australian and overseas-born care workers. Design: A pre- and post-evaluation design and a sub-group analysis. Settings and participants: This study was undertaken in four large-sized aged care facilities in Australia. Direct care workers were invited to participate in the study. Methods: The intervention lasted 12 months. Data were collected at baseline, 6 months and 12 months using the Clinical Cultural Competency Questionnaire and site champion reports. One-way ANOVA was applied to determine the changes of outcomes over time for the whole group. A mixed effect linear regression model was applied in the sub-group analyses to compare the differences of outcomes between the Australian-born and overseas-born groups. Results: One hundred and thirteen staff participated in the study including Australian-born (n = 62) and overseas-born (n = 51). Registered nurses were trained as site champions to lead the program. The results showed a statistically significant increase in participants' scores in Knowledge (p = .000), Skills (p = .000), Comfort Level (p = .000), Importance of awareness (p = .01) and Self-Awareness (p = .000) in a 12-month follow-up. The increased scores in the Skills (p = .02) and Comfort Level (p = .001) were higher in the Australian-born group compared to the overseas-born group. The results also showed a statistically significant increase in participants' overall satisfaction scores with the program at 12 months (p = .009). The overseas-born group demonstrated a higher score in Desire to Learn More (p = .016) and Impact of the Program on Practice (p = .014) compared to the Australian-born group. Conclusion: A nurse-led cross-cultural care program can improve aged care workers' cultural competence.

Original languageEnglish
Article number104356
Number of pages10
JournalNurse Education Today
Publication statusPublished - Apr 2020


  • Aged care
  • Aged care workers
  • Cultural competence
  • Education interventions
  • Nurse-led


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