Culture competence and the primary care provider.

Nurse practitioners and other primary care health providers in the United States increasingly interact with clients of diverse cultures, races, and ethnic backgrounds. If this interaction is not culturally competent, underutilization of health care services, perceived noncompliance, frustration, anger, and, ultimately, inequities in the health status of clients can result. Providing culturally competent care that fosters positive health outcomes is a challenge. This article reviews concepts of culture and cultural competence and describes six elements essential to mastering cultural competence in clinical encounters with multicultural clients. Cultural competence is seen as a continuous process, rather than an end in itself. Culturally competent care requires a change of world view for both the provider and client, with the interaction creating a new cultural reality for both within the context of health care.