Cultural Awareness and Family Satisfaction: The Moderating Roles of Nurses’ Positive Emotions and Nurse–Family Cultural Similarity

This study examined whether nurses' cultural awareness is associated with family members' satisfaction with care in nursing homes and whether this relationship is influenced by cultural dissimilarity and nurses' positive emotions. A cross-sectional, multi-informant design included 121 nurse-family member encounters across three facilities. Nurses reported cultural awareness and positive emotions; family members rated satisfaction after each encounter. A double moderated multiple linear regression with hierarchical variable entry was used to test the study hypotheses. Cultural awareness alone did not significantly predict satisfaction (b = -0.07, p = .525). However, cultural dissimilarity was associated with lower satisfaction (b = -0.35, p < .001), and higher nurse-reported positive emotions were also accompanied by reduced satisfaction (b = -0.13, p = .015). Cultural awareness interacted with both moderators: its effect on satisfaction was stronger when dissimilarity was low (b = -0.51, p = .040) and emotional expression was high (b = -0.33, p = .029). These findings highlight the complexity of cultural and emotional dynamics in shaping family satisfaction in care.