Date of Conferral

2-18-2026

Degree

Ph.D.

School

Psychology

Advisor

Leann Stadtlander

Abstract

As a result of the growing diversity among citizens requiring medical care, there has been a substantial increase in immigrants globally and in the United States. In the U.S. healthcare system, nurse practitioners (NPs) have been facing increased cultural challenges. The purpose of this quantitative study was to determine the relative importance of cultural competence and compassion fatigue in predicting nursing prescribing self-efficacy. Cultural competence served as the theoretical framework, as it focuses on how NPs can effectively communicate with patients from diverse backgrounds by understanding and respecting cultural differences, thereby building trust, improving patient outcomes, and providing quality healthcare. A cross-sectional, non-experimental, correlational survey design was used. Online surveys were completed via Survey Monkey by 153 NPs with a Doctor of Nursing Practice degree and a valid prescribing license who were at least 21 years old, English-speaking, and resided in the United States. A hierarchical multiple regression analysis revealed that certain aspects of cultural competency and compassion fatigue did not significantly influence nurse prescription practices. The results highlighted a significant negative relationship between low self-reported prescribing self-efficacy and nursing practices. Results suggested that increased cultural awareness might paradoxically lower self-efficacy by heightening awareness of prescribing risks, contradicting the intended goal of enhanced competence. Conversely, reducing compassion fatigue through sustained training and support can enhance NPs’ well-being directly, which may improve patient care, reduce costs, and foster systemic resilience as positive social changes

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