TABLE 3.

Themes, subthemes and concepts.

Themes	Subthemes or categories	Concepts and verbatim quotes
Patients’ understanding of culture	Description of culture and its importance	Identification of culture ‘I would usually say South African, ne [right] … Ya [yes], a so-called coloured [mixed race] Yes, it is very, very important.’ (P1, Mixed race, Christian)
	Values or norms	Food, Dress code, Respect, Kindness ‘Muslims, they don’t eat certain food and if you know that I don’t eat pork, I don’t eat anything that’s cooked out of a Christian’s pot, that’s my culture …’ (P7, Mixed race, Muslim)
Importance of cultural competence in nursing	Nurses’ cultural knowledge	Knowledge about patients’ cultures ‘Yes it is very important … they will find out about how the Muslim culture lives [the Muslim patients’ lifestyle].’ (P7, Indian, Muslim)
	Nurses’ self-awareness	Nurses to understand their own cultures ‘So they know themselves better and that will help them in understanding other people’s cultures.’ (P9, Caucasian, Christian)
	Cultural needs do change	Re-definition of culture ‘We are not to be disrespectful in any way but with modern times things has [have] changed. Our dressings are different. Our talking is different because we used to talk the mother language but nobody talks the mother language anymore.’ (P3, Indian, Hindu)
Meeting patients’ cultural needs	Cultural skill	Asking patients about important cultural information ‘Like what type of food do you eat? … because different cultures eat different food.’ (P14, African, Christian)
	Cultural encounters	Making time to talk to patients ‘It’s to communicate to the patient or person, communication is playing [plays] a good role because then we will know each other understanding each other.’ (P1, Mixed race, Christian)
	Cultural practices or beliefs	Giving patients privacy for cultural practices ‘[I] need, the nurse must respect my culture and the things that I want to do, maybe when I come to the hospital and I know that maybe I’m going to stay for two days and I must carry my bible in the morning or just like a … in the night I can read my bible and maybe I must be free of the people of church when they visit me, I must be comfortable.’ (P20, Mixed race, Christian)
	Role of the nurses and unit managers	Managers need to supervise nurses and nurses should be culturally competent ‘So the role of the sister in charge in the ward, she might see if the nurses are treating the patient okay [well], alright, and then she must also take care of [it] if the patient complains, she must do her best to help.’ (P15, African, Christian)
	Benefits for the patients and nurses	Patient satisfaction, Improved knowledge about patients’ cultures ‘[W]hat I know of, it will make things even better, not only just for the patient but obviously the nurse will get to know more about the patient as well. That’s how the nurse starts learning different cultures in fact.’ (P7, Indian, Muslim)
Evaluation of nurses’ cultural competence	Some satisfaction for Christians	Some needs of Christians are met ‘When they see me read my bible, they don’t have a problem with that.’ (P11, African, Christian)
	Dissatisfaction with nurses’ cultural competence	Unmet cultural needs or discrimination ‘[B]ecause he’s light of [in] complexion, they didn’t even had [have] a …, they treated him so bad, I had such a bad experience with that [those] nurses.’ (P1, Mixed race, Christian)