我们建议在文化和谐护理的实践和教学中继续发展文化能力概念的知识，尽管要修改概念的定义以适应建构主义的观点。根据Guba和Lincoln(1994, 2005)的观点，建构主义本体论拒绝单一现实的概念，而倾向于多元的、社会建构的现实的概念。因此，文化被认为是特定历史语境下的社会建构。这一文化概念从文化的行为角度出发，侧重于健康体验的语境意义。建构主义认识论是交易主义和主观主义的认识论。个体对现实的建构是通过这些现实中的行动者之间的互动来完善的(Guba & Lincoln, 1994)。鼓励护士在更广泛的背景下理解一个人的复杂性是建构主义观点的一部分。它是基于专业人员之间、专业人员与患者之间的共同理念和辩证互动。这些互动并没有掩盖个人之间或个人与结构之间的权力关系，因为他们关注批判性思维和人际意识。
We propose that the development of knowledge on the concept of cultural competence be continued in the practice and teaching of culturally congruent nursing care, although with a modified definition of the concept to fit a constructivist perspective. According to Guba and Lincoln (1994, 2005), the constructivist ontology rejects the idea of a single reality and favors instead the idea of multiple, socially constructed realities. Hence, culture is considered to be a social construct in a specific historical context. This concept of culture departs from a behavioral perspective of culture, by focusing on the contextual significance of health experiences. The constructivist epistemology is transactional and subjectivist. Individual constructions of reality are refined by interactions between the actors in those realities (Guba & Lincoln, 1994). Encouraging nurses to understand the complexity of a person within a broader context is part of a constructivist perspective. It is based on shared ideas and dialectical interactions between professionals and between professionals and patients. These interactions do not obscure power relations between individuals or between individuals and structures as they focus on critical thinking and interpersonal awareness.