A valid and reliable scale to assess cultural sensibility in nursing

BACKGROUND

Cultural sensibility is an important concept linked to the achievement of cultural competence. Health professionals must first improve their cultural sensibility to become culturally competent and to be able to offer competent care to culturally diverse populations. Aim To develop and psychometrically test the Cultural Sensibility Scale for Nursing (CUSNUR), a cultural sensibility scale that can be used in nursing for the achievement of competencies needed to care for culturally diverse populations.

DESIGN AND METHODS

The cross-sectional survey was conducted over two stages. The first stage involved the cross-cultural and discipline-specific adaptation of an existing scale addressing this concept in the field of law using the reverse translation method. Second, validation of the scale was carried out from October 2016-June 2017 by studying the psychometric properties of the questionnaire through an analysis of content acceptability and reliability and through exploratory factor analysis (EFA).

RESULTS

The questionnaire was designed to be clear, easy to understand, and of adequate length, and experts involved in content validation agreed that the scale meets these criteria. A total of 253 nursing students participated in the validation stage. Four factors were identified from the EFA: (1) patient and health professional behaviours, (2) self-assessments, (3) self-awareness, and (4) cultural influence. Two items were excluded. Factorial saturation is adequate for all factors (>0.30). The Cronbach alpha was measured as 0.75.

CONCLUSIONS

This study presents the first version of the CUSNUR and demonstrates that the scale is valid and reliable.

The Spanish version of the Cultural Competence Assessment (CCA-S): Transcultural validation study and proposed refinement

BACKGROUND

Cultural competence (CC) is becoming an essential component of healthcare professionals. There is a gap in the research evaluating CC in order to develop competency-based approach programs. Spain has become a multicultural society and it is necessary to evaluate and promote CC attitudes to reduce the disparity of care for vulnerable and minority groups.

OBJECTIVES

To adapt and validate the Cultural Competence Assessment (CCA) of Schim et al. (2003), to get evidence-based data of CC in Spanish healthcare professionals.

METHOD

A process of translation/back-translation and cultural adaptation was carried out in accordance with international standards. An on-line cross-sectional survey questionnaire was used. Statistical and metrical analysis was based in a sample of 568 healthcare professionals who worked daily with patients in a health care institution in South Catalonia in 2018.

RESULTS

The results of the exploratory factorial analysis and subsequent confirmatory analysis showed that the data had an adequate fit for a four-factor model. The reliability analysis results confirm an acceptable consistency for each subscale: active behaviour (0.86), seeking information (0.86), awareness (0,94), and sensitivity (0.69). ANOVA showed no differences between healthcare professionals, age and gender. The scores showed a normal distribution and it was proposed a standardization of scores.

CONCLUSIONS

The translation and transcultural-validation process of the CCA resulted in a Spanish-language for the 25 items, like the original. The psychometric analysis proved that the Spanish version is a reliable and valid instrument. This scale is going to be useful to analyze healthcare professional's attitudes to create effectiveness training programs focused on specific needs. The four-factor model and the standardization of the scores will be useful to achieve future objectives about research in cultural competence in healthcare professionals.

Embracing diversity and transcultural society through community health practicum among college nursing students

Based on 2015 annual report of foreign spouse populations were above 507,266 people in Taiwan. Most of them (68%) came from Mainland China, 29% from south-east Asia. 92% of foreign spouses were female (2015). Therefore, a challenge arises for nursing students to provide care to clients with multiple cultural variations in Taiwan. The study objectives were to explore the related factors of cultural care competence and estimate the effects of a short-term reinforced cultural course. The study used a quasi-experimental design. All participants were investigated to measure that changed in cultural competence before and after the community practice period. Of 95 participants, 46 experimental group students engaged with 3 times workshops. The study was conducted from May to August in 2015 at Southern Taiwan. The study results showed a significantly improvement of transcultural nursing competence from comparing control group with experimental group by ANCOVA analysis (p < .05). The study approved that the cultural workshop along with the community health nursing practice curriculum might develop students' transcultural nursing competence. In the future, in order to providing cultural sensitively care, a sustained transcultural curriculum should be advocated at Nursing schools in Taiwan.

Nursing students' perspectives of the health and healthcare issues of Australian Indigenous people

BACKGROUND

Indigenous people are the most disadvantaged population within Australia with living conditions comparable to developing countries. The Bachelor of Nursing programme at the University of Western Sydney has embedded Indigenous health into the undergraduate teaching programme, with an expectation that students develop an awareness of Indigenous health and healthcare issues.

AIM

To gain insight into students' perceptions of Indigenous people and whether the course learning and teaching strategies implemented improved students' learning outcomes and attitude towards Indigenous people and Indigenous health in Australia.

DESIGN

A mixed methods prospective survey design was chosen.

METHODS

Students enrolled in the Indigenous health subject in 2013 were invited to complete pre- and post-subject surveys that contained closed- and open-ended questions. Students' socio-demographic data was collected at baseline, but the 'Attitude Toward Indigenous Australians' (ATIA) scale, and the 3-item Knowledge, Interest and Confidence to nursing Australian Indigenous peoples scale were administered at both pre- and post-subject surveys.

RESULTS

502 students completed the baseline survey and 249 students completed the follow-up survey. There was a statistically significant attitudinal change towards Indigenous Australians, measured by the ATIA scale, and participants' knowledge, intent to work with Indigenous Australians and confidence in caring for them increased significantly at follow-up. Based on the participants' responses to open-ended questions, four key themes emerged: a) understanding Indigenous history, culture and healthcare; b) development of cultural competence; c) enhanced respect for Indigenous Australians' culture and traditional practices; and d) enhanced awareness of the inherent disadvantages for Indigenous Australians in education and healthcare. There were no statistically significant socio-demographic group differences among those who commented on key themes.

CONCLUSION

Addressing health inequalities for Indigenous Australians is paramount. Nurses need cultural awareness and sensitivity to deliver culturally appropriate healthcare in Australia.

Exploring beliefs of the four major ethnic groups in Melbourne regarding healthcare and treatment

Objectives. To explore and compare beliefs about healthcare and treatment of four ethnic groups attending a Melbourne emergency department (ED), and the corresponding perceptions held by emergency clinicians. Method. Prospective survey of ED doctors and patients from Greek, Italian, Vietnamese and Anglo-Saxon backgrounds. Results. Vietnamese patients were least likely to believe their ethnic group received the best available care but less likely to believe in the existence of ethnic healthcare disparities. They were most likely to have an ethnically concordant GP and preferred most strongly to raise sensitive issues with an ethnically concordant doctor. Anglo-Saxon patients placed less importance on family support and older Anglo-Saxons were less likely than other groups to turn to God for comfort. Doctors perceived the existence of ethnic healthcare disparity, which was not perceived by the ethnic groups themselves. They underestimated the extent of patient-perceived disease control, external supports for coping, or use of complementary practitioners. Doctors overestimated patient perceived importance of doctor-patient ethnic concordance for Anglo-Saxons but underestimated the importance this has for Vietnamese patients. They also underestimated importance of clinician-demonstrated cultural understanding. Conclusions. Beliefs about healthcare and treatment differ across the four major ethnic groups attending a Melbourne ED. Doctors’ misperceptions of patients’ beliefs suggest that cultural competence amongst ED doctors could be improved. What is already known about this subject? Among English speaking countries, Australian society is one of the more ethnically diverse. Australia’s increasingly multicultural landscape has been accompanied by minority health inequity, as seen in the States and UK. Internationally, several systems for improving ethnic health have been proposed, most notably the development of cultural competency. Like other settings, optimal healthcare delivery in emergency department (ED) settings demands a patient-centred, culturally competent approach. However, attaining this may be threatened by the time pressure of the clinical exchange and communication barriers, particularly for non-English speaking patients. For this reason, it is important to better understand the healthcare beliefs of ED patients and the corresponding perceptions held by doctors. What does this paper add? This study explored differences in beliefs regarding healthcare and treatment of the four major ethnic groups attending a Melbourne ED, and assessed the degree of cultural understanding amongst ED doctors towards these groups. We report several differences in the beliefs of the four patient groups and several misperceptions held by doctors. What are the implications for practitioners? Currently available cultural competency training programs for healthcare professionals are either inadequate or inaccessible. Further educational programs are necessary to improve cultural competence amongst practitioners. Strategies to improve ED clinicians’ understanding of health beliefs and how they impact on the patient-centred care approach may be required.