Who is our consumer? Shaping nursing programs to meet emerging needs

Development of a Cultural Competence Assessment Instrument

This article describes initial testing of an instrument designed to provide evidence of cultural competence among health care providers and staff. The Cultural Competence Assessment (CCA) instrument was based on a model describing cultural competence components (fact, knowledge, attitude, and behavior). Content and face validity were confirmed through expert panel review, subject feedback, and field-testing. The CCA was administered to an interdisciplinary health care team in a community hospice setting. Preliminary findings suggest that the CCA performed well. Internal consistency reliability for the scale was 0.92. Construct validity by factor analysis demonstrated that 25 items had loadings above 0.42. Construct validity was supported with a significant correlation to the widely used Inventory for Assessing the Process of Cultural Competence among Health care Professionals (IAPCC). Validity also was supported by significant differences between individuals with different educational levels and prior diversity training. The CCA is a promising tool to measure cultural competence in populations with a wide range of educational levels and backgrounds.

A review of the concept of culture in holistic nursing literature

Core Value IV of the American Holistic Nurses' Association includes valuing the client's cultural background. The authors reviewed all article abstracts from two major holistic nursing journals for a 3-year period (N = 198). References to concepts of culture or ethnicity were found in only 9.6% of abstracts. Many theorists and researchers did not discuss how the theory or research findings varied between culturally or ethnically diverse samples. When culture is a core value, practitioners and researchers cannot assume that culture has been considered without stating what was the interaction of culture with the phenomenon of concern. The authors recommend that nurses develop cultural competence in caring for clients from differing cultural orientations by (a) committing to improve their knowledge of multiple cultures; (b) exploring their own cultural background; (c) seeking exposure to cultures other than their own; and (d) regularly discussing culture and ethnicity in nursing theory, research, and practice.