Psychometric assessment of the cultural capacity scale Spanish version in Chilean nursing students

Designing, implementing, and evaluating a mobile app-based cultural care training program to improve the cultural capacity and humility of nursing students

BACKGROUND

Given the growing cultural diversity among healthcare clients, it is crucial for nursing education to have a clear mission: to effectively train future nurses by incorporating cultural care curricula. The goal is to equip them with the necessary cultural capacity and humility. This study focused on designing, developing, and evaluating a mobile app-based cultural care training program, with the aim of enhancing the cultural capacity and humility of nursing students.

METHODS

This experimental study utilized the five steps of the ADDIE instructional model (analysis, design, development, implementation, and evaluation) to design a mobile app-based cultural care training program. The first three steps involved designing and developing the program, drawing upon Purnell's model for cultural competence and Foronda's rainbow model of cultural humility. In the fourth step, the cultural care training program was implemented in 16 modules among 80 internship nursing students. These students were randomly assigned to either the intervention or control groups, with 40 students in each group. Finally, in the fifth step, the effectiveness of the mobile app-based program was evaluated by administering the Cultural Capacity Scale, and the Foronda Cultural Humility Scale before and one month after the cultural care training. The collected data were analyzed using SPSS22, employing techniques such as paired t-test, chi-square test, and independent samples t-test.

RESULTS

A total of 76 students completed the study, with 39 students in the intervention group and 37 students in the control group. Prior to the mobile app-based cultural care training program, there were no significant differences in cultural capacity and humility scores between the two groups (p > 0.05). However, following the completion of the program, the intervention group exhibited higher scores in cultural capacity and humility compared to the control group (p < 0.05).

CONCLUSION

Based on the findings, it can be concluded that the mobile app-based cultural care training program had a positive impact on the cultural capacity and humility of undergraduate nursing students. These results indicate the importance of nurse educators designing comprehensive training programs that incorporate innovative approaches to enhance cultural capacity and humility among nursing students at all academic levels.

Spanish adaptation and validation of the Cultural Competence Assessment Tool (CCATool) for undergraduate nursing students

AIM

To analyse and validate a contextually adapted version of the Papadopoulos' Cultural Competence Assessment Tool (CCATool) for Spanish undergraduate nursing students.

BACKGROUND

Globalization has driven and intensified international migration. Thus, nurses must treat patients of many different cultural origins. Accordingly, both cultural competence and an appropriate tool with which to evaluate it are required.

METHODS

The CCATool questionnaire was adapted for use in a Spanish context and was evaluated through a questionnaire completed by 262 undergraduate nursing students. Seven days later, the same students completed the questionnaire, without any intervention, and a subgroup of 144 students completed the questionnaire for a third time after taking a course in Transcultural Care. The reliability, sensitivity and stability of the questionnaire were assessed.

RESULTS

The reliability of the questionnaire obtained an adequate Cronbach's alpha of 0.81. Stability was assessed at seven days, using the intraclass correlation coefficient, which showed good/excellent results. Moreover, the questionnaire was able to detect the changes related to the nursing educative programme, thus highlighting a good sensitivity of the tool.

CONCLUSION

Cultural competence is an essential element of nurses' education, and instruction in this area should begin as soon as possible. In addition, an appropriate evaluation system is required. For this purpose, the present study describes and analyses a valid, reliable tool for use with undergraduate nursing students in Spain.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Health and education policies must be sensitive to the ethnic and cultural differences of the patients who are cared for, and address the situations that cause difficulties in care. Hospitals and health centres must offer good care to patients from diverse cultures, so one of the necessary situations is the training and evaluation of the cultural competence of health professionals.

Psychometric Properties of Nurse Cultural Competence Scale among Filipino Nurses

Purpose: Assessment of the cultural competence of nurses is becoming an important parameter in assessing the provision of quality care to patients especially in multicultural populations such as the Philippines. The study was conducted to assess the construct validity and internal consistency reliability of the Nurse Cultural Competence Scale (NCCS) among Filipino nurses. Methods: A methodological study was utilized and a convenience sample of 124 Filipino nurses were included in the study. An exploratory factor analysis was used to assess the construct validity of the instrument while internal consistency reliability was determined using Cronbach’s α coefficient and item-total correlations. Results: The 20-item NCCS was loaded on one dimension with factor loadings ranging from 0.72 to 0.95, explaining 79.19% of the total variance. Cronbach’s α was 0.986 which demonstrated high reliability and item-total correlations were between 0.811 and 0.929. Conclusion: The NCCS is a reliable and valid instrument for the measurement of cultural competencies among Filipino nurses. Keywords: Cultural competence, Filipino nurses, Reliability, Validity

Psychometric properties of instruments used to measure the cultural competence of nurses: A systematic review

BACKGROUND

Cultural competence is a key component of culturally congruent nursing care. In order to reduce healthcare inequalities and to identify potentials for improvement in nursing practice, researchers need to be able to assess cultural competence properly. Although many instruments for the assessment of cultural competence have been developed, their measurement properties have not yet been reviewed systematically. Such an overview of existing instruments, however, would allow researchers to identify the most valid and reliable instrument for nursing practice.

OBJECTIVE

The purpose of conducting this review is to identify and critically appraise the psychometric properties of instruments used to measure the cultural competence of nurses.

METHODS

A systematic literature search was performed in November 2019 in the following electronic databases: Cumulative Index of Nursing and Allied Health Literature, Embase, PsycINFO and PubMed. Studies that were conducted to assess any measurement property of instruments used to measure the cultural competence of nurses were included. Two reviewers independently screened the articles and assessed the risk of bias using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The quality of included instruments was assessed on the basis of the updated criteria for good measurement properties, and the quality of the summarised results was graded based on the principles of Grading of Recommendations Assessment, Development and Evaluation.

RESULTS

In total, 44 studies describing 21 instruments were included in this study. We found that most instruments were tested for at least some forms of validity, but seldom for reliability. The quality of the psychometric properties was evaluated using the criteria for good measurement properties for the following: content validity, structural validity, internal consistency, reliability, measurement error and construct validity. No studies were found in which cross-cultural validity, criterion validity, or the responsiveness of the included instruments were evaluated. The Transcultural Self-Efficacy Tool, the Cultural Competence Assessment, and the Cultural Competence Health Practitioner Assessment showed sufficient levels of quality for psychometric properties and can be recommended for the assessment of cultural competence in nurses.

CONCLUSION

Given the broad availability of self-administered instruments to assess cultural competence, the development of new instrument is not recommended. A particular need was identified to conduct further psychometric evaluation studies on existing instruments and to adapt them accordingly, and especially on less frequently evaluated properties, such as reliability, measurement error and responsiveness.

Incivility among nursing faculty: A multi-country study

BACKGROUND

In nursing programs, incivility can be a main issue affecting future registered nurses, and this may threaten patient safety. Nursing faculty play an important role in this scenario to reduce incivility.

PURPOSE

The aim of this study was to assess incivility among nursing faculty in different countries.

METHOD

This descriptive (cross-sectional) study was conducted to assess the extent of incivility among nursing faculty by using Incivility in Nursing Education-Revised tool and a non-probability (convenience) sampling method was used. Three hundred ninety-five nursing faculty in 10 countries distributed in four continents participated in this study.

RESULTS

The results indicated that levels of incivility among participants in different countries were significantly different. Also, there was a significant difference (F = 9.313, P value = 0.000) among the nursing faculty concerning the behaviours that have been rated as disruptive. Furthermore, there was a significant difference (F = 6.392, P value = 0.000) among participants regarding uncivil behaviours that have occurred during the past 12 months.

CONCLUSION

Regular assessments are needed to highlight uncivil behaviours and reduce them by making policies and rules in order to enhance academic achievement in nursing education.

A Multicountry Perspective on Cultural Competence Among Baccalaureate Nursing Students

PURPOSE

To assess cultural competence among nursing students from nine countries to provide an international perspective on cultural competence.

DESIGN

A descriptive, cross-sectional design.

METHODS

A convenience sample of 2,163 nursing students from nine countries was surveyed using the Cultural Capacity Scale from April to November 2016.

RESULTS

The study found a moderate range of cultural competence among the students. The ability to teach and guide other nursing colleagues to display culturally appropriate behavior received the highest competence rating, while the ability to discuss differences between the client's health beliefs or behaviors and nursing knowledge with each client received the lowest competence rating. Differences in cultural competence were observed between students from different countries. Country of residence, gender, age, year of study, attendance at cultural-related training, the experience of taking care of patients from culturally diverse backgrounds and patients belonging to special population groups, and living in a multicultural environment were identified as factors affecting cultural competence.

CONCLUSIONS

The international perspective of cultural competence among nursing students provided by this study serves as a vital preview of where nursing education currently stands in terms of providing the necessary preparatory competence in the cultural aspect of care. The variation of cultural competence among nursing students from different nations should serve as a cue for designing a focused yet multimodal nursing education program in guiding them to be culturally sensitive, culturally adaptive, and culturally motivated.

CLINICAL RELEVANCE

The training of nursing students in providing competent culturally appropriate care should be ensured considering that adequate preparation of nursing students guarantees future competent nursing practice, which can positively impact the nursing profession in any part of the globe.