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Raigal-Aran L, Roldán-Merino J, Martins T, Sequeira C, Ferré-Grau C, Belzunegui-Eraso A, Sampaio F. Translation, Adaptation, and Validation of the Cultural Competence Assessment in Portuguese Nurses. J Nurs Meas 2023; 31:510-521. [PMID: 37848230 DOI: 10.1891/jnm-2022-0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Background and Purpose: Previous research shows significant benefits resulting from improving culturally competent nursing care. Thus, the purpose of this study was to translate, adapt, and validate the Cultural Competence Assessment (CCA) in a sample of Portuguese nurses. Methods: A psychometric study of the CCA, after translation into European Portuguese, was performed with a snowball sample of 284 nurses. Participants were asked to fill in a sociodemographic questionnaire and the CCA. Results: The four-factor model of the CCA (Portuguese version) exhibited satisfactory indices of fitness without item nine. Cronbach's alpha was 0.85. Correlations between subscales and the total score scale were strong and statistically significant. Conclusions: These data add to the cultural competence knowledge of nurses to promote better practices and culturally competent care.
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Affiliation(s)
| | | | - Teresa Martins
- Nursing School of Porto, Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, Portugal
| | - Carlos Sequeira
- Nursing School of Porto, Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, Portugal
| | | | - Angel Belzunegui-Eraso
- History and Art Department, Faculty of Arts, Universitat Rovira i Virgili, Tarragona, Catalunya, Spain
| | - Francisco Sampaio
- Nursing School of Porto, Porto, Portugal
- CINTESIS@RISE, Nursing School of Porto (ESEP), Porto, Portugal
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Psychometric Evaluation of Turkish Version of the Cultural Competence Assessment Tool: CCA-EUnurse Project. Healthcare (Basel) 2023; 11:healthcare11050670. [PMID: 36900675 PMCID: PMC10001360 DOI: 10.3390/healthcare11050670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
It is important to understand nurses' cultural competency all across the world, as globalization and international migration are increasing day by day. The evaluation of the cultural competence of nurses is necessary to provide better quality and adequate health services to individuals, and to improve patient satisfaction and health outcomes. The aim of this study is to evaluate the validity and reliability of the Turkish version of the "Cultural Competence Assessment Tool". The methodological study was performed to assess instrument adaptation and validity and reliability testing. This study was conducted in a university hospital in western region of Turkey. The study sample consisted of 410 nurses who worked in this hospital. Validity was tested using content validity index, Kendall's W test and exploratory and confirmatory factor analyses. Reliability was tested using item-total and interitem correlations, Cronbach's α coefficient of reliability and test-retest analysis. The results of this research demonstrated that the Cultural Competence Assessment Tool showed a good construct validity, internal reliability and test-retest reliability. Confirmatory factor analysis indicated that a construct with four factors showed an acceptable model fit. In conclusion, this study concluded that the Turkish version of the Cultural Competence Assessment Tool is a valid and reliable measurement tool.
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Osmancevic S, Großschädl F, Lohrmann C. Cultural competence among nursing students and nurses working in acute care settings: a cross-sectional study. BMC Health Serv Res 2023; 23:105. [PMID: 36726095 PMCID: PMC9890795 DOI: 10.1186/s12913-023-09103-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/24/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The increasing cultural diversity in healthcare in European countries, including Austria, has highlighted the need to enhance nurses' cultural competence. Assessing cultural competence and identifying relevant influencing factors can help to improve culturally competent care. The aim of this study was to assess the cultural competence of nurses and nursing students working in Austrian acute care settings and to identify influencing factors using the Cultural Competence Assessment scale. METHODS A cross-sectional design was used. Data collection was carried out in March 2021 with nurses and nursing students in the last year of their studies who were working in Austrian acute care settings. Descriptive analysis was applied to display the general characteristics of the study participants and the levels of their overall cultural competence. A multiple linear regression analysis was conducted to analyze the influencing factors of cultural competence. RESULTS The nurses' cultural competence level was moderate to high (mean = 3.89; SD = .48). Their age, educational level, cultural diversity training and self-perceived cultural competence significantly influenced the level (F (6, 875) = 18.971, p < .0000, adj. R2 = 1.09). CONCLUSIONS Providing culturally competent healthcare services for culturally diverse patients is essential for all healthcare professionals, and especially for nurses who spend the most time with patients. Effective interventions, such as educational training, need to be implemented in order to deliver culturally competent care and potentially reduce disparities in healthcare and improve patient outcomes.
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Affiliation(s)
- Selvedina Osmancevic
- grid.11598.340000 0000 8988 2476Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4, 8010 Graz, Austria
| | - Franziska Großschädl
- grid.11598.340000 0000 8988 2476Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4, 8010 Graz, Austria
| | - Christa Lohrmann
- grid.11598.340000 0000 8988 2476Medical University of Graz, Institute of Nursing Science, Universitätsplatz 4, 8010 Graz, Austria
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Yeh YC, Hung CF, Lin CY, Wu YY, Kuo CH, Potenza MN, Cheng CH, Chen KL. The animated assessment of theory of mind for people with schizophrenia (AToMS): development and psychometric evaluation. Eur Arch Psychiatry Clin Neurosci 2022; 273:663-677. [PMID: 36253583 DOI: 10.1007/s00406-022-01498-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
Theory of mind (ToM) deficits in people with schizophrenia have been reported and associated with impaired social interactions. Thus, ToM deficits may negatively impact social functioning and warrant consideration in treatment development. However, extant ToM measures may place excessive cognitive demands on people with schizophrenia. Therefore, the study aimed to develop a comprehensible Assessment of ToM for people with Schizophrenia (AToMS) and evaluate its psychometric properties. The AToMs was developed in 5 stages, including item formation, expert review, content validity evaluation, animation production, and cognitive interviews of 25 people with schizophrenia. The psychometric properties of the 16-item AToMS (including reliability and validity) were then tested on 59 people with schizophrenia. The newly developed animated AToMS assesses 8 ToM concepts in the cognitive and affective dimensions while placing minimal neurocognitive demands on people with schizophrenia. The AToMS presented satisfactory psychometric properties, with adequate content validity (content validity index = 0.91); mostly moderate item difficulty (item difficulty index = 0.339-0.966); good discrimination (coefficients = 0.379-0.786), internal consistency (Cronbach's α = 0.850), and reliability (intraclass correlation coefficient = 0.901 for test-retest, 0.997 for inter-rater); and satisfactory convergent and divergent validity. The AToMS is reliable and valid for evaluating ToM characteristics in people with schizophrenia. Future studies are warranted to examine the AToMS in other populations (e.g., people with affective disorders) to cross-validate and extend its utility and psychometric evidence.
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Affiliation(s)
- Ya-Chin Yeh
- Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung, 821004, Taiwan
| | - Chi-Fa Hung
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, 804201, Taiwan.,Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 833401, Taiwan.,College of Humanities and Social Sciences, National Pingtung University of Science and Technology, 912301, Pingtung, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan. .,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan. .,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan. .,Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan.
| | - Yuh-Yih Wu
- Department of Special Education, National Kaohsiung Normal University, Kaohsiung, 802561, Taiwan
| | - Chun-Hong Kuo
- Department of Academic Office, Kaohsiung Municipal Nan-Zih Special School, Kaohsiung, 811214, Taiwan
| | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Connecticut Mental Health Center, New Haven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, CT, USA.,Child Study Center, Yale School of Medicine, New Haven, CT, USA.,Department of Neuroscience, Yale University, New Haven, CT, USA.,Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Chun-Hua Cheng
- Department of Occupational Therapy, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, 802211, Taiwan
| | - Kuan-Lin Chen
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan. .,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan. .,Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 701401, Taiwan.
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Osmancevic S, Großschädl F, Stijic M, Lohrmann C. The German version of the Cultural Competence Assessment (CCA-G): cross-cultural adaptation and validation study in Austrian acute care settings. BMC Nurs 2022; 21:77. [PMID: 35365142 PMCID: PMC8973569 DOI: 10.1186/s12912-022-00854-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/23/2022] [Indexed: 11/25/2022] Open
Abstract
Background Adapting practices to respond sensitively to increasingly culturally diverse patients can be challenging. Therefore, cultural competence among nurses needs to be assessed to evaluate their current cultural competence and the need for interventions to improve daily nursing practice. Little is known about cultural competence of nurses in German-speaking countries, including Austria, as there is currently no validated tool in German to assess cultural competence in nurses. The aims of this study were to translate and cross-culturally adapt the Cultural Competence Assessment scale in German and to evaluate its psychometric properties. Methods This is a methodology study with a cross-sectional design. Conducting a convenience sampling, Austrian nurses working in the direct care of patients in acute care settings were invited to participate in this study. Data collection was conducted in March 2021. The translation and cross-cultural adaptation were conducted by following the guidelines of Sousa et al. (J Eval Clin Pract 17:268-74, 2011) and Beaton et al. (Spine 25:3186-91, 2000). The face and content validity, structural validity, and internal consistency reliability of the Cultural Competence Assessment scale, which consists of 25 items, was evaluated. Data were analysed using content validity index, confirmatory factor analyses as well as McDonald’s Omega. Descriptive statistics were computed with the statistical software IBM SPSS Statistics 26, while the confirmatory factor analysis was conducted with the R package Lavaan. Results Overall, 915 nurses completed the questionnaire. Twenty items had an acceptable item content validity index. Using confirmatory factor analyses, a two-factor model with 14 items yielded a good fit (x2/df = 3.16; CFI = .923; TLI = .908; RMSEA = .055 (.049–.062) and SRMR = .039). Internal consistency reliability was found to be acceptable, as indicated by a Omega of .87. Conclusion The German version of the Cultural Competence Assessment scale (CCA-G) can be recommended for measuring cultural competence behaviour of nurses in acute care settings. The 14-item scale showed strong construct validity and acceptable internal consistency. Further research using repeated measures could determine the cultural sensitivity and indicate if the tool is applicable in other healthcare settings and for other healthcare professionals. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00854-w.
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Affiliation(s)
- Selvedina Osmancevic
- Institute of Nursing Science, Medical University of Graz, Universitätsplatz 4, 8010, Graz, Austria.
| | - Franziska Großschädl
- Institute of Nursing Science, Medical University of Graz, Universitätsplatz 4, 8010, Graz, Austria
| | - Marko Stijic
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Auenbruggerplatz 2/5, 8036, Graz, Austria.,University Clinic for Neurology, Clinical Department of Neurogeriatrics, Medical University of Graz, Auenbruggerplatz 22, 8036, Graz, Austria
| | - Christa Lohrmann
- Institute of Nursing Science, Medical University of Graz, Universitätsplatz 4, 8010, Graz, Austria
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Osmancevic S, Schoberer D, Lohrmann C, Großschädl F. Psychometric properties of instruments used to measure the cultural competence of nurses: A systematic review. Int J Nurs Stud 2020; 113:103789. [PMID: 33212330 DOI: 10.1016/j.ijnurstu.2020.103789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/31/2020] [Accepted: 10/01/2020] [Indexed: 10/23/2022]
Abstract
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.
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Affiliation(s)
- S Osmancevic
- Institute of Nursing Science, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria.
| | - D Schoberer
- Institute of Nursing Science, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria.
| | - C Lohrmann
- Institute of Nursing Science, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria.
| | - F Großschädl
- Institute of Nursing Science, Medical University of Graz, Universitätsplatz 4, 8010 Graz, Austria.
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Oyesanya TO, Turkstra LS, Brown RL. Development, Reliability, and Validity of the Perceptions of Brain Injury Survey. J Nurs Meas 2020; 28:229-258. [PMID: 32571977 DOI: 10.1891/jnm-d-19-00007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to assess psychometric properties of the Perceptions of Brain Injury Survey (PBIS), an instrument designed to assess nurses' perceptions and preparation to care for patients with traumatic brain injury (TBI). METHODS We adapted two instruments to create the PBIS, and 724 nurses completed the PBIS at three hospitals. RESULTS Final instrument has 66 items and is composed of four subscales, which can be used independently. Results showed Cronbach's alpha for the overall scale was excellent (.93) and alphas for each composite subscale were acceptable to excellent (.73-.93). Findings also suggest good discriminant validity and evidence of external validity. CONCLUSIONS The PBIS is a reliable and valid measure for assessing nurses' perceptions of caring for patients with TBI in practice or research.
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Raigal-Aran L, Ferré-Grau C, Belzunegui-Eraso A. The Spanish version of the Cultural Competence Assessment (CCA-S): Transcultural validation study and proposed refinement. NURSE EDUCATION TODAY 2019; 72:47-53. [PMID: 30419420 DOI: 10.1016/j.nedt.2018.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/28/2018] [Accepted: 10/24/2018] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- Laia Raigal-Aran
- Nursing Department, Faculty of Nursing, Universitat Rovira i Virgili, Avinguda Catalunya, 35, 43002 Tarragona, Spain.
| | - Carme Ferré-Grau
- Nursing Department, Faculty of Nursing, Universitat Rovira i Virgili, Avinguda Catalunya, 35, 43002 Tarragona, Spain.
| | - Angel Belzunegui-Eraso
- History and Art History Department, Faculty of Arts, Universitat Rovira i Virgili, Avinguda Catalunya, 35, 43002 Tarragona, Spain.
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