Psychometric evaluation of the perceived prejudice in health care scale-modified (PPHC-M) among baccalaureate student nurses

Validation of the first peoples cultural capability measurement tool with undergraduate health students: A descriptive cohort study

BACKGROUND

Health professional graduates require the capacity to work safely, both clinically and culturally, when delivering care to Indigenous peoples worldwide. In the Australian context, the Aboriginal and Torres Strait Islander Health Curriculum Framework (The Framework) provides guidance for health professional programs to integrate, teach and assess Aboriginal and Torres Strait Islander peoples' (First Peoples) health content. There is, however, a lack of validated tools that measure the development of students' cultural capabilities.

OBJECTIVES

To validate the Cultural Capability Measurement Tool with a cohort of health professional students.

DESIGN

A descriptive cohort design was used.

SETTING AND PARTICIPANTS

All students (N = 753) enrolled in a discrete First Peoples Health course at an Australian university were invited to complete the Cultural Capability Measurement Tool.

METHODS

The tool was tested for reliability, content and construct validity using confirmatory factor analysis; and concurrent validity using and the Cultural Understanding Self-Assessment Tool.

RESULTS

A sample of 418 (73% response rate) was recruited. Most participants were enrolled in the Bachelor of Nursing program (n = 369, 82%). The Cultural Capability Measurement Tool had a Cronbach's alpha coefficient of 0.86. A five-factor solution was confirmed which reflected the cultural capability domains and accounted for 51% of the variance. Scores correlated with students' cultural understanding (r = 0.28, p < 0.001).

CONCLUSIONS

Successful implementation of The Framework requires instruments to measure changes in students' cultural capabilities. Measuring nursing students' cultural capabilities can inform their development, identify areas of strengths and deficits for educators, and will ultimately contribute to the development of a culturally safe nursing workforce.

Evaluation of the psychometric properties of the Korean version of the Cultural Competence Assessment

AIM

The 25 item Cultural Competence Assessment assesses the cultural competence of multiple types of healthcare providers. This study aimed to examine the validity and reliability of the Korean version of the questionnaire (KCCA) and to determine the need for changes to improve its validity and reliability.

METHODS

Data from 161 hospital nurses were used for the item analysis and to assess the reliability and construct validity of the KCCA before and after the deletion of nine items.

RESULTS

The KCCA did not demonstrate acceptable construct validity and subscale internal reliability. Nine items with high interitem correlations, high modification indices, and relatively lower factor loadings were deleted. The 16 item Modified KCCA showed improved construct validity, convergent and discriminant validity, and reliability.

CONCLUSION

While further psychometric evaluation of the Modified KCCA should be undertaken with larger samples and diverse professionals, the study's data provide evidence that the Modified KCCA might be a more suitable measure for use among Korean healthcare providers.

The state of research on racial/ethnic discrimination in the receipt of health care

OBJECTIVES

We conducted a review to examine current literature on the effects of interpersonal and institutional racism and discrimination occurring within health care settings on the health care received by racial/ethnic minority patients.

METHODS

We searched the PsychNet, PubMed, and Scopus databases for articles on US populations published between January 1, 2008 and November 1, 2011. We used various combinations of the following search terms: discrimination, perceived discrimination, race, ethnicity, racism, institutional racism, stereotype, prejudice or bias, and health or health care. Fifty-eight articles were reviewed.

RESULTS

Patient perception of discriminatory treatment and implicit provider biases were the most frequently examined topics in health care settings. Few studies examined the overall prevalence of racial/ethnic discrimination and none examined temporal trends. In general, measures used were insufficient for examining the impact of interpersonal discrimination or institutional racism within health care settings on racial/ethnic disparities in health care.

CONCLUSIONS

Better instrumentation, innovative methodology, and strategies are needed for identifying and tracking racial/ethnic discrimination in health care settings.