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Radhamony R, Cross WM, Townsin L, Banik B. Culturally and Linguistically Diverse Community Access and Utilisation of the Mental Health Service: An Explanation Using Andersen's Behavioural Model. Issues Ment Health Nurs 2024; 45:758-765. [PMID: 38954511 DOI: 10.1080/01612840.2024.2359602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
Andersen's Behavioural Model of Health Service Use (ABMHSU) is a multilevel model that helps understand the factors influencing health service access and utilisation. This framework is a widely used model for health service use in general, as well as in immigrant populations and vulnerable populations. ABMHSU, in this project, provided a framework to explain how the mental health nurses' cultural competence can influence the Victorian CALD community members' mental health care access and utilisation. A unique model of ABMHSU in the current multiple-method project provided a theoretical framework for examining the factors associated with people from the CALD community accessing mental health services in an Australian context to answer the research questions. The key findings of the research were discussed with reference to the extant literature and with triangulation of research results with the ABMHSU in the context of Victoria. The researchers argue that even though predisposing, enabling, and need factors are necessary to determine whether a person is selected for expert care for mental health issues, these factors alone are insufficient. Ongoing research is essential to ascertain the potential of mental health nurses' cultural competence education and cultural responsiveness in addressing the mental health service access and utilisation of the heterogeneous CALD communities. Additional research is advocated to identify the supplementary factors, as there is a dearth of research exploring the potential of ABMHSU worldwide.
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Affiliation(s)
- Reshmy Radhamony
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
| | - Wendy M Cross
- School of Health, Federation University, Ballarat, Australia
| | - Louise Townsin
- School of Health, Federation University, Ballarat, Australia
- Research Office, Torrens University, Adelaide, South Australia, Australia
| | - Biswajit Banik
- Institute of Health and Wellbeing, Federation University, Berwick, Victoria, Australia
- Manna Institute, Regional Australia Mental Health Research and Training Institute, University of New England, Armidale, New South Wales, Australia
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Červený M, Tóthová V. Self-reported cultural competence among Czech and Slovakian nurses: A comparative correlation study. Int Nurs Rev 2024. [PMID: 38650482 DOI: 10.1111/inr.12969] [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: 06/21/2023] [Accepted: 03/23/2024] [Indexed: 04/25/2024]
Abstract
AIM This study aimed to compare the level of cultural competence among nurses working in clinical practice in Slovakia and the Czech Republic. BACKGROUND Demographic changes have greatly affected the health sector in Slovakia and the Czech Republic. By identifying the level of nurses' cultural competence, many of the complications encountered in caring for patients from different cultures can be avoided. However, few studies have explored the cultural competence of nurses in clinical practice in these countries. METHOD This study was cross-sectional, descriptive, and comparative. It followed the STROBE checklist and used the Cultural Competence Assessment Tool questionnaire to collect data. Descriptive and inferential statistical tests were utilized for data analysis, using SASD 1.5.8 and IBM SPSS Statistics version 28.0.0. RESULTS The sample comprised 424 nurses, with 202 from the Czech Republic and 222 from Slovakia, primarily female. Most nurses in both countries have not received cultural diversity training. Nevertheless, nurses in both countries indicate the necessity of conducting a cultural impact assessment of patients' health. Cultural diversity training significantly increases the level of cultural competence in nurses. DISCUSSION Lower cultural competence scores can negatively impact nursing care for patients from different cultures, leading to additional cultural challenges. IMPLICATIONS FOR NURSING AND HEALTH POLICY The findings highlight the need for enhanced cultural competence among nurses. Nurses need to learn and utilize cultural information to help maximize healthcare for patients from different cultures. By providing nurses with cultural knowledge and skills, they will be able to deliver more effective and culturally competent care to patients from varied cultural backgrounds.
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Affiliation(s)
- Martin Červený
- Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, the Czech Republic
| | - Valérie Tóthová
- Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, the Czech Republic
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Asadizaker M, Ebadi A, Molavynejad S, Yadollahi S, Saki Malehi A. Development and Psychometric Evaluation of the Clinical Nursing Cultural Competence Scale. J Nurs Meas 2023; 31:615-625. [PMID: 37353320 DOI: 10.1891/jnm-2021-0095] [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: 06/25/2023]
Abstract
Background and Purpose: Cultural competence in clinical nurses can lead to comprehensive care for patients from different cultures. Currently, an appropriate instrument to assess cultural competence in clinical nurses is limited. This study aimed to design and determine the psychometric properties of the clinical nursing cultural competence scale (CNCCS). Methods: This methodological study was conducted in 2018-2019 in two phases. In the first phase, a literature review and semistructured interviews with 18 clinical nurses from Isfahan and Ahvaz were conducted, and the results were used for item generation. In the second phase, the face, content, construct validity, and reliability of the questionnaire were assessed. For construct validity assessment through exploratory factor analysis (EFA), 200 clinical nurses were purposefully recruited to fill out CNCCS. Results: In the first phase, 140 items were produced. In the second phase, the item number was reduced to 40 after the face and content validity assessment. In EFA for construct validity assessment, 13 more items were deleted, and the remaining 27 items were loaded on six factors. The Cronbach's alpha and the test-retest intraclass correlation coefficient were CNCCS 0.86 and 0.93, respectively. Conclusions: The CNCCS had acceptable psychometric characteristics in Iranian nurses and can be used for assessing cultural competence among clinical nurses. The use of this scale can help nursing policymakers and managers develop their understanding of nursing cultural competence and develop strategies for its improvement.
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Affiliation(s)
- Marziyeh Asadizaker
- Associate Professor of Nursing, Department of Nursing, Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abbas Ebadi
- Professor of Nursing, Department of Nursing, Behavioral Sciences Research Center Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Shahram Molavynejad
- Associate Professor of Nursing, Department of Nursing, Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Safoura Yadollahi
- Assistant Professor of Nursing, Department of Nursing, Kashan University of Medical Sciences, Kashan, Iran
| | - Amal Saki Malehi
- Department of Biostatistics and Epidemiology, Thalassemia & Hemoglobinopathy Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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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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Pope K, Hewlin-Vita H, Chu EMY. The Human Library and the development of cultural awareness and sensitivity in occupational therapy students: a mixed methods study. Front Med (Lausanne) 2023; 10:1215464. [PMID: 37841019 PMCID: PMC10569027 DOI: 10.3389/fmed.2023.1215464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/01/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Monash university in Australia has adopted the Human Library as a teaching activity aimed at enhancing occupational therapy (OT) students' cultural awareness and sensitivity; however, its effect on cultural competence in healthcare profession students has not been previously investigated. Aim To examine whether participation in a Human Library can facilitate the development of OT students' cultural awareness and sensitivity and to understand the factors contributing to changes in cultural competence from the students' perspective. Method This is a mixed-method study. Quantitative data was collected by participant characteristic survey and pre/post-Human Library cultural competence assessment (CCA). The quantitative data was used to inform the selection of participants and questions for the second qualitative phase. Quantitative data were analyzed using independent samples and paired t-tests, analysis of variance and Pearson correlation. Qualitative data were analyzed using coding reliability thematic analysis. Results Statistically significant increases were noted in CAS, CCB and overall CCA scores from pre- to post-Human Library. Participant characteristics such as gender, work experience in aged care and the health sector had a positive effect on pre-Human Library CCA results. Qualitative data demonstrated that participants perceived they had a level of cultural competence prior to attending the Human Library however, still made gains in cultural awareness and sensitivity and were motivated and inspired to provide culturally congruent healthcare. Conclusion The Human Library can be considered for inclusion within a suite of learning methods for healthcare professional student curricula as a cost-effective, flexible teaching method for the development of competencies for culturally congruent healthcare.
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Affiliation(s)
- Kirsty Pope
- Department of Occupational Therapy, Monash University, Melbourne, VIC, Australia
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Yu H, Flores DD, Bonett S, Bauermeister JA. LGBTQ + cultural competency training for health professionals: a systematic review. BMC MEDICAL EDUCATION 2023; 23:558. [PMID: 37559033 PMCID: PMC10410776 DOI: 10.1186/s12909-023-04373-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 05/17/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Health disparities experienced by LGBTQ + individuals have been partially attributed to health professionals' lack of cultural competence to work with them. Cultural competence, the intricate integration of knowledge, skills, attitudes, and behaviors that improve cross-cultural communication and interpersonal relationships, has been used as a training framework to enhance interactions between LGBTQ + patients and health professionals. Despite multiple published LGBTQ + cultural competency trainings, there has been no quantitative appraisal and synthesis of them. This systematic review assessed articles evaluating the design and effectiveness of these trainings and examined the magnitude of their effect on cultural competence outcomes. METHODS Included studies quantitatively examined the effectiveness of LGBTQ + cultural competency trainings for health professionals across all disciplines in various healthcare settings. 2,069 citations were retrieved from five electronic databases with 44 articles meeting inclusion criteria. The risk of bias in the included studies was assessed by two authors utilizing the Joanna Briggs Institute critical appraisal checklists. Data extracted included study design, country/region, sample characteristic, training setting, theoretical framework, training topic, modality, duration, trainer, training target, measurement instrument, effect size and key findings. This review followed the PRISMA statement and checklist to ensure proper reporting. RESULTS 75% of the studies were published between 2017 and 2023. Four study designs were used: randomized controlled trial (n = 1), quasi-experimental pretest-posttest without control (n = 39), posttest only with control (n = 1) and posttest only without control (n = 3). Training modalities were multiple modalities with (n = 9) and without simulation (n = 25); single modality with simulation (n = 1); and with didactic lectures (n = 9). Trainings averaged 3.2 h. Ten studies employed LGBTQ + trainers. The training sessions resulted in statistically significant improvements in the following cultural competence constructs: (1) knowledge of LGBTQ + culture and health (n = 28, effect size range = 0.28 - 1.49), (2) skills to work with LGBTQ + clients (n = 8, effect size range = 0.12 - 1.12), (3) attitudes toward LGBTQ + individuals (n = 14, effect size range = 0.19 - 1.03), and (4) behaviors toward LGBTQ + affirming practices (n = 7, effect size range = 0.51 - 1.11). CONCLUSIONS The findings of this review highlight the potential of LGBTQ + cultural competency training to enhance cultural competence constructs, including (1) knowledge of LGBTQ + culture and health, (2) skills to work with LGBTQ + clients, (3) attitudes toward LGBTQ + individuals, and (4) behaviors toward LGBTQ + affirming practices, through an interdisciplinary and multi-modal approach. Despite the promising results of LGBTQ + cultural competency training in improving health professionals' cultural competence, there are limitations in study designs, sample sizes, theoretical framing, and the absence of longitudinal assessments and patient-reported outcomes, which call for more rigorous research. Moreover, the increasing number of state and federal policies that restrict LGBTQ + health services highlight the urgency of equipping health professionals with culturally responsive training. Organizations and health systems must prioritize organizational-level changes that support LGBTQ + inclusive practices to provide access to safe and affirming healthcare services for LGBTQ + individuals.
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Affiliation(s)
- Hyunmin Yu
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 USA
| | - Dalmacio Dennis Flores
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 USA
| | - Stephen Bonett
- School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA 19104 USA
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Renner RM, Ennis M, Maazi M, Dunn S, Norman WV, Kaczorowski J, Guilbert E. Development and pilot testing of the 2019 Canadian Abortion Provider Survey. Pilot Feasibility Stud 2023; 9:49. [PMID: 36959670 PMCID: PMC10034882 DOI: 10.1186/s40814-023-01279-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Substantial changes in abortion care regulations, available medications and national clinical practice guidelines have occurred since a 2012 national Canadian Abortion Provider Survey (CAPS). We developed and piloted the CAPS 2019 survey instrument to explore changes of the abortion provider workforce, their clinical care as well as experiences with stigma and harassment. METHODS We undertook development and piloting in three phases: (1) development of the preliminary survey sections and questions based on the 2012 survey instrument, (2) content validation and feasibility of including certain content aspects via a modified Delphi Method with panels of clinical and research experts, and (3) pilot testing of the draft survey for face validity and clarity of language; assessing usability of the web-based Research Electronic Data Capture platform including the feasibility of complex skip pattern functionality. We performed content analysis of phase 2 results and used a general inductive approach to identify necessary survey modifications. RESULTS In phase 1, we generated a survey draft that reflected the changes in Canadian abortion care regulations and guidelines and included questions for clinicians and administrators providing first and second trimester surgical and medical abortion. In phase 2, we held 6 expert panel meetings of 5-8 participants each representing clinicians, administrators and researchers to provide feedback on the initial survey draft. Due to the complexity of certain identified aspects, such as interdisciplinary collaboration and interprovincial care delivery differences, we revised the survey sections through an iterative process of meetings and revisions until we reached consensus on constructs and questions to include versus exclude for not being feasible. In phase 3, we made minor revisions based on pilot testing of the bilingual, web-based survey among additional experts chosen to be widely representative of the study population. Demonstrating its feasibility, we included complex branching and skip pattern logic so each respondent only viewed applicable questions based on their prior responses. CONCLUSIONS We developed and piloted the CAPS 2019 survey instrument suitable to explore characteristics of a complex multidisciplinary workforce, their care and experience with stigma on a national level, and that can be adapted to other countries.
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Affiliation(s)
- Regina M Renner
- Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, BC Canada, V6Z 2K8, Canada.
- Contraception and Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, 4500 Oak Street, Vancouver, BC Canada, V6H 3N1, Canada.
| | - Madeleine Ennis
- Department of Obstetrics and Gynaecology, University of British Columbia, Suite 930, 1125 Howe Street, Vancouver, BC Canada, V6Z 2K8, Canada
- Contraception and Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, 4500 Oak Street, Vancouver, BC Canada, V6H 3N1, Canada
| | - Mahan Maazi
- Contraception and Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, 4500 Oak Street, Vancouver, BC Canada, V6H 3N1, Canada
| | - Sheila Dunn
- Contraception and Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, 4500 Oak Street, Vancouver, BC Canada, V6H 3N1, Canada
- Department of Family and Community Medicine, University of Toronto, 27 King's College Cir, Toronto, ON Canada, M5S 1A1, Canada
| | - Wendy V Norman
- Contraception and Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, 4500 Oak Street, Vancouver, BC Canada, V6H 3N1, Canada
- Department of Family Practice, University of British Columbia, 3Rd Floor David Strangway Building, 5950 University Boulevard, Vancouver, BC Canada, V6T 1Z3, Canada
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Janusz Kaczorowski
- Contraception and Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, 4500 Oak Street, Vancouver, BC Canada, V6H 3N1, Canada
- Department of Family and Emergency Medicine, Université de Montréal, Montreal, Pavillon Roger-Gaudry, 2900 Edouard Montpetit Blvd, Montreal, QC, H3T 1J4, Canada
| | - Edith Guilbert
- Contraception and Abortion Research Team, Women's Health Research Institute, BC Women's Hospital and Health Centre, 4500 Oak Street, Vancouver, BC Canada, V6H 3N1, Canada
- Department of Obstetrics, Gynecology and Reproduction, Laval University, 2325 Rue de L'Université, Québec City, QC Canada, G1V 0A6, Canada
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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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Brady B, Sidhu B, Jennings M, Saberi G, Tang C, Hassett G, Boland R, Dennis S, Ashton-James C, Refshauge K, Descallar J, Lim D, Said CM, Williams G, Sayed S, Naylor JM. The Natural Helper approach to culturally responsive disease management: protocol for a type 1 effectiveness-implementation cluster randomised controlled trial of a cultural mentor programme. BMJ Open 2023; 13:e069120. [PMID: 36697054 PMCID: PMC9884889 DOI: 10.1136/bmjopen-2022-069120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Chronic disease is a leading cause of death and disability that disproportionately burdens culturally and linguistically diverse (CALD) communities. Self-management is a cornerstone of effective chronic disease management. However, research suggests that patients from CALD communities may be less likely to engage with self-management approaches. The Natural Helper Programme aims to facilitate patient engagement with self-management approaches (ie, 'activation') by embedding cultural mentors with lived experience of chronic disease into chronic disease clinics/programmes. The Natural Helper Trial will explore the effect of cultural mentors on patient activation, health self-efficacy, coping efforts and health-related quality of life (HRQoL) while also evaluating the implementation strategy. METHODS AND ANALYSIS A hybrid type-1 effectiveness-implementation cluster-randomised controlled trial (phase one) and a mixed-method controlled before-and-after cohort extension of the trial (phase 2). Hospital clinics in highly multicultural regions in Australia that provide healthcare for patients with chronic and/or complex conditions, will participate. A minimum of 16 chronic disease clinics (clusters) will be randomised to immediate (active arm) or delayed implementation (control arm). In phase 1, the active arm will receive a multifaceted strategy supporting them to embed cultural mentors in their services while the control arm continues with usual care. Each cluster will recruit an average of 15 patients, assessed at baseline and 6 months (n=240). In phase 2, clusters in the control arm will receive the implementation strategy and evaluate the intervention on an additional 15 patients per cluster, while sustainability in active arm clusters will be assessed qualitatively. Change in activation over 6 months, measured using the Patient Activation Measure will be the primary effectiveness outcome, while secondary effectiveness outcomes will explore changes in chronic disease self-efficacy, coping strategies and HRQoL. Secondary implementation outcomes will be collected from patient-participants, mentors and healthcare providers using validated questionnaires, customised surveys and interviews aligning with the Reach, Effectiveness, Adoption, Implementation, Maintenance framework to evaluate acceptability, reach, dose delivered, sustainability, cost-utility and healthcare provider determinants. ETHICS AND DISSEMINATION This trial has full ethical approval (2021/ETH12279). The results from this hybrid trial will be presented at scientific meetings and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ACTRN12622000697785.
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Affiliation(s)
- Bernadette Brady
- Allied Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Balwinder Sidhu
- Multicultural Health Service, South Western Sydney Local Health District, Bankstown, NSW, Australia
| | - Matthew Jennings
- Allied Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Golsa Saberi
- Multicultural Health Service, South Western Sydney Local Health District, Bankstown, NSW, Australia
| | - Clarice Tang
- Allied Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Geraldine Hassett
- Rheumatology, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Robert Boland
- Allied Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Dennis
- Allied Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Claire Ashton-James
- Sydney Medical School, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kathryn Refshauge
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Randwick, New South Wales, Australia
| | - David Lim
- School of Health Sciences, Western Sydney University, Campbelltown, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Catherine M Said
- Physiotherapy Department, Western Health, St Albans, Victoria, Australia
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Sunshine Hospital, St Albans, VIC, Australia
| | - Gavin Williams
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Physiotherapy Department, Epworth HealthCare, Richmond, Victoria, Australia
| | - Samia Sayed
- Multicultural Health Service, South Western Sydney Local Health District, Bankstown, NSW, Australia
| | - Justine M Naylor
- Allied Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Randwick, New South Wales, Australia
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Bakaa N, Southerst D, Côté P, Macedo L, Carlesso LC, MacDermid J, Mior S. Assessing cultural competency among Canadian chiropractors: a cross-sectional survey of Canadian Chiropractic Association members. Chiropr Man Therap 2023; 31:1. [PMID: 36635694 PMCID: PMC9835226 DOI: 10.1186/s12998-023-00474-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND There is a paucity of research assessing cultural competency among Canadian chiropractors. Therefore, the aims of this study were to (1) measure cultural competency among Canadian chiropractors, (2) understand chiropractors' perspectives of challenges and attitudes regarding the delivery of chiropractic services to equity-seeking communities, and (3) assess contextual factors associated with cultural competency. METHODS We conducted a cross-sectional survey of members of the Canadian Chiropractic Association (CCA) (May-July 2021). The survey instrument consisted of 57 questions related to demographics, cultural competency, perceptions about health disparities, and challenges in delivery of rehabilitation. Cultural competency was measured using the Cultural Awareness and Sensitivity and Cultural Competence Behaviours subscales of the Cultural Competence Assessment Instrument. We conducted a multivariate linear regression to assess factors that may be associated with cultural competency. RESULTS A total of 3143 CCA members responded (response rate of 41%). Mean scores for the Cultural Awareness and Sensitivity subscale were 5.8/7 (95% CI 5.7; 5.8) and 4.2/7 (95% CI 4.1; 4.2) for the Cultural Competence Behaviour subscale. Most chiropractors (72-78%) reported observing important cultural health disparities across various care-related outcomes. Cost of services and language were identified as barriers to providing care to equity-seeking communities. Cultural Awareness and Sensitivity scores were weakly associated with gender (men), years of clinical practice, cultural health disparities, the statement "I think some people have an agenda to look for discrimination even where it does not exist (DEI attitudes)," race (Caucasian), and prior DEI training, (R2 = 0.15, p < 0.0001). Cultural Competence Behaviour scores were weakly associated with race (Caucasian), cultural health disparities, prior DEI training, increased years of clinical experience, and higher Cultural Awareness and Sensitivity scores (R2 = 0.19, p < 0.0001). CONCLUSION This study provides the first description of cultural competency within the chiropractic profession in Canada. Findings suggest a gap between knowledge and behaviour and uncover several barriers and challenges that may inform the development of profession-specific training in cultural competence.
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Affiliation(s)
- Nora Bakaa
- grid.25073.330000 0004 1936 8227School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Danielle Southerst
- grid.266904.f0000 0000 8591 5963Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Canada
| | - Pierre Côté
- grid.266904.f0000 0000 8591 5963Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Canada
| | - Luciana Macedo
- grid.25073.330000 0004 1936 8227School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Lisa C. Carlesso
- grid.25073.330000 0004 1936 8227School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Joy MacDermid
- grid.25073.330000 0004 1936 8227School of Rehabilitation Sciences, McMaster University, Hamilton, Canada ,grid.39381.300000 0004 1936 8884School of Physical Therapy, Western University, London, Canada
| | - Silvano Mior
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Canada. .,Division of Research and Innovation, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
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Southerst D, Bakaa N, Côté P, Macedo L, Carlesso L, MacDermid J, Mior S. Diversity of the chiropractic profession in Canada: a cross-sectional survey of Canadian Chiropractic Association members. Chiropr Man Therap 2022; 30:52. [PMID: 36494690 PMCID: PMC9733254 DOI: 10.1186/s12998-022-00463-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Little is known about the diversity of the chiropractic profession with respect to gender, sexual orientation, race, ethnicity and community of practice. This knowledge is important as profession representation of key equity seeking groups may impact quality of care and access for vulnerable communities. The aim of this cross-sectional survey was to explore the diversity of the chiropractic profession in Canada. METHODS All registered members of the Canadian Chiropractic Association (N = 7721) were invited to participate in a web-based survey between May and June 2021. Survey questions explored diversity with respect to personal demographics (age, sex, gender, sexual orientation, race, ethnicity, language) and practice characteristics (community setting, practice type). Where possible, survey data was compared to data from the 2016 Census of the Canadian population. RESULTS We received a total of 3143 survey responses (response rate-41%). The average age of our sample was 44.7 years (standard deviation 12.7). Forty-five percent were female with the same proportion (45.2%) self-identifying as women. Ninety-one percent of the sample self-identified as heterosexual. With respect to race, 80% of respondents were Caucasian. Seventy percent of chiropractors in our sample identified with Canadian ancestry and 29% with European ancestry. In comparison to the Canadian population, some visible minorities were underrepresented. The greatest discrepancy between the Canadian population and our sample was in the proportion of Black and Indigenous chiropractors. With respect to ethnicity, chiropractors identifying themselves with Canadian ancestry were overrepresented in our sample compared to others, specifically those with North American Indigenous and South, Central and Latin American ancestry. Sixty-one percent of chiropractors practiced in major cities and most work in interdisciplinary clinics (42% Complementary and Alternative Medicine and 33% rehabilitation). CONCLUSIONS This study provides an initial description of diversity within the chiropractic profession in Canada. Women represent less than 50% of the profession nationally. Overall, there is little racial and ethnic diversity in the chiropractic profession compared to the Canadian population, with Black and Indigenous peoples being underrepresented. Future work should focus strategies to foster the development of a more diverse chiropractic workforce.
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Affiliation(s)
- Danielle Southerst
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Canada
| | - Nora Bakaa
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Pierre Côté
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Canada
| | - Luciana Macedo
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Lisa Carlesso
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Joy MacDermid
- School of Physical Therapy, Western University, London, Canada
| | - Silvano Mior
- Institute for Disability and Rehabilitation Research, Ontario Tech University, Oshawa, Canada.
- Division of Research, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
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El Arab RA, Urbanavice R, Jakavonyte-Akstiniene A, Skvarcevskaja M, Austys D, Mateos JT, Briones-Vozmediano E, Rubinat-Arnaldo E, Istomina N. Cultural competency among Lithuanian nurses and preparedness to work with intercultural immigrants: A quantitative study protocol. Front Public Health 2022; 10:1025508. [PMID: 36452953 PMCID: PMC9702516 DOI: 10.3389/fpubh.2022.1025508] [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: 08/23/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Health care providers are increasingly required to provide care to patients from diverse cultural backgrounds. A culturally competent approach could be used to address gaps in the health care of migrants, whether they are refugees, asylum seekers, or undocumented migrants. From June 2021 onward, there are estimated to be 4,300 asylum seekers in Lithuania who crossed the Belarusian border. Furthermore, ~65 thousand Ukrainians registered within 6 months of the beginning of the war on 24 February 2022. Aim To determine the cultural competence of Lithuanian nurses using the Nurse Cultural Competence Scale (NCCS) questionnaire. Methods A quantitative study evaluating the cultural competency of nursing professionals will be conducted using the Lithuanian version of the Nurse Cultural Competence Scale (NCCS). The study will be conducted in Lithuanian municipalities and will involve primary, secondary, and tertiary health care providers. Discussion This study will provide data that can guide the development and evaluation of interventions designed to reduce health disparities among migrants, including the need to identify the appropriate type of cultural competency training for nurses. In addition to the results of this study, it may provide an indication of other cultural competency required for nurses. This includes consideration of religion, sexual orientation, gender identity, household classifications on the basis of urban vs. rural areas, language spoken, and country of origin.
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Affiliation(s)
- Rabie Adel El Arab
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain,Healthcare Research Group (GRECS), Institute for Biomedical Research (IRBLleida), Lleida, Spain,Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania,*Correspondence: Rabie Adel El Arab
| | - Rita Urbanavice
- Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania,Department of Nursing, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | - Agne Jakavonyte-Akstiniene
- Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania,Department of Nursing, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | - Marija Skvarcevskaja
- Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania,Department of Nursing, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | - Donatas Austys
- Department of Nursing, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | - Jose Tomas Mateos
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain,Healthcare Research Group (GRECS), Institute for Biomedical Research (IRBLleida), Lleida, Spain
| | - Erica Briones-Vozmediano
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain,Healthcare Research Group (GRECS), Institute for Biomedical Research (IRBLleida), Lleida, Spain
| | - Esther Rubinat-Arnaldo
- Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain,Healthcare Research Group (GRECS), Institute for Biomedical Research (IRBLleida), Lleida, Spain
| | - Natalja Istomina
- Health and Social Services for Asylum Seekers Research Group, Vilnius University, Vilnius, Lithuania,Department of Nursing, Faculty of Medicine, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
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Torr C. Culturally competent care in the neonatal intensive care unit, strategies to address outcome disparities. J Perinatol 2022; 42:1424-1427. [PMID: 35241768 DOI: 10.1038/s41372-022-01360-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/09/2022] [Accepted: 02/17/2022] [Indexed: 11/09/2022]
Abstract
In the past two years, we have witnessed social unrest, the unequal effects of a pandemic across our society, and a focus on how systems in the United States produce unequal outcomes along racial and cultural divides. With increased national awareness, there has also been a call for change in healthcare, specifically racial inequities in Neonatal Intensive Care Unit (NICU) outcomes (1). While race may be a data point used to classify outcomes, it has no basis in biology, and merely identifying it does not make it simple to address. To address these inequities we need to look past the social construct of race and to the social aspects of our care in the NICU. Focusing on small and large changes that we can make as individuals, units, and as a specialty that can improve the care and outcomes of this at-risk patient population. This perspective focuses on culturally congruent care, trauma-informed care, and other approaches to reduce disparities in neonatal outcomes.
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Affiliation(s)
- Carrie Torr
- University of Utah School of Medicine, Salt Lake City, UT, USA.
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15
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Balachandran P, Karuveettil V, Janakiram C. Development and validation of cultural competence assessment tool for healthcare professionals, India. Front Public Health 2022; 10:919386. [PMID: 36081476 PMCID: PMC9445189 DOI: 10.3389/fpubh.2022.919386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/27/2022] [Indexed: 01/22/2023] Open
Abstract
Culture influences an individual's perception of "health" and "sickness". Therefore, cultural competence assessment of healthcare professionals is very important. Existing assessment scales have limited application in India due to the nation's rich cultural diversity and heterogeneous healthcare streams. This study was undertaken to develop and validate a cultural competence assessment tool for healthcare professionals in India. A cross-sectional study using convenience sampling was conducted following all standard steps among 290 healthcare professionals in India. Item reduction was followed by estimation of validity and reliability. Responses were recorded on a five-point Likert scale, ranging from strongly disagree to strongly agree. The resultant tool, named Cultural Competence Assessment Tool-India (CCT-I) showed an acceptable internal consistency (Cronbach's alpha =0.734). Inter-rater agreement was 81.43%. Face, content, and construct validity were demonstrated. There was no statistically significant difference in cultural competence between the healthcare streams based on years of clinical experience. There was statistically significant difference between streams of healthcare (p-value =0.009) and also between dentistry and Ayurveda groups (p-value = 0.003). This comprehensive tool can be used as the first step toward designing cultural competence training of healthcare manpower and the establishment of culturally sensitive healthcare organizations.
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Affiliation(s)
| | | | - Chandrashekar Janakiram
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, India
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Wasmuth S, Belkiewitz J, Bravata D, Horsford C, Harris A, Smith C, Austin C, Miech E. Protocol for evaluating external facilitation as a strategy to nationally implement a novel stigma reduction training tool for healthcare providers. Implement Sci Commun 2022; 3:88. [PMID: 35962426 PMCID: PMC9372956 DOI: 10.1186/s43058-022-00332-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Identity Development Evolution and Sharing (IDEAS) is a theatre-based intervention for reducing healthcare provider stigma. IDEAS films are created by collecting narratives from people who have experienced discrimination and healthcare inequity, partnering with professional playwrights to create theatrical scripts that maintain the words of the narratives while arranging them into compelling storylines involving several interviews, and hiring professional actors to perform and record scenes. IDEAS implementation requires a moderator to establish a respectful learning environment, play the filmed performance, set ground rules for discussion, and moderate a discussion between healthcare providers who viewed the film and invited panelists who are members of the minoritized population being discussed. IDEAS’ impact on provider stigma is measured via pre/post Acceptance and Action Questionnaire – Stigma (AAQ-S) data collected from participating providers. The objectives of this manuscript are to provide narrative review of how provider stigma may lead to healthcare inequity and health disparities, describe the conceptual frameworks underpinning the IDEAS intervention, and outline methods for IDEAS implementation and implementation evaluation.
Methods
This manuscript describes a hybrid type 3 design study protocol that uses the Consolidated Framework for Implementation Research (CFIR) to evaluate external facilitation, used as an implementation strategy to expand the reach of IDEAS. CFIR is also used to assess the impact of characteristics of the intervention and implementation climate on implementation success. Implementation success is defined by intervention feasibility and acceptability as well as self-efficacy of internal facilitators. This manuscript details the protocol for collection and evaluation of implementation data alongside that of effectiveness data. The manuscript provides new information about the use of configurational analysis, which uses Boolean algebra to analyze pathways to implementation success considering each variable, within and across diverse clinical sites across the USA.
Discussion
The significance of this protocol is that it outlines important information for future hybrid type 3 designs wishing to incorporate configurational analyses and/or studies using behavioral or atypical, complex, innovative interventions. The current lack of evidence supporting occupational justice-focused interventions and the strong evidence of stigma influencing health inequities underscore the necessity for the IDEAS intervention.
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Wang R, Duan G, Wu Y, Su Y, Li J, Liao L, Xu H. Effectiveness of Chinese Native Culture Education for Improving Undergraduate Nursing Students' Transcultural Self-Efficacy. DISEASE MARKERS 2022; 2022:5813946. [PMID: 35909887 PMCID: PMC9337925 DOI: 10.1155/2022/5813946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 04/12/2022] [Indexed: 11/25/2022]
Abstract
Aim The aim of this study is to evaluate the impact of Chinese native culture education based on Chinese native culture on the intercultural competence of undergraduate nursing students. Method A quasi-experimental design with pretest and posttest was used. We recruited nursing students from 4 classes of the School of Nursing in our hospital in 2016 as research subjects. Undergraduate nursing students (n = 79) who completed one semester of education in indigenous Chinese culture completed a demographic questionnaire and the transcultural self-efficacy tool (TSET). Chinese native culture education is the topics related to nursing, consistent with the culture of Chinese patients under the background of Chinese native culture, including the dietary habits, taboos, religions, values, particularly Chinese medicine, and specific diseases. The control group (n = 91) was students who did not participate in Chinese native culture education and completed the instrument during the same time frame. Result Students who participated in Chinese native cultural education significantly improved their transcultural self-efficacy in three dimensions: cognition, emotion, and practice. Compared with the control group, the students in the cultural education group had higher change scores in three sizes of transcultural self-efficacy. Conclusion When strengthening cultural education for undergraduate nursing students, adding content related to Chinese native culture can improve their transcultural self-efficacy and meet the growing cultural needs of patients.
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Affiliation(s)
- Rong Wang
- XiangYa School of Public Health, Central South University, Changsha, Hunan 410001, China
- School of Nursing, University of South China, Hengyang, Hunan 421001, China
| | - GongXiang Duan
- School of Nursing, University of South China, Hengyang, Hunan 421001, China
| | - YuanYuan Wu
- Wuxi Tongren Rehabilitation Hospital, Wuxi, Jiangsu 214000, China
| | - YinHua Su
- School of Nursing, University of South China, Hengyang, Hunan 421001, China
| | - JianZhi Li
- School of Nursing, University of South China, Hengyang, Hunan 421001, China
| | - Li Liao
- School of Nursing, University of South China, Hengyang, Hunan 421001, China
| | - Huilan Xu
- XiangYa School of Public Health, Central South University, Changsha, Hunan 410001, China
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Pratt-Chapman ML. Learning Outcomes of Diverse Oncology Professionals After the TEAM Cultural Competency Training. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:662-667. [PMID: 32902787 PMCID: PMC9205792 DOI: 10.1007/s13187-020-01865-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 05/29/2023]
Abstract
Racial, ethnic, sexual, and gender minorities are more likely to report challenges with oncology provider communication and quality of care. The Together-Equitable-Accessible-Meaningful (TEAM) training was developed to improve health equity across cancer care organizations by guiding teams of interprofessional learners through planning and implementation of quality improvements to advance equitable, accessible, and patient-centered cancer care. This study compared changes to self-reported cultural competence as measured by the Cultural Competency Assessment (CCA); Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS); and Interprofessional Socialization and Valuing Scale (ISVS). The primary aim of the study was to assess changes to self-reported cultural competence; the secondary aim was to examine changes to interprofessional valuation from baseline to post-intervention. Results indicated statistically significant improvements in self-reported Cultural Competency Behaviors (p = .055), a subscale of the CCA, and Attitudinal Awareness toward sexual and gender minorities (p = .046), a subscale of the LGBT-DOCSS, using p < .10 as statistically significant. These subscale results drove statistically significant improvements for their respective composite scales. No other statistically significant results were found. This study suggests that cultural competency training among interprofessional oncology health care professionals can be effective. Given the growing diversity within the USA, additional opportunities for cultural competency training are needed.
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Affiliation(s)
- Mandi L Pratt-Chapman
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
- The GW Cancer Center, The George Washington University, 2600 Virginia Ave, #324, Washington, DC, 20037, USA.
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Walshe N, Condon C, Gonzales RA, Burke E, Chianáin LN, Thamanam N, Smart A, Jordaan G, Regan PO. Cultural Simulations, Authenticity, Focus, and Outcomes: A Systematic Review of the Healthcare Literature. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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20
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Manlangit AT, Jabonete FGV, Ridulme QR. Cultural competence and decision-making of nurse leaders in a university hospital in Saudi Arabia: A descriptive-correlation study. J Nurs Manag 2022; 30:1215-1224. [PMID: 35417928 DOI: 10.1111/jonm.13631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Abstract
AIMS To determine the quality of decision-making and cultural competence in terms of cultural competence behavior and cultural awareness and sensitivity of nurse leaders. Furthermore, this study explores the relationships between selected demographic profiles, cultural awareness and sensitivity, cultural competence behavior, and quality of decision-making. BACKGROUND Diversity contributes to varying beliefs and practices in the workplace. Leaders with cultural competence, awareness, and sensitivity can evaluate alternatives for the decision-making process and develop effective strategies to implement decisions. METHODS A descriptive correlational design was utilized. The respondents (n=122) completed the Cultural Competence Assessment instrument and Decision Making Quality Scale questionnaire. RESULTS Cultural awareness and sensitivity are significantly related to the Middle Eastern race. Furthermore, cultural competence behavior is significantly related to years of experience in Saudi Arabia and leadership positions. Quality of decision-making is significantly related to years of experience in Saudi Arabia. Cultural awareness, sensitivity, and cultural competence behavior are significantly related to the quality of decision-making. CONCLUSIONS Culturally aware, sensitive, and competent nurse leaders are more likely to adhere to the quality decision-making criteria. IMPLICATIONS FOR NURSING MANAGEMENT Promoting training and continuing education for nurse leaders are crucial to ensure they possess the right cultural knowledge and skills.
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Affiliation(s)
- Arsenic T Manlangit
- Nursing Affairs Department, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | | | - Queenie R Ridulme
- Faculty of Management and Development Studies, University of the Philippines Open University, Los Banos, Laguna, Philippines
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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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Cho MK, Kim MY. Factors Affecting the Global Health and Cultural Competencies of Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4109. [PMID: 35409791 PMCID: PMC8998792 DOI: 10.3390/ijerph19074109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/21/2022] [Accepted: 03/29/2022] [Indexed: 11/16/2022]
Abstract
Recently, various global health issues, including coronavirus disease 2019 (COVID-19), have been observed in relation to rapid changes in world health conditions; consequently, nurses’ global health and cultural knowledge have become increasingly important. Therefore, this study aimed to identify factors affecting the global health and cultural competencies of nursing students. The study design was a cross-sectional study with 108 participants; all participants were fourth-year nursing college students in S and C cities. Global health competency, cultural competency, global health confidence, cultural nursing confidence, and metacognition were surveyed online, and the data were collected from October 30 to November 7, 2018. The collected data were analyzed using descriptive statistics, independent t-test, Pearson’s correlation, and hierarchical multiple regression. The total mean scores for global health competency and the cultural nursing competency were 63.01 ± 8.78 and 134.94 ± 17.78, respectively. Global health competency had a positive correlation with cultural competency (r = 0.49, p < 0.001), cultural nursing confidence (r = 0.26, p = 0.006), and metacognition (r = 0.22, p = 0.023). Cultural competency showed a positive correlation with global health confidence (r = 0.31, p = 0.001), cultural nursing confidence (r = 0.51, p < 0.001), and metacognition (r = 0.40, p < 0.001). Cultural competency was found to be a significant factor affecting global health competency, with an explanatory power of 23.1% (F = 17.10, p < 0.001). Cultural nursing confidence and metacognition had significant effects on cultural competency, with an explanatory power of 34.3% (F = 14.97, p < 0.001). Cultural confidence and metacognition were important factors influencing cultural competency, and cultural competency was shown to be an important factor influencing global health competency.
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Affiliation(s)
- Mi-Kyoung Cho
- Department of Nursing Science, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju 28644, Korea;
| | - Mi Young Kim
- College of Nursing, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 15588, Korea
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Avdylaj L, Ličen S. Identifikacija merskih instrumentov za merjenje kulturnih kompetenc pri medicinskih sestrah in študentih zdravstvene nege. OBZORNIK ZDRAVSTVENE NEGE 2022. [DOI: 10.14528/snr.2022.56.1.3085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: Merjenje kulturnih kompetenc je temeljni korak pri oceni strategij učenja kulturnih kompetenc ter doseganju kulturne kompetentnosti med medicinskimi sestrami in študenti zdravstvene nege. Namen sistematičnega regleda literature je bil proučiti vsebino in lastnosti vprašalnikov ter izbrati najprimernejše vprašalnike za ocenjevanje kulturnih kompetenc pri medicinskih sestrah in študentih zdravstvene nege. Metode: Izveden je bil sistematični pregled literature v podatkovnih bazah CINAHL, ERIC, EBSCO in ScienceDirect. Uporabljeni so bili angleški izrazi: transcultural nursing, cultural competent care, cultural competency, education nursing, questionaire. V pregled so bili vključeni izvirni znanstveni članki z ustrezno preiskovano tematiko, dostopni v celotnem besedilu ter objavljeni po letu 2010. 2010.Rezultati: Izmed 247 člankov je bilo v končno analizo vključenih 11 člankov. Med analiziranimi vprašalniki smo na podlagi vsebine ter psihometričnih lastnosti, kot sta zanesljivost in konstrukcijska veljavnost, ugotovili, da so štirje vprašalniki najbolj primerni za merjenje kulturnih kompetenc pri medicinskih sestrah, trije vprašalniki za merjenje kulturnih kompetenc pri študentih zdravstvene nege in en vprašalnik pri medicinskih sestrah v izobraževanju.Diskusija in zaključek: Določeni vprašalniki, ki smo jih vključili v naš pregled, so na podlagi analize kakovosti merilnih lastnosti vprašalnikov primernejši za merjenje kulturnih kompetenc pri medicinskih sestrah, ostali vprašalniki pa za merjenje kulturnih kompetenc pri študentih zdravstvene nege. Sistematični pregled literature predstavlja dobro izhodišče za druge raziskovalce s področja merjenja kulturnih kompetenc pri izboru ustreznih vprašalnikov za nadaljnje raziskave.
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A Systematic Review of Global Health Assessment for Education in Healthcare Professions. Ann Glob Health 2022; 88:1. [PMID: 35083127 PMCID: PMC8740639 DOI: 10.5334/aogh.3389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: Methods: Results: Conclusions:
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Radhamony R, Cross WM, Townsin L. Nursing Education to Enhance Culturally and Linguistically Diverse (CALD) Community Access to Mental Health Services: A Scoping Review. Issues Ment Health Nurs 2021; 42:1048-1063. [PMID: 34080932 DOI: 10.1080/01612840.2021.1925792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Research has found that training health care professionals can enhance the access of the culturally diverse community to appropriate mental health services. Yet, little research has been conducted that explicitly focuses on improving nursing knowledge, skills, attitudes, and behaviours that can enhance the access of the Culturally and Linguistically Diverse (CALD) community. This scoping review aims to locate, summarise, and recap what is known in the academic literature about educational interventions and programs to improve mental health nurses' cultural competence. Examining how educational interventions and programs can improve mental health nurses' knowledge, skills, attitudes, and behaviours to facilitate Culturally and Linguistically Diverse (CALD) community access to mental health services can also identify gaps in knowledge to report future research areas. Fifteen studies included in the review reported a positive effect of cultural competence interventions; however, it was difficult to establish a single effective intervention method due to the significant heterogenicity in cultural competence intervention strategies. Most studies in this scoping review included nurses as participants. However, only one study solely focussed on cultural competence intervention for mental health nurses. Two other studies included mental health nurses as participants, along with other mental health professionals. Henceforth, there is a prerequisite for more research focussing on enhancing mental health nurses' cultural competency. Additional research is required to evaluate educational interventions' impact on improving cultural competence attributes on specific practitioner behaviours and the effects on health care and health care outcomes. This review can form a basis for future research studies that will emphasise the impact of cultural competence interventions for mental health nurses.
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Affiliation(s)
- Reshmy Radhamony
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Wendy M Cross
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Louise Townsin
- Research Office, Torrens University Australia, Adelaide, South Australia, Australia.,Federation University Australia, Berwick, Victoria, Australia
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Xanthos C. The Relationship Between Patient-Centeredness and Cultural Competence Among Primary Care Physicians in the Southern US. J Gen Intern Med 2021; 36:3252-3253. [PMID: 33051839 PMCID: PMC8481387 DOI: 10.1007/s11606-020-06298-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/05/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Clare Xanthos
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA. .,, Barnet, UK.
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Cho MK, Choi MY. Development and effectiveness of a global health competency promotion program for Korean undergraduate nursing students. Nurs Open 2021; 8:3086-3098. [PMID: 34346566 PMCID: PMC8510740 DOI: 10.1002/nop2.1021] [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: 01/05/2021] [Revised: 07/07/2021] [Accepted: 07/22/2021] [Indexed: 11/10/2022] Open
Abstract
Aim This study aimed to assess the effectiveness of a programme designed to promote global health competency among nursing students. Design It used a randomized pre–post‐test comparison group design to compare the effects of a global health competency programme among nursing students. Methods Data collection for the pre‐test was carried out for 2 days (25–26 October 2018) and that of post‐test was conducted for 2 days (23–24 December 2018). A total of 38 fourth‐year nursing students participated in this study (14 in the international nursing group, 11 in the transcultural nursing group and 13 in the complementary and alternative medicine group). The participants were from the nursing department of a university in Cheongju. Results There were no statistically significant differences between the groups in the pre‐test homogeneity test. The international nursing group showed statistically significant improvements between the pre‐ and post‐tests in global health competency, cultural competency, global health confidence and cultural nursing confidence.
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Affiliation(s)
- Mi-Kyoung Cho
- Department of Nursing Science, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Mi-Young Choi
- Department of Nursing Science, College of Medicine, Chungbuk National University, Cheongju, Korea
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Martinez-Hernaez A, Bekele D, Sabariego C, Rodríguez-Laso Á, Vorstenbosch E, Rico-Uribe LA, Ayuso-Mateos JL, Sánchez-Niubò A, Rodríguez-Mañas L, Haro JM. The Structural and Intercultural Competence for Epidemiological Studies (SICES) guidelines: a 22-item checklist. BMJ Glob Health 2021; 6:e005237. [PMID: 33853845 PMCID: PMC8728389 DOI: 10.1136/bmjgh-2021-005237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/15/2022] Open
Abstract
Structural and intercultural competence approaches have been widely applied to fields such as medical training, healthcare practice, healthcare policies and health promotion. Nevertheless, their systematic implementation in epidemiological research is absent. Based on a scoping review and a qualitative analysis, in this article we propose a checklist to assess cultural and structural competence in epidemiological research: the Structural and Intercultural Competence for Epidemiological Studies guidelines. These guidelines are organised as a checklist of 22 items and consider four dimensions of competence (awareness and reflexivity, cultural and structural validation, cultural and structural sensitivity, and cultural and structural representativeness), which are applied to the different stages of epidemiological research: (1) research team building and research questions; (2) study design, participant recruitment, data collection and data analysis; and (3) dissemination. These are the first guidelines addressing structural and cultural competence in epidemiological inquiry.
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Affiliation(s)
| | - Deborah Bekele
- Medical Anthropology Research Center, Rovira i Virgili University, Tarragona, Spain
| | - Carla Sabariego
- Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Swiss Paraplegics Foundation, Nottwil, Switzerland
| | | | - Ellen Vorstenbosch
- Teaching, Research and Innovation Unit, Sant Joan de Deu Health Park, Sant Boi de Llobregat, Spain
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
| | - Laura Alejandra Rico-Uribe
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
- Department of Psychiatry, Autonomous University of Madrid, Madrid, Spain
| | - José Luis Ayuso-Mateos
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
- Department of Psychiatry, Autonomous University of Madrid, Madrid, Spain
| | - Albert Sánchez-Niubò
- Teaching, Research and Innovation Unit, Sant Joan de Deu Health Park, Sant Boi de Llobregat, Spain
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- CIBERFES, CIBER Institute of Health Carlos III, Madrid, Spain
- Geriatrics Department, Getafe University Hospital, Getafe, Spain
| | - Josep Maria Haro
- Teaching, Research and Innovation Unit, Sant Joan de Deu Health Park, Sant Boi de Llobregat, Spain
- CIBERSAM, CIBER Institute of Health Carlos III, Madrid, Spain
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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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Parker M, Fang X, Bradlyn A. Costs and effectiveness of a culturally tailored communication training program to increase cultural competence among multi-disciplinary care management teams. BMC Health Serv Res 2020; 20:784. [PMID: 32831063 PMCID: PMC7446111 DOI: 10.1186/s12913-020-05662-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several studies have demonstrated that cultural competence improves patient-provider communication, which promotes adherence to established care plans and improves patient satisfaction and health outcomes. However, there is very little data available regarding the costs associated with the development and implementation of cultural competence training, or the cost-effectiveness of these programs. To that end, this evaluation aims to describe costs, program effectiveness, and cost-effectiveness of a culturally tailored communication training program to improve cultural competence among multi-disciplinary care management teams. METHODS As part of a region-wide quality improvement initiative to reduce healthcare disparities among African American patients with uncontrolled hypertension, three multi-disciplinary care management teams were invited to participate in a two-part communication training program. A paired samples t-test was used to assess program effectiveness based on participant responses to a validated cultural competence self-assessment survey 2 weeks before and after the training program. A micro-costing approach was used to estimate programmatic costs for content development and delivery. Cost-effectiveness was then determined using the average cost-effectiveness ratio, and sensitivity analyses were conducted to assess the impact of participant mix on this result. RESULTS All scores (n = 17) improved after training; however, only the culturally competent behaviors (CCB) subscale change was statistically significant (p = 0.02). Overall program costs were $5754.19. The average program cost per participant was $138.51, with an ACER of $337.83 per 1-unit increase in CCB score. Sensitivity analyses yielded a range of ACERs between $122.59 and $457.07, where all participants are support staff or nurses, respectively. CONCLUSIONS Culturally tailored communication training increases how frequently participants demonstrate culturally competent behaviors and may be a cost-effective intervention for care management teams to address individual cultural competence. Detailed costs associated with cultural competence training are largely unavailable in the literature; as such, these data may serve as a financial framework for organizations considering the implementation of similar programs.
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Affiliation(s)
- Marie Parker
- Kaiser Foundation Health Plan of Georgia, 3495 Piedmont Road, NE, Atlanta, GA, 30305, USA.
- Georgia State University School of Public Health, Urban Life Building, 140 Decatur Street, Suite 439, Atlanta, GA, 30303, USA.
- Center for Research and Evaluation, Kaiser Permanente, 1375 Peachtree Street, NE, Atlanta, GA, 30309, USA.
| | - Xiangming Fang
- Georgia State University School of Public Health, Urban Life Building, 140 Decatur Street, Suite 439, Atlanta, GA, 30303, USA
- China Agricultural University, 17 Qinghua E Rd, Haidian District, Beijing, China
| | - Andrew Bradlyn
- Center for Research and Evaluation, Kaiser Permanente, 1375 Peachtree Street, NE, Atlanta, GA, 30309, USA
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Lee SE, Lee MH, Peters AB, Gwon SH. Assessment of Patient Safety and Cultural Competencies among Senior Baccalaureate Nursing Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4225. [PMID: 32545746 PMCID: PMC7346008 DOI: 10.3390/ijerph17124225] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 11/17/2022]
Abstract
This descriptive, correlational, cross-sectional study examined nursing students' educational experiences on self-reported perceptions of patient safety and cultural competence in terms of curriculum content and learning venues. We performed descriptive analyses and a one-way analysis of variance with a sample of senior-year nursing students (N = 249) attending three state universities in the United States. We used the Nurse of the Future Nursing Core Competency Model, the Patient Safety Competency Self-Evaluation Tool for Nursing Students, and The Cultural Competence Assessment Instrument. Overall, participants reported that patient safety and cultural competencies were addressed in their curricula primarily through classroom activities as opposed to laboratory/simulation or clinical settings. Among the required patient safety knowledge topics, elements of highly reliable organizations were covered the least. For patient safety competency, participants reported higher scores for attitude and lower scores for skill and knowledge. For cultural competency, participants scored much higher for cultural awareness and sensitivity than behavior. There was no statistically significant difference between scores for patient safety and cultural competencies by nursing school. The results support the need for curriculum development to include all important aspects of patient safety and cultural competencies in various teaching/learning venues.
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Affiliation(s)
- Seung Eun Lee
- Mo-Im Kim Nursing Research Institute and Yonsei University College of Nursing, Seoul 03722, Korea;
| | - Meen Hye Lee
- School of Nursing, University of North Carolina Wilmington, Wilmington, NC 28401, USA
| | - Anya Bostian Peters
- Susan and Alan Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA 01854, USA;
| | - Seok Hyun Gwon
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
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Kang J, Song J, Noh W. A systematic review and meta‐analysis of the effects of global health competency improvement programs on nurses and nursing students. J Adv Nurs 2020; 76:1552-1566. [DOI: 10.1111/jan.14355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 01/23/2023]
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Oldland E, Botti M, Hutchinson AM, Redley B. A framework of nurses’ responsibilities for quality healthcare — Exploration of content validity. Collegian 2020. [DOI: 10.1016/j.colegn.2019.07.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Oikarainen A, Mikkonen K, Kenny A, Tomietto M, Tuomikoski AM, Meriläinen M, Miettunen J, Kääriäinen M. Educational interventions designed to develop nurses’ cultural competence: A systematic review. Int J Nurs Stud 2019; 98:75-86. [DOI: 10.1016/j.ijnurstu.2019.06.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/08/2019] [Accepted: 06/14/2019] [Indexed: 01/08/2023]
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Lin MH, Chang TH, Lee YH, Wang PY, Lin LH, Hsu HC. Developing and validating the Nursing Cultural Competence Scale in Taiwan. PLoS One 2019; 14:e0220944. [PMID: 31408503 PMCID: PMC6692013 DOI: 10.1371/journal.pone.0220944] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/27/2019] [Indexed: 11/18/2022] Open
Abstract
Background Culture influences personal health habits and behavior, and healthcare personnel possess different views of cultural perspectives. Currently, an appropriate instrument to assess cultural competence in clinical practice is limited. The present study aimed to develop and examine the psychometric properties of the Nursing Cultural Competence Scale (NCCS) for clinical nurses. Methods Developing and assessing the scale was carried out in two phases: Phase I involved a qualitative research to explore the themes of nurses’ cultural competence and instrument development; Phase II established construct validity of the scale using a sample of 246 nurses in Taiwan. Data from the questionnaire were analyzed using exploratory factor analysis, confirmatory factor analysis, internal consistency and test-retest reliability. Analysis results were used to determine the reliability and validity of the developed scale. Results The results showed four factors including cultural awareness ability, cultural action ability, cultural resources application ability, and self-learning cultural ability were generated by exploratory factor analysis, and these factors explained 62.0% of total variance. Cronbach’s α of the Nursing Cultural Competence Scale was .88, and test-retest reliability correlation was .70. Conclusions The establishment of the tool will facilitate accurate monitoring of the cultural competence among nurses and nursing managers, which can inform the construction of nursing policies aimed at pledge cultural competence expansion.
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Affiliation(s)
- Mei Hsiang Lin
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan, R.O.C
| | | | | | - Pao Yu Wang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan, R.O.C
| | - Li Hui Lin
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan, R.O.C
| | - Hsiu Chin Hsu
- Graduate Institute of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taiwan, R.O.C
- * E-mail:
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Sung S, Park HA. Perceived cultural differences in healthcare for foreign patients visiting South Korea: tool development and measurement. BMC Health Serv Res 2019; 19:197. [PMID: 30922381 PMCID: PMC6437978 DOI: 10.1186/s12913-019-3965-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 02/20/2019] [Indexed: 11/10/2022] Open
Abstract
Background We developed a 41-item tool measuring cultural differences in healthcare as perceived by foreign patients visiting South Korea. Methods The tool was tested on 256 foreign patients who visited three tertiary hospitals in Seoul, South Korea. Content validity was explored by two physicians and eight nurses working in an international healthcare department. Structural validity was tested via exploratory factor analysis and by testing two hypotheses: (1) there are perceived cultural differences between the South Korean healthcare and those of foreign patients’ home countries (one-sample t-test); and, (2) Perceived cultural differences vary among language groups (analysis of variance). We also calculated Cronbach’s alpha. Results The content validity index of the tool was 0.97. Exploratory factor analysis identified seven significant factors: hospital care and services, food, the healthcare system, communication, the healthcare facility, religion, and cultural values. The overall Cronbach’s alpha for the tool was 0.96, indicating very high internal consistency. We found that foreign patients visiting South Korean hospitals perceived that the healthcare culture differed significantly from that of their home country. The perceived cultural differences varied significantly by language group. Conclusions Nurses can use our new tool to understand the cultural differences of foreign patients and provide them with culturally competent nursing care.
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Affiliation(s)
- Sumi Sung
- College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Hyeoun-Ae Park
- College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Zarei B, Salmabadi M, Amirabadizadeh A, Vagharseyyedin SA. Empathy and cultural competence in clinical nurses: A structural equation modelling approach. Nurs Ethics 2019; 26:2113-2123. [PMID: 30803316 DOI: 10.1177/0969733018824794] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Forgiveness has the potential to resolve painful feelings arising from nurse-patient conflicts. It would be useful to evaluate direct and indirect important factors which are related to forgiveness in order to design interventions that try to facilitate forgiveness. AIM/OBJECTIVE The purpose of this study was to evaluate the intermediating role of empathy in the cultural competence-forgiveness association among nurses using structural equation modeling. RESEARCH DESIGN The research applied a cross-sectional correlational design. PARTICIPANTS AND RESEARCH CONTEXT The study included 380 nurses eight hospitals in southern Iran. ETHICAL CONSIDERATIONS The Ethics and Research Committee of Birjand University of Medical Sciences approved the study protocol. The voluntary nature of participation was explained consent was obtained from participants, and anonymity was guaranteed. FINDINGS Most of the participants were married and female and fell in the 20- to 30-year-old category. Most of them (89.5%) had a working experience of 1-10 years. The proposed model showed that nurses' empathy intermediated the association between nurses' cultural competence and forgiveness which has fitted the data acceptably (root mean square error approximation = 0.070; comparative fit index = 0.993; goodness-of-fit index = 0.983; and χ2/df = 2.85). CONCLUSION Empathy skills and cultural competence training were essential for interventions aimed at increasing the tendency to forgive patients. In such interventions, planners should aim at increasing nurses' cultural competence in order to enhance their empathy toward patients, which can, in turn, lead to a greater wish to forgive patients.
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Te M, Blackstock F, Fryer C, Gardner P, Geary L, Kuys S, McPherson K, Nahon I, Tang C, Taylor L, Van Kessel G, van der Zwan K, Chipchase L. Predictors of self-perceived cultural responsiveness in entry-level physiotherapy students in Australia and Aotearoa New Zealand. BMC MEDICAL EDUCATION 2019; 19:56. [PMID: 30760254 PMCID: PMC6375174 DOI: 10.1186/s12909-019-1487-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/06/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Ensuring physiotherapy students are well prepared to work safely and effectively in culturally diverse societies upon graduation is vital. Therefore, determining whether physiotherapy programs are effectively developing the cultural responsiveness of students is essential. This study aimed to evaluate the level of self-perceived cultural responsiveness of entry level physiotherapy students during their training, and explore the factors that might be associated with these levels. METHODS A cross sectional study of physiotherapy students from nine universities across Australia and Aotearoa New Zealand was conducted using an online self-administered questionnaire containing three parts: The Cultural Competence Assessment tool, Altemeyer's Dogmatism scale, and the Marlowe-Crowne social desirability scale- short form. Demographic data relating to university, program, and level of study were also collected. Data was analysed using one-way ANOVA, t-tests and multiple regression analysis. RESULTS A total of 817 (19% response rate) students participated in this study. Overall, students had a moderate level of self-perceived cultural responsiveness (Mean (SD) = 5.15 (0.67)). Fewer number of weeks of clinical placement attended, lower levels of dogmatism, and greater social desirability were related to greater self-perceived cultural responsiveness. Additionally, fourth year undergraduate students perceived themselves to be less culturally responsive than first and second year students (p < 0.05). CONCLUSIONS These results provide educators with knowledge about the level of self-perceived cultural responsiveness in physiotherapy students, and the factors that may need to be assessed and addressed to support the development of culturally responsive practice.
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Affiliation(s)
- Maxine Te
- School of Science and Health, Western Sydney University, Penrith, NSW 2751 Australia
| | - Felicity Blackstock
- School of Science and Health, Western Sydney University, Penrith, NSW 2751 Australia
| | - Caroline Fryer
- School of Health Sciences, University of South Australia, Adelaide, SA Australia
| | - Peter Gardner
- School of Physiotherapy and Exercise Science, Curtin University, Bently, WA Australia
| | - Louise Geary
- School of Allied Health, La Trobe University, Melbourne, VIC Australia
| | - Suzanne Kuys
- School of Physiotherapy, Australian Catholic University, Brisbane, QLD Australia
| | - Kerstin McPherson
- School of Community Health, Charles Sturt University, Bathurst, NSW Australia
| | - Irmina Nahon
- Faculty of Health, University of Canberra, ACT Bruce, Australia
| | - Clarice Tang
- School of Allied Health, La Trobe University, Melbourne, VIC Australia
| | - Lynne Taylor
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Gisela Van Kessel
- School of Health Sciences, University of South Australia, Adelaide, SA Australia
| | - Kelly van der Zwan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD Australia
| | - Lucy Chipchase
- School of Science and Health, Western Sydney University, Penrith, NSW 2751 Australia
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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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A contemporary review of understanding the religious and cultural diversity of patients dying or who have died in the intensive care unit. A South African perspective. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Fioravanti MA, Hagle H, Puskar K, Knapp E, Kane I, Lindsay D, Terhorst L, Mitchell AM. Creative Learning Through the Use of Simulation to Teach Nursing Students Screening, Brief Intervention, and Referral to Treatment for Alcohol and Other Drug Use in a Culturally Competent Manner. J Transcult Nurs 2017; 29:387-394. [DOI: 10.1177/1043659617727832] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Introduction: Cultural competency is an integral component in undergraduate nursing education to provide patient-centered care and addressing patients’ cultural differences. Students need to consider the prevalence of alcohol and other drug use/misuse in patients from all cultures. This project combines cultural competency education, simulation, and educating students to use screening, brief intervention, and referral to treatment for alcohol and other drug use. Method: Culturally diverse simulation scenarios were developed and used in the simulation lab with students to reduce stigma surrounding other cultures while learning an evidence-based practice to screen and intervene with patients who use/misuse substances. Results: Results show students value simulation and 91% of the students felt that they were able to apply culturally competent knowledge after the simulation experience. Discussion: Cultural competency principles can be embedded in teaching the broader evidence-based practice of screening, brief intervention, and referral to treatment with undergraduate students. This is a replicable teaching methodology that could be adapted in other schools of nursing.
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Affiliation(s)
| | - Holly Hagle
- Institute for Research, Education, and Training in Addictions, Pittsburgh, PA, USA
| | | | - Emily Knapp
- University of Pittsburgh, Pittsburgh, PA, USA
| | - Irene Kane
- University of Pittsburgh, Pittsburgh, PA, USA
| | - Dawn Lindsay
- Institute for Research, Education, and Training in Addictions, Pittsburgh, PA, USA
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Forsyth CJ, Irving MJ, Tennant M, Short SD, Gilroy JA. Teaching Cultural Competence in Dental Education: A Systematic Review and Exploration of Implications for Indigenous Populations in Australia. J Dent Educ 2017; 81:956-968. [DOI: 10.21815/jde.017.049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/24/2017] [Indexed: 11/20/2022]
Affiliation(s)
| | - Michelle J. Irving
- Poche Centre for Indigenous Health, Faculty of Dentistry; The University of Sydney
| | - Marc Tennant
- International Research Collaborative, Oral Health and Equity; The University of Western Australia
| | - Stephanie D. Short
- Sydney Asia Pacific Migration Centre, Faculty of Health Sciences; The University of Sydney
| | - John A. Gilroy
- WUN Indigenous Research Network, Faculty of Health Sciences; The University of Sydney
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Cultural Competence of Obstetric and Neonatal Nurses. J Obstet Gynecol Neonatal Nurs 2017; 46:423-433. [DOI: 10.1016/j.jogn.2016.11.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2016] [Indexed: 01/01/2023] Open
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Chae D, Kang KH, Benkert R, Doorenbos AZ. Evaluation of the psychometric properties of the Korean version of the Cultural Competence Assessment. Jpn J Nurs Sci 2017; 15:56-66. [PMID: 28387045 DOI: 10.1111/jjns.12169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/01/2016] [Accepted: 01/05/2017] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Duckhee Chae
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Kyeong-Hwa Kang
- Department of Nursing, Hallym University, Chuncheon, South Korea
| | - Ramona Benkert
- College of Nursing, Wayne State University, Detroit, Michigan, USA
| | - Ardith Z Doorenbos
- Department of Biobehavioral Nursing and Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
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Cai D, Kunaviktikul W, Klunklin A, Sripusanapan A, Avant P. Developing a cultural competence inventory for nurses in China. Int Nurs Rev 2017; 64:205-214. [DOI: 10.1111/inr.12350] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- D. Cai
- School of Nursing; Nantong University; Nantong China
| | - W. Kunaviktikul
- Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
| | - A. Klunklin
- Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
| | - A. Sripusanapan
- Faculty of Nursing; Chiang Mai University; Chiang Mai Thailand
| | - P.K. Avant
- School of Nursing; The University of Texas Health Science Center at San Antonio; San Antonio TX USA
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Doorenbos AZ, Morris AM, Haozous EA, Harris H, Flum DR, Doorenbos AZ, Morris AM, Haozous EA, Harris H, Flum DR. Assessing Cultural Competence Among Oncology Surgeons. J Oncol Pract 2016; 12:61-2, e14-22. [PMID: 26759469 DOI: 10.1200/jop.2015.006932] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Racial and ethnic minority groups in the United States have the highest mortality rates for the most common cancers. Various factors, including a perceived lack of culturally congruent care and culturally competent providers, might lead minority patients to decline or delay care. As part of a large multimethod study to understand barriers to care among American Indian and Alaskan native patients with cancer, we examined surgical provider attributes associated with culturally congruent care. PATIENTS AND METHODS Surgical providers from six hospitals in the Puget Sound region of Washington State were invited to participate. Participants completed a 50-item survey that assessed demographic data and incorporated the Cultural Competence Assessment (CCA) and the Marlowe-Crowne Social Desirability Scale. RESULTS Survey response rate was 51.1% (N = 253). Participants reported treating diverse patient populations; 71% encountered patients from six or more racial and ethnic groups. More than one half of participants (58%) reported completing cultural diversity training, with employer-sponsored training being the most common type reported (48%; 71 of 147). CCA scores ranged from 5.99 to 13.75 of a possible 14 (mean, 10.3; standard deviation, ±1.3), and receipt of diversity training was associated with higher scores than nonreceipt of diversity training (10.56 v 9.82, respectively; P<.001). After controlling for Marlowe-Crowne Social Desirability Scale score and hospital system,participation in diversity training was the variable most significantly associated with CCA score (P<.001). CONCLUSION Culturally competent care is an essential but often overlooked component of high-quality health care. Future work should compare training offered by various hospital systems.
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Affiliation(s)
- Ardith Z Doorenbos
- University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM
| | - Arden M Morris
- University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM
| | - Emily A Haozous
- University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM
| | - Heather Harris
- University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM
| | - David R Flum
- University of Washington, Seattle, WA; University of Michigan, Ann Arbor, MI; and University of New Mexico, Albuquerque, NM
| | - Ardith Z Doorenbos
- University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM
| | - Arden M Morris
- University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM
| | - Emily A Haozous
- University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM
| | - Heather Harris
- University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM
| | - David R Flum
- University of Washington, Seattle, WA; University of Michigan, AnnArbor, MI; and University of New Mexico, Albuquerque, NM
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Lin CJ, Chang PR, Wang LH, Huang MC. Cultural competence course for nursing students in Taiwan: A longitudinal study. NURSE EDUCATION TODAY 2015; 35:1268-1274. [PMID: 26094199 DOI: 10.1016/j.nedt.2015.05.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/09/2015] [Accepted: 05/28/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Culturally competent care is an essential ability for nursing students. However, little is known about the effects of educational intervention on attitudes or behavior changes with regard to cultural competence in Taiwan. PURPOSE This study evaluates the effects of a cultural competence course for nursing students. METHODS Using a longitudinal study design, 105 participants were assigned to an experiment group (51 participants) and control group (54 participants) based on the school they attended. Students in the experiment group received a two-credit course on cultural competence care. Using the Cultural Competence Assessment Instrument-Chinese Version (CCA-CV), data were collected between 2012 and 2013 at three points in time: before and after the course and again 6 to 8 months after the two groups (experiment and control) had completed the clinical practicum. RESULTS The results of a generalized estimating equation (GEE) analysis indicate that the cultural competence of all participants had improved at the posttest assessment, with the experiment group showing a significantly better improvement over the control group. However, the overall effectiveness of the training diminished with time. This study supports that taking a cultural competence course effectively enhances the cultural competence of nursing students for a limited period of time immediately following the course. CONCLUSIONS AND APPLICATIONS These results support that the benefits of incorporating a cultural competence course in clinical practice should be considered in the future. Furthermore, healthcare institutions should be encouraged to provide greater support and consideration to cultural competence issues in the nursing workplace in order to reinforce and extend the benefits of cultural competence courses provided at nursing schools.
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Affiliation(s)
- Chia-Jung Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan; Department of Nursing, Shu-Zen Junior College of Medicine and Management, Taiwan.
| | | | | | - Mei-Chih Huang
- Department of Nursing/Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Taiwan.
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Schwarz JL, Witte R, Sellers SL, Luzadis RA, Weiner JL, Domingo-Snyder E, Page JE. Development and psychometric assessment of the healthcare provider cultural competence instrument. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2015; 52:52/0/0046958015583696. [PMID: 25911617 PMCID: PMC5813644 DOI: 10.1177/0046958015583696] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study presents the measurement properties of 5 scales used in the Healthcare Provider Cultural Competence Instrument (HPCCI). The HPCCI measures a health care provider's cultural competence along 5 primary dimensions: (1) awareness/sensitivity, (2) behaviors, (3) patient-centered communication, (4) practice orientation, and (5) self-assessment. Exploratory factor analysis demonstrated that the 5 scales were distinct, and within each scale items loaded as expected. Reliability statistics indicated a high level of internal consistency within each scale. The results indicate that the HPCCI effectively measures the cultural competence of health care providers and can provide useful professional feedback for practitioners and organizations seeking to increase a practitioner's cultural competence.
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