Clinical Relevance and Psychometric Properties of the Swedish Version of the Cultural Competence Assessment Instrument

Based on the increasing diversity of Swedish society, health professionals, like occupational therapists, find it challenging to provide culturally competent services to international clients. Consequently, cultural competence among professionals needs to be measured and improved using psychometrically tested instruments. This study examines the clinical relevance, construct validity, and reliability of the Swedish version of the Cultural Competence Assessment Instrument among Swedish occupational therapists. Material and Methods. A randomised sample of 312 Swedish occupational therapists answered a survey based on the Swedish version of the Cultural Competence Assessment Instrument with supplementary questions on the clinical relevance of the instrument. Descriptive statistics were used to examine the clinical relevance of the Swedish version of the Cultural Competence Assessment Instrument. Factor analyses, both exploratory and confirmatory, were run to examine the factor structure. Cronbach’s alpha was performed to assess the internal consistency of the instrument. Results. The participants reported that the 24 items had high clinical relevance. The validation yielded a three-factor model: openness and awareness, workplace support, and interaction skills. All three of these factors showed high loadings. Conclusions. The study results indicated positive clinical relevance and psychometric properties for the Swedish version of the Cultural Competence Assessment Instrument and strong support to be utilised in Sweden. The implications of this study are important given the rapid growth in migration over the last few decades. A self-rating instrument measuring cultural competence could support occupational therapists’ professional knowledge and development when they interact with international clients. As the tool was originally developed in English in the United States, the feedback from the Swedish version could potentially be useful for the instrument in modified form and for use by occupational therapists in English-speaking countries.

Questionário de competências culturais para profissionais de ajuda (QCC-PA)

Objetivo: adaptar e validar o Cultural Competence Assessment Instrument para avaliar as competências culturais dos profissionais de ajuda. O questionário foi selecionado tendo em conta três critérios, nomeadamente: i) o processo de construção do mesmo, na sua versão original, com base numa revisão aprofundada da literatura e dos instrumentos existentes para avaliar o constructo; ii) os indicadores de ajustamento do modelo da validação do instrumento; iii) a adequabilidade e a possibilidade de adaptação aos contextos que se pretendiam avaliar, particularmente junto de profissionais de ajuda a vítimas. Método: a tradução e adaptação do questionário obedeceram às guidelines internacionais neste domínio e a validação foi conduzida com 313 profissionais de ajuda agrupados em três domínios profissionais: área social, área da saúde e área criminal. Resultados: as análises fatoriais exploratória e confirmatória permitiram identificar, para esta amostra e com bom ajustamento psicométrico (e.g., alfa .88), a competência cultural aferida através de quatro fatores: consciência cultural, conhecimento cultural, aptidões técnicas e apoio organizacional. Conclusão: o Questionário de Competências Culturais para Profissionais de Ajuda é uma versão mais pequena da versão original do instrumento, que pode ser utilizada em contextos diferenciados. Este instrumento revela-se, assim, útil na monitorização e supervisão das práticas institucionais no atendimento em contextos de ajuda, ao nível da competência cultural.

The Cultural Competence of Graduating Nursing Students

Purpose: Cultural competence is an essential component in nursing. The purpose of this study was to evaluate the level of cultural competence of graduating nursing students, to identify associated background factors to cultural competence, and furthermore to establish whether teaching multicultural nursing was implemented in nursing education. Design: A structured Cultural Competence Assessment Tool was used in a correlational design with a sample of 295 nursing students in southern Finland. Findings and Conclusions: The level of cultural competence was moderate, and the majority of students had studied multicultural nursing. Minority background ( p = .001), frequency of interacting with different cultures ( p = .002), linguistic skills ( p = .002), and exchange studies ( p = .024) were positively associated to higher cultural competence. Implications for Practice: To improve cultural competence in students, nursing education should provide continuous opportunities for students to interact with different cultures, develop linguistic skills, and provide possibilities for internationalization both at home and abroad.

ReCAP: Assessing Cultural Competence Among Oncology Surgeons

QUESTION ASKED: Are there attributes of surgical providers that are associated with culturally congruent care? SUMMARY ANSWER: Surgical providers reported treating diverse patient populations; 71% encountered patients from six or more racial/ethnic groups. More than half (58%) reported completing cultural diversity training, with employer-sponsored training the most common type reported (48%; 71 of 147). Cultural Competence Assessment 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 (10.56 v 9.82, respectively; P < .001). 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 and the Marlowe-Crowne Social Desirability Scale. Survey response rate was 51.1% (n = 253). BIAS, CONFOUNDING FACTORS(S), DRAWBACKS: Our study has several limitations. Although our survey response rate of 51% was better than that of most physician surveys reported in the literature, we acknowledge that our data cannot represent the experience of all surgeons in the United States who care for racial/ethnic minority patients, as our survey was limited to surgeons practicing in the Puget Sound region. Our survey items on the racial/ethnic and special population diversity encountered by providers were limited to experiences in the past 12 months. We might have obtained a more accurate description of providers’ experience by using a more detailed quantitative measure, but we elected not to use this approach in order to limit respondent burden and thereby improve response rates. This study only surveyed surgical providers, which represents only a snapshot of the cancer care continuum. Future research should include medical oncology providers and others oncology providers to provide a more complete picture of cultural competency across the cancer care continuum. REAL-LIFE IMPLICATIONS: Culturally competent care is an essential but often overlooked component of high-quality health care. In our study sample, most surgical providers who treated racially and ethnically diverse patients perceived that they had a high level of cultural awareness, and their perceived and measured cultural awareness were highly correlated in our analyses. As US demographics become increasingly diverse, these data provide encouraging evidence that surgical providers are generally culturally sensitive and culturally aware, and perhaps more important, that they place a high value on cultural awareness. Our results also demonstrate that exposure to cultural diversity training was the single most important contributor to culturally congruent care, indicating a substantial need to continue existing diversity training interventions. Future work should compare training offered by various hospital systems. [Table: see text]