J Korean Acad Community Health Nurs.  2019 Sep;30(3):281-294. 10.12799/jkachn.2019.30.3.281.

Development of the Cultural Competence Scale for Registered Nurses (CCS-RN)

• Kim KW
• Kim SH
• Kim YH
• Kim HK
• Park HS
• Lee SH
• Jeong GH

• KMID: 2459368
• DOI: http://doi.org/10.12799/jkachn.2019.30.3.281

Abstract

PURPOSE
This study is to develop the Cultural Competence Scale for Registered Nurses (CCS-RN) and to examine its validity and reliability.
METHODS
The item pool was generated based on related scales, a wide review of the literature, and in-depth interviews with nurses according to Purnell's cultural competence model. Content validity was verified by nursing experts. Construct validity using exploratory factor analysis, convergent validity using correlation coefficients, discriminant validity, internal consistency reliability, and test-retest reliability were examined.
RESULTS
The CCS-RN consists of a 35-item/7-factor solution with 54.1% of the total variance explained. The convergent validity of CCS-RN was supported. Cronbach's α was .94 for the total scale and ranged from .77 to .90 for the seven factors. Test-retest reliability was moderate.
CONCLUSION
The evaluation of the psychometric properties of the CCS-RN shows that this scale is expected to be a valid and reliable measure of cultural competence among nurses. This scale may be useful for assessing nurses' own cultural competence and thus contribute to strengthening cultural competence.

Keyword

Cultural competency; Nursing; Psychometrics; Reproducibility of results

MeSH Terms

Cultural Competency*
Humans
Nurses*
Nursing
Psychometrics
Reproducibility of Results
Weights and Measures

Reference

References

1. Ministry of Justice. November 2018 statistical monthly report of immigration service and foreign policy [Internet]. Seoul: Ministry of Justice;2018. [cited 2019 Jamuary 03]. Available from:. http://www.moj.go.kr/viewer/skin/doc.html?rs=/viewer/result/bbs/160&fn=1546651724857101.

2. Kim SH, Kim KW, Bae KE. Experiences of nurses who provide childbirth care for women with multi-cultural background. Journal of Korean Public Health Nursing. 2014; 28(1):87–101. https://doi.org/10.5932/JKPHN.2014.28.1.87.

3. Hwang M, Jang I. A study of predictors influencing access to health care service by immigrant wives: Focusing on different analysis using andersen behavioral model. Journal of Governance Studies. 2017; 12(1):31–57.

4. Kim SH. The conception and factors that affect the utilization of health care services among foreign migrant workers in Korea. Journal of Multi-Cultural Contents Studies. 2015; 18:255–297.

5. Ministry of Gender Equality and Family. An analysis on the national survey of multicultural families 2015 [Internet]. Seoul: Ministry of Gender Equality and Family;2017. [cited 2018 December 28]. Available from:. http://www.mogef.go.kr/kor/skin/doc.html?fn=63_199.pdf&rs=/rsfiles/201908/.

6. Jeong GH, Park HS, Kim KW, Kim YH, Lee SH, Kim H-K. A concept analysis of cultural nursing competence. Korean Journal of Women Health Nursing. 2016; 22(2):86–95. https://doi.org/10.4069/kjwhn.2016.22.2.86.

7. Gil Estevan MD, Solano Ruiz MDC. Application of the cultural competence model in the experience of care in nursing professionals primary care. Aten cion Primaria. 2017; 49(9):549–556. https://doi.org/10.1016/j.aprim.2016.10.013.

8. Purnell L. Are we really measuring cultural competence? Nursing Science Quarterly. 2016; 29(2):124–127. https://doi.org/10.1177/0894318416630100.

9. Chae DH, Lee CY. Development and psychometric evaluation of the Korean version of the cultural competence scale for clinical nurses. Asian Nursing Research. 2014; 8(4):305–312. https://doi.org/10.1016/j.anr.2014.06.004.

10. Oh WO, Park ES, Suk MH, Im YJ. Development and psychometric evaluation of the transcultural self-efficacy scale for nurses. Journal of Korean Academy of Nursing. 2016; 46(2):293–304. https://doi.org/10.4040/jkan.2016.46.2.293.

11. Henderson S, Horne M, Hills R, Kendall E. Cultural competence in healthcare in the community: A concept analysis. Health & Social Care in the Community. 2018; 26(4):590–603. https://doi.org/10.1111/hsc.12556.

12. Purnell L. The Purnell model for cultural competence. Journal of Transcultural Nursing. 2002; 13(3):193–196. https://doi.org/10.1177/10459602013003006.

13. MacCallum RC, Widaman KF, Zhang S, Hong S. Sample size in factor analysis. Psychological Methods. 1999; 4(1):84–99. https://doi.org/10.1037/1082-989X.4.1.84.

14. Streiner DL, Norman GR, Cairney J. Health measurement scales: A practical guide to their development and use. 5th ed. Oxford: Oxford University Press;2014. p. 186–192.

15. Wang Y-W, Davidson MM, Yakushko OF, Savoy HB, Tan JA, Bleier JK. The scale of ethnocultural empathy: Development, validation, and reliability. Journal of Counseling Psychology. 2003; 50(2):221–234. https://doi.org/10.1037/0022-0167.50.2.221.

16. Kim J-Y. A study on color-blind racial attitudes and cultural competence of service providers in multicultural settings: Focusing on moderating effects of cultural empathy and multicultural training [dessertation]. [Seoul]: The Catholic University of Korea;2013. p. 205.

17. Park HJ, Kim NH. Relationship between cultural sensitivity, empathy, and competency of nursing students. Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology. 2017; 7(4):487–498. https://doi.org/10.14257/AJMAHS.2017.04.09.

18. Colaizzi PE. Psychological research as the phenomenological views. Valle RS, King M, editors. Existential phenomenological alternative for psychology. New York, NY: Oxford University Press;1978. p. 48–71.

19. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health. 2007; 30(4):459–467. https://doi.org/10.1002/nur.20199.

20. Pett MA, Lackey NR, Sullivan JJ. Making sense of factor analysis: The use of factor analysis for instrument development in health care research. Thousand Oaks, CA: Sage;2003. p. 348.

21. Brown TA. Confirmatory factor analysis for applied research. 2nd ed. New York, NY: The Guilford Press;2015. p. 462.

22. Cicchetti DV. Methodological commentary the precision of reliability and validity estimates re-visited: Distinguishing between clinical and statistical significance of sample size re-uirements. Journal of Clinical and Experimental Neuropsychology. 2001; 23(5):695–700. https://doi.org/10.1076/jcen.23.5.695.1249.

23. Campinha-Bacote J. The process of cultural competence in the delivery of healthcare services: The journey continues. 5th ed. Cincinnati, OH: Transcultural C.A.R.E. Associates;2007. p. 133.

24. Bernal H, Froman R. Influences on the cultural self-efficacy of community health nurses. Journal of Transcultural Nursing. 1993; 4(2):24–31. https://doi.org/10.1177/104365969300400205.

25. Schwarz JL, Witte R, Sellers SL, Luzadis RA, Weiner JL, Domingo-Snyder E, et al. Development and psychometric assessment of the healthcare provider cultural competence instrument. Inquiry: A Journal of Medical Care Organization, Provision and Financing. 2015; 52:1–8. https://doi.org/10.1177/0046958015583696.

26. Schim S, Doorenbos A, Miller J, Benkert R. Development of a cultural competence assessment instrument. Journal of Nursing Measurement. 2003; 11(1):29–40. https://doi.org/10.1891/106137403780954949.

27. Jeffreys M, Dogan E. Factor analysis of the transcultural self-efficacy tool (TSET). Journal of Nursing Measurement. 2010; 18(2):120–139.

28. Iacobucci D, Duhachek A. Advancing?: Measuring reliability with confidence. Journal of Consumer Psychology. 2003; 13(4):478–487. https://doi.org/10.1207/S15327663JCP1304_14.

29. Shen Z. Cultural competence models and cultural competence assessment instruments in nursing: A literature review. Journal of Transcultural Nursing. 2015; 26(3):308–321. https://doi.org/10.1177/1043659614524790.

30. Kang HY. Cultural and and health: Understanding of multicultural society in Korea. 2nd ed. Seoul: Hyunmoonsa;2015. p. 243.