Background: The Hospital Survey on Patient Safety Culture (HSOPSC) is widely utilized in multiple languages across the world. Despite culture and language variations, research studies from Latin America use the Spanish language HSOPSC validated for Spain and the United States. Yet, these studies fail to report the translation method, cultural adaptation process, and the equivalence assessment strategy. As such, the psychometric properties of the HSOPSC are not well demonstrated for cross-cultural research in Latin America, including Peru. The purpose of this study was to develop a target-language HSOPSC for cross-cultural research in Peru that asks the same questions, in the same manner, with the same intended meaning, as the source instrument. Methods: This study used a mixed-methods approach adapted from the translation guideline recommended by Agency for Healthcare Research and Quality. The 3-phase, 7-step process incorporated translation techniques, pilot testing, cognitive interviews, clinical participant review, and subject matter expert evaluation. Results: The instrument was translated and evaluated in 3 rounds of cognitive interview (CI). There were 37 problem items identified in round 1 (14 clarity, 12 cultural, 11 mixed); and resolved to 4 problems by round 3. The pilot-testing language clarity inter-rater reliability was S-CVI/Avg = 0.97 and S-CVI/UA = 0.86; and S-CVI/Avg = 0.96 and S-CVI/UA = 0.83 for cultural relevance. Subject matter expert agreement in matching items to the correct dimensions was substantially equivalent (Kappa = 0.72). Only 1 of 12 dimensions had a low Kappa (0.39), borderline fair to moderate. The remaining dimensions performed well (7 = almost perfect, 2 = substantial, and 2 = moderate).

The U.S. Navy sponsors annual Pacific Partnership deployments to provide humanitarian and disaster relief training for the U.S. military, partner nations, nongovernmental organizations, and host nations. Communication between these groups and the local populations receiving medical care is problematic in that sufficient numbers of capable translators are often unavailable or vastly undertrained with respect to medical terminology and practice. In addition, should Pacific Partnership respond to a real disaster, adequate numbers of translators will likely be unavailable as a result of the disaster itself. Consequently, medical providers will require alternate methods of communication previously tested for efficacy and validity. One such method is the use of pictograms designed to represent common medical maladies. To determine whether pictograms meet the 85% congruence level required by the American National Standards Institute, 36 images were provided to English-speaking physician assistants and nurse practitioners for interpretation with three images repeated within the array to assess internal validity of the questionnaire. Of the 33 distinct images, 26 (79%) reached 85% congruence showing that validated images may be a method of communication in circumstances where medical providers and patients speak discordant languages.

No abstract

Purpose: This study assessed levels of stress and coping strategies in physician assistant (PA) students. Methods: The study used a descriptive, cross-sectional design. Data were collected through an electronic survey that was sent to all current student members of the Texas Academy of Physician Assistants (N = 560). The Perceived Stress Scale was used to measure level of stress, and the Brief COPE Inventory was used to measure coping strategies. Results: A total of 146 (26.3%) students participated in the study. Most respondents were female, young, single, and Caucasian/non-Hispanic. The mean stress score was 33.3, higher than that reported in the overall general US population. Areas of most concern included feeling nervous and stressed, feeling upset about unexpected happenings, and an inability to control life's irritations and manage personal problems. Self-distraction, venting, and self-blame were the most frequently used unhealthy coping strategies. Acceptance, active coping, and emotional support were the most frequently used positive coping strategies.Conclusion: The results of this study indicated that students in PA training experience higher levels of stress than the general population in the United States, making healthy coping strategies among PA students particularly important. The results of this study can inform future research, curriculum design, teaching methods, and educational intervention in PA training programs.

American Indian patients with DM had access enabling patient education via telemedicine. Future work should examine patient technology preferences and effectiveness of technology-based education in improving outcomes among medically underserved populations.