Evaluating cultural competence among Japanese clinical nurses: Analyses of a translated scale

Abstract

This paper describes the factor analysis testing and construct validation of the Japanese version of the Caffrey Cultural Competence Health Services (J-CCCHS). The inventory, composed of 28 items, was translated using language and subject matter experts. Psychometric testing (exploratory factor, alpha reliability, and confirmatory factor analyses) was undertaken with nurses (N = 7494, 92% female, mean age 32.6 years) from 19 hospitals across Japan. Principal components extraction with varimax rotation yielded a 5-factor solution (62.31% variance explained) that was labeled: knowledge, comfort-proximal, comfort-distal, awareness, and awareness of national policy. Cronbach α for the subscales ranged from 0.756 to 0.892. In confirmatory factor analysis using the robust maximum likelihood estimator, the chi-square test was as follows: χ (340) = 14604.44, P < .001. After correlated errors were introduced, there was evidence of improved model fit (χ (335) = 8681.61, P < .05) but the other indices showed improvement (RMSEA = .058 [90% CI, 0.057-0.059], TLI = .891, CFI = .903, and SRMR = .059). The discriminating power of the J-CCCHS was indicated by statistically mean differences in J-CCCHS subscale scores between predefined groups. Taking into consideration that this is the first foray into construct validation for this instrument, and that fit was improved when a subsequent data driven model was tested, and it has the ability to distinguish between known groups that are expected to differ in cultural competence, the instrument can be of value to clinicians and educators alike.

Evaluating the cross-cultural competence instrument for healthcare professionals (CCCHP) among nurses in Okinawa, Japan

“…There are designated medical facilities for the U.S. military, but some patients visit hospitals in Okinawa for specialized medical care and for convenience. In this study, 96% of the participants had experience caring for foreign patients and 72% had traveled overseas, which is higher than the national average, based on Noji's study (n = 7494); 70% of the nursing staff had experienced caring for foreign patients and 29% had been abroad [10]. As a result, our participants could have higher MC and S scores compared to nurses in other prefectures.…”

“…A psychometric properties scale can help to provide a better understanding of weaknesses and suggestions to improve the cross-cultural competence among healthcare professionals [8][9][10][11][12]. It is desirable that the scale can also measure the knowledge and skills of transcultural care that are required in clinical settings for the multidisciplinary healthcare team.…”

“…In another study, Noji et al translated the Caffrey Cultural Competence in Healthcare Scale (CCCHS), which was developed in the United States, to measure the cross-cultural competence of Japanese nursing staff [10]. The CCCHS is a shorter survey of 28-items with five factors: knowledge, transcultural nursing care within the work team, transcultural nursing care outside the work team, awareness of the limitations, and understanding of policy.…”

Evaluation of Cultural Competences and Factors Affecting Cultural Competences of Nurses Working in a University Hospital

“…26 Japonya'da hemşirelerde yapılan bir araştırmada yurt dışında yaşamış olmanın kültürel yeterlilik üzerinde olumlu yönde etkili olduğu bulunmuştu. 27 Choi ve Kim'in (2018) araştırmasında altı aydan fazla bir ülkede yaşama durumunun kültürel yeterlilik üzerine olumlu yönde etkili olduğu sonucu bulmuşlardır. 28 Yurt dışında yaşayan hemşireler farklı kültürden bireylerle tanışmakta ve farklı kültürleri tanımaktadır.…”

“…Noji ve arkadaşlarının (2017) hemşirelerle yaptıkları bir çalışmada farklı kültürden bireylere bakım vermenin kültürel yeterliliği olumlu etkilediği bulunmuştur. 27 Bir başka araştırmada da yabancı hasta bakımı eğitimi alma durumunun kültürel yeterliliği olumlu etkilediği belirlenmiştir. 25 Tanrıverdi ve arkadaşlarının (2019) yaptığı çalışmada ise yabancı uyruklu hastalara bakım veren hemşirelerin kültürel duyarlılıkları yerel hastalara bakım veren hemşirelere göre daha yüksek çıkmıştır.…”