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Evaluating cultural competence among Japanese clinical nurses: Analyses of a translated scale
Author(s) -
Noji Ariko,
Mochizuki Yuki,
Nosaki Akiko,
Glaser Dale,
Gonzales Lucia,
Mizobe Akiko,
Kanda Katsuya
Publication year - 2017
Publication title -
international journal of nursing practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.62
H-Index - 55
eISSN - 1440-172X
pISSN - 1322-7114
DOI - 10.1111/ijn.12551
Subject(s) - varimax rotation , cronbach's alpha , confirmatory factor analysis , structural equation modeling , psychology , exploratory factor analysis , construct validity , factor analysis , clinical psychology , competence (human resources) , psychometrics , statistics , medicine , social psychology , mathematics
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 2 (340) = 14604.44, P < .001. After correlated errors were introduced, there was evidence of improved model fit (χ 2 (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.