BACKGROUND AND OBJECTIVE

The Oswestry Disability Index (ODI)–English is a valid and reliable instrument for disability measurement in low back pain (LBP) patients. There is no existing ODI–Ilokano that evaluates LBP patients. This study aimed to cross-culturally adapt the ODI–English into Ilokano.

The ODI–English was cross-culturally adapted into Ilokano through a process that included forward translation, synthesis of the translations, back translation, expert committee review, and testing of the pre-final version.

Forward translation focused on capturing the essence of terms related to pain intensity, personal care, and daily activities, achieving consensus on phrases that accurately mirrored the original English meanings. Subsequent synthesis refined these translations, emphasizing idiomatic and conceptual equivalence over literal interpretations, particularly in nuanced areas like sleep disturbance and social life activities. Backward translation processes aligned Ilokano and English terms, especially for pain intensity and personal care, ensuring consistency across languages. The expert committee review addressed spelling, word choice, and sentence structure, making strategic adjustments for cultural relevance. Pilot testing with participants from Ilocos Norte and Ilocos Sur, Philippines highlighted comprehension challenges with specific terms, leading to adaptations like replacing 'milya' and 'yarda' with metric units and retaining culturally sensitive terms with supplementary English explanations.

This study refined the ODI–English into a culturally adapted Ilokano version, focusing on semantic, idiomatic, and cultural equivalence. Incorporating pilot testing feedback, such as modifying measurement units and addressing sensitive terms, highlighted the thorough adaptation process. The collaborative translation efforts and diverse patient input ensured a culturally resonant ODI version for Ilokano speakers. This adaptation enhances physical therapy practices by improving patient assessments and advocates for adapting patient-reported outcomes to diverse cultures, advancing patient-centered care.

BACKGROUND

Type 2 diabetes is the most common type of diabetes in the Philippines. Diabetic foot complications represent a prevalent and significant chronic concern for individuals with type 2 diabetes. This poses an immediate community health concern, as diabetic complications may threaten an individual's well-being.

This study intends to cross-culturally adapt the Diabetic Foot Knowledge Subscale (DFKS) and Foot Self-Care Behavior Scale (FSCBS) questionnaires into the Filipino language as an assessment tool among Filipinos with diabetes.

The study employed a psychometric research design, where it entailed Phase A and Phase B. Phase A involved the forward translation of the DFKS and FSCBS questionnaires, followed by the synthesis of the translations and backward translation. Subsequently, an expert committee reviewed the translations and concluded the final version. The final translated versions of the questionnaires ensured that it can be understood by an individual who has a Grade 6 level of reading proficiency. Phase B entailed the validity testing with the evaluation of the expert committee, and reliability testing of the said questionnaires with a sample size of 30 participants. A wash-out period of 24 hours was given for the test-retest reliability, followed by data analysis. The validity and reliability of the questionnaires were measured using the item and scale content validity indices and the internal consistency and test-retest reliability, respectively, to ensure their accuracy and appropriateness. The content validity of the questionnaires was evaluated individually by the experts using a Likert scale from 1-4, with 4 being the highest meaning the item was very relevant and succinct. Scores per item were between 3 and 4, which indicate that the translated version of the items were relevant and succinct or were relevant but needed minor revisions.

The validity scores for the translated DFKS and FSCBS questionnaires were obtained using the Scale Content Validity Index (S-CVI) with a score of 0.96 and 0.92, respectively. Moreover, all items in the questionnaires obtained an Item Content Validity Index (I-CVI) of 0.88-1.00. The DFKS also has an acceptable internal consistency with a Cronbach’s alpha of 0.72, while the FSCBS has a good internal consistency with a Cronbach’s alpha of 0.85. The test-retest reliability shows an acceptable Spearman’s correlation at 0.76 for the DFKS and a strong positive Pearson correlation coefficient at 0.73 for the FSCBS.

The validity of the two questionnaires was acceptable and the test-retest reliability showed a strong positive correlation among the items thereby making the cross-cultural adaptation of the questionnaires successful. The Filipino versions of the DFKS and FSCBS questionnaires accurately measure the knowledge and behavior of individuals with type 2 diabetes, respectively.

BACKGROUND

Without adequate preparation and competence, nursing students entering the practice might not respond effectively to the growing health and healthcare disparities among the LGBTQ+ population.

Guided by Pacquiao's Framework for Culturally Competent Healthcare, the study aimed to describe and to compare nursing students' self-rated LGBTQ+ care competence by personal, sociocultural, and educational characteristics, and identify the relationship between LGBTQ+ care competence, level of compassion, and the number of LGBTQ+-related topics offered in nursing curriculum.

A cross-sectional study was implemented through online survey among fourth-year nursing students (N = 208) from nursing schools in Metro Manila using a sociodemographic questionnaire, the Lesbian, Gay, Bisexual, and Transgender-Nursing Education Assessment instrument, the Revised Short Version of the Compassionate Love for Humanity Scale, and the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale. Data were analyzed using descriptive and inferential statistics.

Nursing students' overall LGBTQ+ care competence mean rating score was 5.21 out of 7.0. Attitudinal awareness had the highest mean rating score (mean= 6.34, SD= 0.98), followed by basic knowledge (mean= 4.93, SD= 1.27) and clinical preparedness (mean=4.25, SD=1.23). Significant differences in the overall LGBTQ+ care competence mean rating scores were found based on exposure to LGBTQ+-related media contents (p=.03), personal experience in caring for LGBTQ+ clients (p=.00), ethnicity (p=.020), friends' acceptance of LGBTQ.

Findings show that the current generation of nursing students has more positive awareness, acceptance, and attitudes toward the LGBTQ+ population. Embedding LGBTQ+ health in the nursing curriculum must be strategically placed.

OBJECTIVES: To develop a Chinese version of the Stress Adaption Scale (SAS) and to assess its reliability and validity among Chinese patients with multimorbidity. METHODS: The Brislin model was used to translate, synthesize, back-translate, and cross culturally adapt the SAS. A total of 323 multimorbidity patients selected by convenience sampling method from four hospitals in Zhejiang province. The critical ratio method, total question correlation method, and graded response model (item characteristic curve and item discrimination) were used for item analysis. Cronbach's alpha coefficient and split-half reliability were used for the reliability analysis. Content validity analysis, structural validity analysis, and criterion association validity analysis were performed by expert scoring method, confirmatory factor analysis, and Pearson correlation coefficient method, respectively. RESULTS: The Chinese version of the SAS contained 2 dimensions of resilience and thriving, with a total of 10 items. In the item analysis, the critical ratio method showed that the critical ratio of all items was greater than 3.0 (P<0.001); the correlation coefficient method showed that the Pearson correlation coefficients for all items exceeded 0.4 (P<0.01). The graded response model showed that items of the revised scale exhibited distinct item characteristic curves and all items had discrimination parameters exceeding 1.0. In the reliability analysis, Cronbach's alpha coefficient of the revised Chinese version of the SAS scale was 0.849, and the split-half reliability was 0.873. In the validity analysis, the item-level content validity index and scale-level content validity index both exceeded 0.80. In the confirmatory factor analysis, the revised two-factor model showed satisfactory fit indices (χ²/df=3.115, RMSEA=0.081, RMR=0.046, GFI=0.937, AGFI=0.898, CFI=0.936, TLI=0.915). In the criterion-related validity analysis, the Chinese version of the SAS score was negatively correlated with the Perceived Stress Scale and the Treatment Burden Questionnaire, with correlation coefficients of －0.592 and －0.482, respectively (both P<0.01). CONCLUSIONS The Chinese version of the SAS has good reliability and validity, which can be used to evaluate the stress adaption capacity among multimorbidity patients in China, and provides a reference for developing individualized health management measures.
Humans ; Adaptation, Psychological ; Asian People ; China ; Multimorbidity ; Reproducibility of Results ; Stress, Psychological/psychology* ; Surveys and Questionnaires ; Translating ; Cross-Cultural Comparison

Background: There are several metrics for determining cultural competency in nurses, but none of them apply to Filipino nurses caring for patients with mental health issues in the Philippines setting. Purpose: The goal of this study was to create a cultural competency tool for Filipino nurses (CCTFN) caring for patients with mental health issues in hospitals, communities, or schools. Methodology: A sequential exploratory design was used. The qualitative phase utilized a scoping review and guided interviews, followed by the quantitative phase involving the validity test by five experts and the reliability tests participated by 140 nurses in Zamboanga City. IBM SPSS Statistics 22.0 was used to examine the data. Results: The scoping review utilized PRISMA to search for eligible articles and the interviews resulted in an initial 51-item pool. The tool's content validity (S-CVI=0.992) was confirmed by a panel of experts. The inter-rater (ICC=0.773), inter-item (α =0.838) reliability, and exploratory factor analysis revealed four factors that accounted for 68.38 percent variance, resulting in 25 valid items. The four factors were “awareness on the Filipino concept of mental illness,” “attitudes towards fostering an efficient relationship between patient with mental health problems and self,” “skills in addressing cultural needs and issues of patients with mental health problems,” and “knowledge on socio-political factors affecting patients with mental health problems.” Conclusion/Implications for Practice Overall, the CCTFN was found to be valid and reliable. This tool can improve nursing care and inform training programs in the Philippines to improve mental health service provision and reduce stigma.
Cultural Competency ; Psychiatric Nursing

OBJECTIVES: Patients from different social environments and cultural backgrounds have different nursing needs. If nurses ignore the cultural differences of patients, it is easy to lead to the strained nurse-patient relationship, affect the nursing effect and cause harm to patients. Critical cultural competence (CCC) can help nurses to meet the nursing needs of patients from different cultural backgrounds, which is beneficial to building a harmonious nurse-patient relationship and improving the quality of nursing. Almutairi, et al designed the Critical Cultural Competence Scale (CCCS) which can be used to evaluate accurately nurses' CCC. No studies have reported the development of a critical cultural competence measurement tool for nurses or the introduction of foreign scales in China. This study aims to conduct Chinese and cross-cultural debugging and test the reliability of the English version of the CCCS in order to form CCCS suitable for Chinese cultural background and provide an effective evaluation tool for investigating the current situation of clinical nurses' CCC. METHODS: This study used Brislin's back-translation model to translate and back-translation the English version of CCCS. The Chinese version of CCCS was then created through cross-cultural debugging by expert consultation and a pre-survey with a sample size of 30 clinical nurses. From August to October 2019, 580 clinical nurses were surveyed using a whole group sampling method. The participants were randomly divided into 2 groups with a 7꞉3 ratio. One group (n=406) was used for exploratory factor analysis and reliability analysis, while the other group (n=174) was used for confirmatory factor analysis. Six experts used the scale-level content validity index (S-CVI) and the item-level content validity index (I-CVI) to assess content validity. In the exploratory factor analysis, items were screened using the critical ratio method, and were tested using the KMO (Kalser-Meyer-Olkin) index, Bartlett's sphericity test, and principal component analysis. In the confirmatory factor analysis, average variance extracted (AVE), goodness of fit index (GFI), adjusted goodness of fit index (AGFI), and root mean square error of approximation (RMSEA) were used to assess the degree of fit of the constructed model. For the total scale and the 4 subscales, the Cronbach's α coefficient, split-half reliability, and retest reliability were used to assess the scale's reliability. RESULTS: The S-CVI was 0.930, while the I-CVI ranged from 0.833 to 0.944. For all items, the critical ratio exceeded 3, and the difference between the high and low subgroups was statistically significant (P<0.05). Exploratory factor analysis revealed critical knowledge subscale had a KMO value of 0.676, with the total scale and other 3 subscales all having a KMO value >0.8 and a chi-square value of 814.32 to 12 442.45 for the Bartlett's spherical test, with degree of freedom ranging from 21 to 136 (P<0.001), indicating that all items were suitable for factor analysis. The principal component analysis showed that 17, 12, 7, and 7 items were extracted from the 4 subscales, with 4, 3, 2, and 2 components whose eigenvalues were more than 1, and the cumulative variance contribution was 66.0%, 54.3%, 56.6%, and 70.2%, respectively. The confirmatory factor analysis showed that the AVE of the 4 subscales were 0.637, 0.499, 0.560, and 0.565, GFI was 0.904, AGFI was 0.863, and RMSEA was 0.076. The Cronbach's α coefficient for the total scale and subscales ranged from 0.811 to 0.878, the split-half reliability ranged from 0.707 to 0.842, and the retest reliability was 0.827. CONCLUSIONS The Chinese version of the CCCS has good reliability and validity, and it can be used as a valid assessment tool for clinical nurses' critical cultural competence in China.
Humans ; Cultural Competency ; Reproducibility of Results ; Psychometrics/methods* ; Factor Analysis, Statistical ; China

Background: The COVID-19 pandemic focused public attention on the importance of responsible tourism. The purpose of this study was to characterise irresponsible tourist behaviour leading to deportation from the destination country Methods: A web-based search of media reports relating to deportations of tourists was conducted. Results: The most common reasons for deportation were related to indecent exposure or physical damage to sacred monuments and violations of COVID-19-related national public health rules. Other incidents resulted from social media posts and breach of environmental regulations. Conclusions The results of this study may inform future research efforts and targeted public awareness campaigns.
Deportation ; COVID-19 ; Cultural Competency

PURPOSE: The partners of cancer patients commonly provide the needs of cancer patients along cancer trajectory except for patients with gynecological cancer. In developing countries including Indonesia, who have strong family bonding, the family of cancer patients are involved more intensely in providing cancer care. This situation may bring the cancer patients' families experience the burden and decrease their quality of life. Therefore, assessing the family's supportive needs are as important as patient supportive needs. There are more gynecological cancer survivors in Indonesia; however, little is recognized about partners' supportive needs due to lack of validated assessment tools to measure it. This study aimed to translate, culturally adapted and test the validity and reliability of the CaSPUN questionnaire among partner of Indonesia gynecological cancer patients. DESIGN: First, the procedures of forward-backward translation and modification of the CaSPUN were conducted to ensure cultural adaptation. Second, using convenience sampling with 295 partners of gynecological cancer patients, we tested the construct validity and internal consistency of the CaSPUN-Indonesia Version (CaSPUN-I). We conducted Exploratory Factor Analysis to explore the factor structure of CaSPUN-I and Cronbach Alpha to confirm internal consistency reliability. RESULTS: The CaSPUN were modified to make more understandable and culturally appropriate in the Indonesian context. Five factors were extracted from EFA in the CaSPUN-I with factor loadings of items between 0.41 and 0.85. The Cronbach's alpha coefficient for the CaSPUN-I ranged from 0.96-0.97. CONCLUSION: The CaSPUN Indonesia version presents acceptable validity and reliability for assessing supportive care needs among families of Indonesian gynecological cancer patients. The CaSPUN-I can be used by healthcare providers to assess and design the supportive care program for family of Indonesia gynecological cancer patients.
Cancer Survivors ; Needs Assessment ; Cross-Cultural Comparison ; Indonesia

PURPOSE: To identify needs for pregnancy and postpartum adaptation of Chinese immigrant women and Vietnamese immigrant women in South Korea. METHODS: A descriptive research design was employed. Data were collected from 244 Chinese immigrant women and Vietnamese immigrant women from 3 provinces, 20 health care centers, and multi-cultural family support centers. Data were analyzed with descriptive statistics, t-test and ANOVA. RESULTS: An average score for needs perceived by Chinese immigrant women was significantly higher than that perceived by Vietnamese immigrant women. There were significantly differences in physical and emotional adaptation after childbirth, nutrition during pregnancy, cross cultural understanding and personal respect, and adaptation daily activity during pregnancy between the 2 groups. The highest score of needs in Chinese immigrant women was for nutrition during pregnancy and that in Vietnamese immigrant women was for baby rearing and family support. CONCLUSION: Based on needs of pregnancy and postpartum adaption, nursing intervention program in consideration of cultural characteristics of Chinese immigrant women and Vietnam immigrant women need to be developed for their pregnancy and postpartum health care.
Adaptation, Physiological ; Asian Continental Ancestry Group ; Cultural Characteristics ; Delivery of Health Care ; Emigrants and Immigrants ; Emotional Adjustment ; Female ; Humans ; Korea ; Needs Assessment ; Nursing ; Parturition ; Postpartum Period ; Pregnancy ; Prenatal Nutritional Physiological Phenomena ; Research Design ; Vietnam

No abstract available.
Cultural Diversity ; Humans