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.

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 purpose of this study was to develop a program to improve the cultural competence of nursing students related to North Korean defectors and to investigate the effectiveness of the program. METHODS: There were 36 nursing students in the experimental group and 30 in the control group, who were recruited from a university in I-city, Korea. A Chi-square, t-test, and ANOVA with the SPSS/Win 21.0 program were used to analyze the data. RESULTS: After the intervention, the experimental group showed a statistically significant increase in the total score for multicultural awareness toward North Korean defectors over the control group (t=0.85, p=.026). Scores for cognitive area (t=0.89; p=.037), ritual area (t=-0.10, p=.915), and action area (t=1.18, p=.031) increased, but the conscious area score was not statistically significant. The experimental group showed a statistically significant increase in the total score for multi-cultural efficacy for North Korean refugees (t=0.36, p=.030). Scores for cognitive area (t=0.63; p=.029), working area (t=0.05, p=.955), and emotional area (t=0.79 and p=030) increased, but the working area score was not statistically significant. CONCLUSION: It was found that the program to promote multicultural efficacy related to North Korean defectors applied in this study was effective in enhancing multicultural awareness and efficacy of nursing students.
Cultural Competency ; Democratic People's Republic of Korea ; Humans ; Korea ; Nursing ; Refugees ; Students, Nursing

PURPOSE: This study aimed to seek agreement on the core components of an e-learning cultural competence program for Korean public health workers (PHWs) while prioritizing educational content areas. METHODS: A two-round Delphi study was performed with 16 Korean experts from five disciplines. Data were collected between August 30 and November 24, 2017. A questionnaire was developed from literature reviews and previous focus group interviews concerning PHWs. The panel members were asked to rate the importance and urgency of educational content areas and the effectiveness of teaching–learning methods and gave opinions on their appropriate frequency, duration, and target audience. Responses were analyzed using descriptive statistics. A median of 4.0 or greater or a rate of agreement of 75% or greater was considered a “consensus” for the purposes of this study. RESULTS: All consenting participants responded to two-round surveys. Participants reached consensus on thirty-one educational content areas. Of these, the highest priorities were “necessity of cultural competence of PHWs,” “health characteristics according to race and ethnicity,” and “establishing trusting relationships with migrants.” The most effective teaching–learning method was case-based learning, with seven to eight sessions of training and duration of fewer than 30 minutes per session. CONCLUSION: Multidisciplinary experts proposed 12 prioritized educational content areas and effective teaching–learning methods as well as their frequency, duration, and target audiences, reflecting Korea-specific multicultural phenomena and the nature of the work of PHWs. These findings can contribute to preparing PHWs to provide culturally competent services to migrants in their communities.
Consensus ; Continental Population Groups ; Cultural Competency ; Delphi Technique ; Education ; Focus Groups ; Health Personnel ; Humans ; Korea ; Learning ; Methods ; Public Health ; Transients and Migrants

PURPOSE: This study examined the mediating and moderating effects of multicultural efficacy in the relationship between cultural empathy and cultural competence in child care teachers. METHODS: A cross-sectional descriptive survey design was used. The participants were 277 child care teachers at private and public daycare centers in G and S districts of Seoul. The survey instruments included a cultural empathy questionnaire, a multicultural efficacy scale, and a cultural competence scale. Data were analyzed using the SPSS and AMOS programs. For data analysis, descriptive statistics, correlation, and mediating and moderating effect analyses were performed. Bootstrapping was implemented to verify the mediating effect of the model developed herein. RESULTS: Positive correlations among cultural empathy, multicultural efficacy, and cultural competence were noted. Multicultural efficacy showed a significant mediating effect on the relationships between cultural empathy and cultural competence. However, there was no moderating effect. CONCLUSION: In order to enhance the cultural competence of child care teachers, it is necessary to develop a strategy that can promote their cultural empathy and multicultural efficacy. Furthermore, these results will ultimately enhance the role of child care teachers, thus contributing to the normal growth and development of multicultural children.
Child ; Child Care ; Child ; Cultural Competency ; Cultural Diversity ; Empathy ; Growth and Development ; Humans ; Negotiating ; Self Efficacy ; Seoul ; Statistics as Topic

BACKGROUND: The purpose of this study was to examine the cultural competence of nurses caring for foreign patients in general hospitals. METHODS: The subjects are 308 nurses who work in general hospitals in Seoul and Gyeonggi-do. The data, collected using a structured questionnaire on cultural competence, coping strategy, multicultural experience, intercultural uncertainty, and intercultural anxiety, were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation analysis, and hierarchical multiple regression. RESULTS: Cultural competence was significantly associated with marital status, level of education, type of ward, and number of cared foreign patients. In hierarchical multiple regression analysis, the level of cultural competence was significantly associated with married, master degree qualified, high level of coping strategy and multicultural experience, and low level of cultural uncertainty. CONCLUSION: The findings revealed the need for educational programs which can contribute to lower the intercultural uncertainty and to enhance coping strategies dealing with foreign patients. In addition, individual and organization efforts to provide opportunities to expand nurses' multicultural experience will affect nurses' cultural competence development.
Anxiety ; Cultural Competency ; Education ; Gyeonggi-do ; Hospitals, General ; Humans ; Marital Status ; Seoul ; Uncertainty

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

BACKGROUND: The purpose of this study was to identify the level of cultural competence and effects of the experiences of multicultural education and multicultural contact on cultural competence among Korean nursing students.METHODS: This study involved 233 nursing students from two colleges. Data collection was conducted through questionnaires about the experiences of multicultural education, multicultural contact, and cultural competence.RESULTS: The main results were as follows. Cultural competence of participants was found to be moderate(M=3.45, SD=0.45). Among the experiences of multicultural education and multicultural contact, grade level, multicultural in-class education, multicultural education in non-cultural class, multicultural education in extra-curricular programs, the experience of caring for foreign patients, and acquiring multicultural information from mass-media were variables with a statistically significant correlation with cultural competence.CONCLUSION: When developing a program to enhance cultural competence, it is necessary to develop level-specific programs considering the differences by grade level, encourage extra-curricular activities, and construct systematic educational programs applying various teaching methods.
Cultural Competency ; Data Collection ; Education ; Humans ; Nursing ; Students, Nursing ; Teaching