Evaluation of reliability and validity regarding the Chinese version of Critical Cultural Competence Scale for clinical nurses. / 临床护士评判性文化能力量表的汉化及信效度评价.

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.

Analysis on the Effect of the Rehabilitation Intervention-Centered Targeted Nursing Model on the Cardiac Function Recovery and Negative Emotions in Patients with Acute Myocardial Infarction.

Rehabilitation intervention which refers to the functional training by caregivers with the aid of specialized nursing techniques and the progressive promotion of patients' training initiative, with the purpose of improving mobility and quality of life, is of great significance. The purpose of the study was to investigate the effect of the rehabilitation intervention-centered targeted nursing model on the cardiac function recovery and negative emotions in patients with acute myocardial infarction (AMI). A total of 120 AMI patients admitted to our hospital between January 2019 and January 2020 were selected as the study subjects and randomly divided into group A (n = 60) and group B (n = 60), in which the group B patients received routine nursing combined with rehabilitation intervention, while based on the treatment in group B, the patients in group A underwent rehabilitation intervention-centered targeted nursing model. Then, the cardiac function indexes, negative emotion score, levels of risk factors for heart failure, complication rate (CR), and the quality of life (QOL) of the patients were compared between the two groups. The cardiac function indexes of the patients after nursing in group A were significantly better than those in group B (P < 0.001); the negative emotion scores of the patients after nursing in group A were significantly lower than those in group B (P < 0.001); the levels of risk factors for heart failure of the patients after nursing in group A were significantly lower than those in group B (P < 0.001); the CR of the patients in group A at 15 d and 30 d after admission was significantly lower than that in group B (P < 0.05); the QOL scores of the patients after nursing in group A were significantly higher than those in group B (P < 0.001). Rehabilitation intervention-centered targeted nursing model can optimize cardiac function, weaken the levels of risk factors for heart failure, reduce the incidence of complications, improve psychological conditions, and enhance the quality of life in AMI patients, which is worthy of application and promotion in clinical practice.

Effectiveness of Chinese Native Culture Education for Improving Undergraduate Nursing Students' Transcultural Self-Efficacy.

Aim: The aim of this study is to evaluate the impact of Chinese native culture education based on Chinese native culture on the intercultural competence of undergraduate nursing students. Method: A quasi-experimental design with pretest and posttest was used. We recruited nursing students from 4 classes of the School of Nursing in our hospital in 2016 as research subjects. Undergraduate nursing students (n = 79) who completed one semester of education in indigenous Chinese culture completed a demographic questionnaire and the transcultural self-efficacy tool (TSET). Chinese native culture education is the topics related to nursing, consistent with the culture of Chinese patients under the background of Chinese native culture, including the dietary habits, taboos, religions, values, particularly Chinese medicine, and specific diseases. The control group (n = 91) was students who did not participate in Chinese native culture education and completed the instrument during the same time frame. Result: Students who participated in Chinese native cultural education significantly improved their transcultural self-efficacy in three dimensions: cognition, emotion, and practice. Compared with the control group, the students in the cultural education group had higher change scores in three sizes of transcultural self-efficacy. Conclusion: When strengthening cultural education for undergraduate nursing students, adding content related to Chinese native culture can improve their transcultural self-efficacy and meet the growing cultural needs of patients.