Psychometric Testing of the Filipino Version of the Clients' Perceptions of Providers' Cultural Competency (CPOPCC) Instrument Among LGBTQ+ Population in the Philippines.

Background and Purpose: Cultural competence is significant in addressing the health needs of vulnerable populations. This study conducted psychometric testing of a cultural competency instrument in the Philippines. Methods: Brislin's translation and a cross-sectional online design were used. Exploratory factor analysis (EFA) with varimax rotation examined construct validity of the 23-item scale among 157 adult LGBTQ+ residents. The scale revealed overall reliability (α = .85) including two subscales (α = .87, α = .81, and α = .61). The EFA yielded three theoretical factorial solutions. Conclusion: The Filipino version of the instrument demonstrated reliability and validity. Measuring clients' perceptions of provider and organizational cultural competency can improve the utilization of healthcare in Filipino LGBTQ+ communities. Future research will examine the dimensional structures of the instrument among expanded LGBTQ+ communities.

Development of the Clients' Perceptions of Providers' Cultural Competency Instrument.

INTRODUCTION: This study developed and validated the Clients' Perceptions of Providers' Cultural Competency instrument. METHOD: A sequential exploratory mixed design identified three constructs derived from the studies of Leininger and others. Constructs were compared with publications on cultural competency. A panel of experts reviewed for content validity. RESULTS: Three hundred and nine mostly Asians and Native Hawaiians completed the questionnaire. Twenty-two items with item-to-total correlation coefficients >.2 were retained. Overall instrument Cronbach's alpha was .89. Construct validity demonstrated the three constructs accounted for 49.6% of variance supported by distinct items with Cronbach's alphas of .82, .83, and .76, respectively. Preliminary criterion validity revealed no statistically significant differences in scores based on the location of services received or race/ethnicity. DISCUSSION: The Clients' Perceptions of Providers' Cultural Competency instrument is congruent with nursing principles of equity and justice by measuring provider cultural competency from a client's perspective. Active client engagement in care contributes to transcultural nursing's goals to improve health equity.

A National Survey Examining Manuscript Dissertation Formats Among Nursing PhD Programs in the United States.

PURPOSE: Among research-focused nursing doctoral (PhD) programs in the United States, the traditional dissertation format has recently given way to a series of publication-ready manuscripts, often bookended by introduction and conclusion chapters. To help programs make decisions about the use of these formats, this study undertook a national survey of programs offering PhDs in nursing. The purpose of this study was to explore the advantages and disadvantages of the traditional format versus manuscript option for dissertations among nursing PhD programs in the United States. DESIGN: Cross-sectional census survey of U.S. nursing PhD programs. METHODS: A web-based survey was administered to all U.S. nursing PhD programs. Respondents indicated formats offered, factors contributing to decisions of which formats to offer, and lessons learned. Descriptive statistics and inductive content analyses were used for analysis. FINDINGS: Of 121 eligible institutions, 79 provided eligible responses (66.7%). The majority (59%) offered both formats; 11% offered the manuscript option only, and 24% offered the traditional format only. Faculty support (or lack thereof) contributed to adoption (or not) of the manuscript option. Respondents' approaches to the manuscript option (e.g., number of papers) and advice are summarized. CONCLUSIONS: Manuscript option dissertations are commonly offered and provide benefits to students and faculty; however, thoughtful implementation is critical. Programs need to agree upon clear expectations and have graduate school support (e.g., formatting). Faculty need mentorship in advising manuscript option students who choose to use this format, and the time and support. Finally, students need additional writing skills that could be provided through coursework or via individual work with mentors. CLINICAL RELEVANCE: As nursing education continues to expand further into doctoral research, programs must examine dissertation formats in order to both prepare future nurse scholars and disseminate nursing research that is critical to improving nursing education, patient care, and clinical practice.

Measuring the Success of a Pipeline Program to Increase Nursing Workforce Diversity.

The purpose of this study was to understand changes in knowledge and opinions of underserved American Indian and Hispanic high school students after attending a 2-week summer pipeline program using and testing a pre/postsurvey. The research aims were to (a) psychometrically analyze the survey to determine if scale items could be summed to create a total scale score or subscale scores; (b) assess change in scores pre/postprogram; and (c) examine the survey to make suggestions for modifications and further testing to develop a valid tool to measure changes in student perceptions about going to college and nursing as a result of pipeline programs. Psychometric analysis indicated poor model fit for a 1-factor model for the total scale and majority of subscales. Nonparametric tests indicated statistically significant increases in 13 items and decreases in 2 items. Therefore, while total scores or subscale scores cannot be used to assess changes in perceptions from pre- to postprogram, the survey can be used to examine changes over time in each item. Student did not have an accurate view of nursing and college and underestimated support needed to attend college. However students realized that nursing was a profession with autonomy, respect, and honor.

A systematic review of the literature on screening for exercise-induced asthma: considerations for school nurses.

Asthma is a major cause of illness, missed school days, and hospitalization in children. One type of asthma common in children is exercise-induced asthma (EIA). EIA causes airway narrowing with symptoms of cough and shortness of breath during exercise. The purpose of this article is to review the literature relevant to screening children and adolescents for EIA and to inform development of a school nurse-led EIA screening program. A systematic review of EIA screening tests was conducted by searching PUBMED for key terms. Sixty-seven articles were identified; after review only seven met the inclusion criteria. The most common screening test was the 6-min exercise challenge. School-based screening programs have the potential to identify EIA among undiagnosed children and adolescents. School nurses are health professionals with the knowledge and skills necessary to develop successful screening programs in the school setting. Based on results of the literature review, we present implications for developing screening programs in schools to identify children with undiagnosed EIA.

Nursing and health sciences workforce diversity research using PhotoVoice: a college and high school student participatory project.

This participatory study used PhotoVoice and qualitative description to (a) mentor baccalaureate nursing and college students in workforce diversity research; (b) explore barriers and facilitators encountered by rural American Indian, Hispanic, and other high school students when attending college and pursuing careers in nursing or the health sciences; and (c) model a process of social action to help existing and future students. Baccalaureate nursing and graduate students participated in all stages of research, including dissemination. Five themes emerged from analysis of PhotoVoice data: (a) being afraid; (b) believing; (c) taking small steps; (d) facing fears; and (e) using support systems. Findings underscore the importance of helping students participate in efforts to increase work-force diversity through research. Increasing nursing and health sciences workforce diversity may require strategies developed within and tailored to specific cultures and communities.

Using the generative nursing model to reframe nursing student transition to practice.

New nurses are leaving hospitals in record numbers after fulfilling their initial employment obligations. Reasons for turnover relate to job dissatisfaction in the form of stressful working conditions, disempowerment, insufficient resources, difficult working relationships, and poor management. The authors discuss an approach for preparing students to manage factors that lead to burnout and new nurse turnover using the Generative Leadership Model as a framework.

Community-based participatory research and American Indian/Alaska Native nurse practitioners: a partnership to promote adolescent health.

PURPOSE: To make recommendations for American Indian/Alaska Native (AI/AN) nurse practitioners (NPs) and university partners who are partnering on community-based participatory (CBPR) research projects. An example of a CBPR study using focus groups to assess an important adolescent health problem is used to illustrate opportunities and challenges for AI/AN NPs. DATA SOURCES: Thirteen focus groups were held with 95 participants on the reservation where the AI/AN NP was a member and working. Results indicated that a majority of the community represented in the focus groups were concerned about substance abuse among its youth. CONCLUSIONS: The NP faced several challenges, including remembering emotional events recounted during focus groups differently than participants. This necessitated debriefing and a recommendation to carefully form policies and procedures before collecting data to anticipate such events. By far, the benefit of the NP's involvement was her ability to identify key members for focus groups, to assist in tribal council meetings, and to schedule meetings. IMPLICATIONS FOR PRACTICE: CBPR research partnerships are enhanced by NPs that are members of the community. CBPR partnerships present opportunities for NPs and university faculty to work on relevant community problems together.

Creating a path: American Indian/Alaska Native high school students pursuing college and a career in nursing.

The purpose of this quantitative descriptive pre- and post-survey study was to analyze four years of data documenting differences in pre- and post-test responses by American Indian/Alaska Native high school students attending a weeklong residency program. The program was designed to provide information and role models to motivate students to go to college and pursue a career in nursing. The survey measured student perceptions of college and nursing. In addition, the analysis included comparisons of responses between students who lived on reservations and those who did not. Results demonstrated that students changed their views of nursing as a profession, how they would be perceived by their tribe, and the financial security they could gain. Students living on their reservations were concerned that college might be too far from home. Recommendations include the need to provide indigenous students with role models and accurate information as well as mentors to support them.

Retention of Native American nurses working in their communities.

PURPOSE: The purpose of this study was to describe the experiences of Native American nurses working in their tribal communities to address retention. DESIGN: An interpretive phenomenological study guided by a Native American research agenda and a Native American nursing practice model. METHODS: In-depth interviews with nine Native American nurses were conducted. Data analysis used interpretive phenomenological procedures including an iterative process with Native American consultants and researchers to develop themes. CONCLUSIONS: Native American nurses experienced a great deal of stress and illness as they attempted to fulfill their mission to help their people. The three themes were: (a) paying the price to fulfill my mission, (b) being and connecting holistically, and (c) transcending the system. Recommendations include strategies for nurse educators, tracking the ethnicity of nurses in each Indian Health Service area, documenting their reasons for leaving, and conducting further research to develop community-based interventions to improve retention.

Native American high school students' perceptions of nursing.

A pilot study was conducted to determine changes in Native American high school students' knowledge and opinions about nursing after attending a 6-day residential summer nursing institute. To date, Native American high school students, particularly those interested in nursing, have not been well researched. Seventeen high school students affiliated with nine Northwest tribes participated in this study. A 66-item, investigator-constructed, pretest-posttest survey included 38 scaled (4-point Likert type) and 20 dichotomous items. Reliability estimates (Cronbach's alpha) were 0.72 and 0.85 for the pretest and posttest, respectively. This pilot study showed an increase in students' knowledge and opinions of professionalism, autonomy, and role importance in nursing after attending the summer nursing institute. A salient and culturally related reason for choosing nursing was to be important to one's tribe. Although the sample was small, the findings provide initial evidence supporting the effectiveness of a nursing education intervention with Native American high school students and an instrument that can measure its success.