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Objective:
To validate an instrument measuring the cultural competence in health care workers from Chile.
Methods:
Using Sue & Sue's theoretical model of cultural competence, we designed a scale, which was assessed by health care workers and experts. Subsequently, the scale was applied to a sample of 483 different health care workers, during 201...
Context in source publication
Context 1
... none of these items met sufficient statistical criteria to claim that they were biased. In the FIA, the EMCC-14 presented configural, metric and scalar invariance ( Table 4). The scale maintained the same number of dimensions in both groups (configural invariance); in addition, the factor loads (metric invariance) and the item means (scalar invariance) were comparable between the groups. ...Citations
... Implica concebir la diversidad como algo positivo, un horizonte normativo de una mejor sociedad, más equitativa y participativa (Walsh, 2010). Para varios autores, es prioritario que los profesionales de la salud adquieran competencias culturales para la atención (Bernales et al., 2017;Correa-Betancour, 2019;Pedrero et al., 2020;Pérez et al., 2018;Veliz-Rojas et al., 2019). Así mismo, la política de salud migrante (Ministerio de Salud, 2017) reconoce a la interculturalidad como un principio rector. ...
... Se han realizado investigaciones sobre el desarrollo y los significados de las competencias culturales en profesionales de la salud en el país. Pedrero et al. (2020, p. 1) desarrollaron y validaron un instrumento para medir competencias culturales en trabajadores de la salud de distintas disciplinas, considerando tres dimensiones (sensibilidad, conocimiento y habilidad). Los resultados indican que el conocimiento registró el puntaje más alto, mientras que la "sensibilidad a los propios prejuicios" ocupó el último lugar. ...
El objetivo de esta investigacióncualitativa esidentificarlos factores que facilitan u obstaculizanlaadquisicióno el fortalecimientode competencias culturales en la labor de los profesionales de atención primaria de salud en Chile. Con base en lasentrevistas semiestructuradas realizadas a 32 profesionales que trabajan en una comuna de Santiago,se efectuó un análisis de contenido considerando cuatro dimensiones de las competencias culturales: conciencia, conocimiento, habilidades y motivación. Este análisis fue discutido en ochoconversatorios con profesionales de atención primaria, académicos/as eintegrantesde colectivos migrantes;estopermitió reconocerlospatrones en eltrato y en la atención que avalanciertas prácticas y valores. Se concluye que los factores analizadosinterpelan a los/as profesionalesyconstituyen un insumo para estimular los procesos de reflexión individual y de los equipos.
... 35,36 En Chile, se ha descrito que en trabajadores de salud este dominio se presenta como menos desarrollado, com-parado con ámbitos como el conocimiento o las habilidades. 37 Este punto debe ser una de las prioridades a considerar en el diseño de estrategias de entrenamiento y medición de efectividad de las mismas. ...
Objetivo principal: Explorar barreras y facilitadores percibidos por profesionales de salud en la atención a migrantes en Atención Primaria de Salud (APS) de Santiago de Chile en 2020. Metodología: Diseño cualitativo, estudio de caso. Se entrevistó a 10 profesionales de APS. Mediante análisis de contenido se determinaron patrones temáticos según Creswell. Se contó con aprobación del Comité de ética de Universidad Andrés Bello, Chile. Resultados principales: El idioma fue percibido como una de las principales barreras para la atención de salud de personas migrantes, así como también la falta de entrenamiento. Como facilitadores destaca la disponibilidad de herramientas tecnológicas para reducir brechas de comunicación y disposición por parte de los profesionales para establecer una relación terapéutica. Conclusión principal: La atención a migrantes en APS requiere estrategias de pertinencia cultural, considerando barreras como el idioma y la falta de entrenamiento, y aprovechando herramientas tecnológicas para una comunicación efectiva.
... Sob a perspectiva etnológica, a cultura corresponde a um conjunto de valores, crenças e costumes que rege o âmbito comportamental de uma sociedade em particular (VANNUCCHI, 1999). É através dela, inclusive, que o indivíduo experimenta, interpreta e compreende a realidade em que vive, criando um senso de identidade coletiva para com seus pares (PEDRERO et al., 2020). ...
A interculturalidade na prática clínica, por ser considerada acessória pelo modelo biomédico hegemônico, é pouco ou quase nada debatida na grade curricular dos cursos de saúde. A partir da identificação deste fator e, consequentemente, da necessidade de se promover atividades alicerçadas na antropologia médica – vertente que busca associar o modo de vida do paciente à maneira com que este se percebe durante os processos de saúde e de doença –, estudantes de medicina de diferentes instituições de ensino idealizaram a ação “Pluralidade do cuidar – A saúde em contexto de interculturalidade”. O evento, estruturado nos moldes de um simpósio e ambientado nos dias 19 e 20 de março de 2021, contou com a participação de palestrantes das mais diversas áreas do conhecimento, a fim de contemplar variadas perspectivas relacionadas à assistência à saúde culturalmente competentes. Com o propósito de desmistificar paradigmas e de sensibilizar os participantes sobre as particularidades do atendimento à populações em situação de vulnerabilidade, o encontro forneceu uma maior ênfase às demandas culturais da comunidade das periferias, dos moradores do campo, da população indígena e dos quilombolas. O presente artigo, portanto, relata a experiência da intervenção e evidencia a necessidade de uma reestruturação dos currículos e dos modelos de ensino-aprendizagem dos cursos universitários de medicina no Brasil, com a intenção de abranger a antropologia médica e de se propiciar uma formação acadêmica cada vez mais holística e humanizada. Apresenta também, nas suas conclusões, de maneira tanto quanti como qualitativa, o feedback dos participantes sobre a atividade.
... El conocimiento cultural presenta la más alta puntuación, siendo superior a la reportada por Pedrero et al. (2020) en profesionales de la salud en general y enfermeros en particular. Según esto, los estudiantes de Enfermería dan más valor al conocimiento relacionado con el impacto social, el estilo de comunicación, el conocimiento sobre los grupos con los que se está en contacto, la migración y el interés por comprender la diversidad cultural asociada a los cuidados de la salud (Pedrero, Bernales y Chepo, 2019). ...
In the current context of cultural diversity, health care requires professionals with cultural competencies who are able to provide quality and culturally relevant care. This article presents the results of a study on the development of cultural competencies in nursing students at a Chilean university, for which the Chilean version of the Cultural Competency Measurement Scale was applied, measuring competencies in three sub-areas: cultural knowledge, sensitivity and skills. The results indicate that students show a high level of competence development in the cultural knowledge dimension, while cultural sensitivity is the least developed. It is concluded that nursing students are culturally competent to provide health care to patients from diverse cultural backgrounds and able to adapt to multicultural contexts in the area of health care.
... While patient perception of health professionals cultural competence is potentially an appropriate evaluation approach (Jongen et al., 2018;Truong et al., 2014), the subjective nature of self-report is problematic due to the potential bias of responses selected for social desirability rather than actual beliefs (Betancourt and Green, 2010;Jongen et al., 2018). Self-report scales are also subject to differences in interpretation of questions and response scales, potentially resulting in measurement bias (Pedrero et al., 2020). Therefore, even the reported positive outcomes must be considered with caution. ...
Objective
To assess the impact of cultural competence training for health professionals on patient outcomes.
Method
A systematic review of cultural competence training interventions for healthcare workers including papers published January 2010 to January 2021, identified through MEDLINE, CINAHL, ERIC and APA PsychINFO. Health conditions were not specified, however, only studies reporting patient outcomes were included. Training frameworks and delivery, measures of health professional cultural competence, and patient outcomes were reviewed.
Results
Of 7879 unique studies identified, five met inclusion criteria including two randomised control trials, two mixed method and one multi-method pre/post study. Professionals reported the training was beneficial, and some improvements in patient perceptions of health providers' cultural competence were found. However, patient health outcomes did not improve significantly in any study.
Conclusion
Cultural competence training is promoted to improve outcomes of patients from culturally diverse backgrounds; however, few studies assess outcomes when examining training impact. Inconsistencies in theoretical frameworks and training makes it difficult to assess the efficacy of training on patient outcomes.
Results
Of 7879 unique studies identified, five met inclusion criteria including two randomised control trials, two mixed method and one multi-method pre/post study. Professionals reported the training was beneficial, and some improvements in patient perceptions of health providers' cultural competence were found. However, patient health outcomes did not improve significantly in any study.
Conclusion
Cultural competence training is promoted to improve outcomes of patients from culturally diverse backgrounds; however, few studies assess outcomes when examining training impact. Inconsistencies in theoretical frameworks and training makes it difficult to assess the efficacy of training on patient outcomes.
Practice implications
To ascertain the benefits of health professional cultural competence training on patient outcomes, research needs to address the issues of definition, theoretical frameworks and implementation approaches to training.
... Los elementos que la componen son: sensibilidad cultural, conocimiento y habilidades para relacionarse con el otro reconociendo su individualidad, autonomía e identidad social (Alizadeth y Chavan, 2015). En dicho estudio, se observó un bajo nivel de sensibilidad cultural (ser consciente de los propios prejuicios y nociones preconcebidas), resultando altamente relevante, porque nuestros prejuicios y estereotipos hacia ciertos grupos culturales se relacionan estrechamente con la forma en que nos relacionamos con ellos (Pedrero et al., 2020). En este sentido, no basta con mantener una 'buena relación' entre familias y profesionales, como lo señala la mayoría de los entrevistados(as). ...
The article approaches the parenting experiences of Latin American migrant parents in Santiago de Chile; focusing on the way they perceive and experience the concept of respectful parenting promoted by the ‘Chile Crece Contigo’ System (ChCC, for its acronym in Spanish). Seventeen semi-structured interviews and a discussion group were conducted with migrant families who attend family health centers in the Metropolitan region of Santiago; as well as semi-structured interviews with the professionals of the ‘Chile Crece Contigo’ System. It is noted that the understanding of respectful parenting is usually strained by the vulnerabilities generated by migration, the message transmission, the role of the community and cultural aspects. Finally, it is concluded that the promotion of respectful parenting should consider the cultural relevance and the migrant condition of families, which usually implies the lack of a support network and experiencing situations of vulnerability.
... Healthcare Workers Cultural Competency (EMCC). 19 This scale is a 14-item instrument designed to measure healthcare workers cultural competence. The scale has 3 subscales: sensitivity to own prejudices, cultural knowledge, and skills to work in culturally diverse environments. ...
Background
The purpose of this study was to validate a survey that can be used by healthcare systems, educators, and researchers to assess healthcare provider SDOH competency; with competency defined as their knowledge, awareness-biases, skills, and actual preparedness to address SDOH challenges.
Methods
An Exploratory Factor Analysis (EFA) was conducted with a sample of 220 healthcare providers, and 6 factors were identified. A Confirmatory Factor Analysis (CFA) was conducted with 303 healthcare providers and the 6-factor solution was supported, with 22 items.
Results
The reliability estimates for the 6 factors are as follows: Factor 1, Action Toward Addressing SDOH (a = .848); Factor 2, SDOH Knowledge (a = .944); Factor 3, Negative Attitude toward Addressing SDOH (a = .790); Factor 4, Systemic Accountability (a = .808); Factor 5, School Preparation (a = .863); and Factor 6, Perception of the Cause of SDOH (a = .940).
Conclusion
The ACN:SDH scale is the first validated measure that can be used to systematically appraise healthcare provider SDOH competency.
... Para diseñar los componentes apropiados propuestos para este diseño, tomamos como referencia resultados ya desarrollados [15], en el que proponen14 ítems o preguntas para diseñar un instrumento de medición altamente eficiente en la validación de un cuestionario para medir las competencias culturales en trabajadores en salud pública. Se revisó la literatura en el área de las tecnologías de reducción de lodos fecales aplicadas a Inodoros secos y sus respectivos instrumentos de medición publicados previamente [2], [3] y [4]. ...
The objective of the study is to build an instrument that allows to know the acceptance of the population towards a technology for the removal of human excreta by propulsion adapted to the dry toilet instead of the conventional system. The sample consisted of 200 lower-middle class residents. The study was quantitative; a survey was applied based on the Likert scale. The respective validation was carried out applying the methodology of exploratory factor analysis through the method of estimating maximum likelihood factors with reliability estimation and measurement bias analysis. The final questionnaire is made up of 6 dimensions, a factorial structure that includes 14 items and its consistency shows an α of 0.81. The instrument was appropriate for psychometric measurement. It is concluded that the acceptance of the technology is conditioned to factors of functionality, aesthetics and hygiene of the system, and there is a predisposition of the user to promote the technology. Keywords: Instrument, toilet, propulsion, excreta, technology. References [1]H. Moule, “Baño seco ecológico”, Reino Unido Patente Nº 1316, mayo 28, 1860. [2]K. L. Kyung, “Designing a Waterless Toilet Prototype for Reusable Energy Using a User-Centered Approach and Interviews”, Applied Sciences, vol. 9, no.919, pp. 2-11, March 2019. [Online]. Available: https://doi:10.3390/app9050919. [3]S. Saxena, B. Ebrazibakhshayesh, S. K. Dentel, D., K. Cha, y P. T. Imhoff, “Drying of fecal sludge in 3D laminate enclosures for urban waste management”, Science of The Total Environment vol. 672, no. 1, pp. 927-937, 2019. [Online]. Available: https://doi.org/10.1016/j.scitotenv.2019.03.487. [4]O.D. Oluwasola Afolabi y M. Sohail. “Microwaving human faecal sludge as a viable sanitation technology option for treatment and value recovery-A critical review”, Journal of Environmental Management journal, vol.187, no.1, pp.401-415, February 2017. [Online]. 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... Various tools and instruments have been validated for the assessment of cultural competence and its dimensions. Recent systematic reviews have identified three domains that are addressed in all the instruments considered, namely cultural awareness and sensitivity, cultural knowledge and cultural skills (Lin et al., 2017;Pedrero et al., 2020;Lin et al., 2019). ...
... However, very few such tools exist for assessing cultural competence within a Spanish-language context. For this reason, we considered it useful to design a suitable validated instrument for use with nursing students taking the Transcultural Care course offered by the University of Málaga (Pedrero et al., 2020;Raigal-Aran et al., 2019). ...
Background
The provision of culturally competent care helps reduce healthcare inequalities. There is a positive association between the cultural competence of nursing professionals and patient satisfaction, and also between nurses' self-efficacy and patients' adherence to treatment. While training in this respect is important, the self-assessment of skills should also be addressed.
Aims
To produce a culturally-validated Spanish-language version of the Transcultural Self-Efficacy Tool (TSET) for use in undergraduate nursing studies, and to evaluate its implementation within the Spanish educational system.
Methods
This cultural adaptation and psychometric validation study was carried out with student nurses from two universities. International standards were followed for the translation and cultural adaptation of the questionnaire. All students completed the questionnaire twice, the second time 14 days after the first. Those who took the Transcultural Care course at the University of Málaga also completed the questionnaire a third time, after concluding this study subject. The reliability, discriminatory capacity, stability and sensitivity to change of the questionnaire were tested and confirmed, and a confirmatory factor analysis was performed.
Results
A total of 286 students took part in this study. Overall, the TSET obtained a reliability score of 0.978, according to Cronbach's alpha test. In relation to nationality of origin, the discriminatory capacity of the questionnaire was −1.067 (−1815 a −0,320) = 0.005. Stability, assessed at 14 days using the intraclass correlation coefficient, was 0.901 (0.873 a 0.923) <0.001. The before-after sensitivity to change for those who took the Transcultural Care course was 1.820 (1558 a 2083) <0.001.
Conclusions
This Spanish-language version of the TSET is culturally suitable for the educational context of undergraduate nursing students in Spain, and its psychometric validation was performed with satisfactory results.
... There seems to be a need of studies comparing cultural competence between different healthcare professionals. This study reported significantly higher scores in the Openness and awareness and Interaction skills in nurses compared to GPs, while other research has reported no significant difference in cultural competence between professionals; however, sensitivity and knowledge regarding cultural competence were found to be higher in GPs compared to nurses (Pedrero et al., 2020). ...
Self‐care is the most important cornerstone of diabetes treatment. As self‐care is affected by cultural beliefs, it is important for healthcare professionals to be able to adapt their educational approach and to be culturally competent. The aim of this study was to describe the cultural competence in Swedish healthcare professionals, specialised in diabetes care and to examine related factors for cultural competence. The healthcare professionals’ perceived level of cultural competence was measured across three domains—Openness and awareness, Workplace support and Interaction skills—in 279 Swedish healthcare professionals from all 21 regions of Sweden, using the Cultural Competence Assessment Instrument (Swedish version—CCAI‐S). Descriptive statistics were used to describe cultural competence in healthcare professionals, and linear regression was conducted to examine factors related to cultural competence. Of the healthcare professionals studied, 58% perceived that they had a high level of Openness and awareness, 35% perceived that they had a high level of Interaction skills and 6% perceived that they had a high level of Workplace support. Two factors were found to be related to cultural competence, namely, high percentage of migrant clients at the healthcare clinic and whether the healthcare professionals previously had developed cultural competence through practical experience, education and/or by themselves. In conclusion, most healthcare professionals perceived that they had cultural openness and awareness but need more support from their workplace to improve their interaction skills. Cultural competence‐related education could support the healthcare professionals to develop interaction skills.
