Abstract
Background. There is limited literature available identifying and describing the instruments that measure cultural competence in nursing students and nursing professionals. Design. An integrative review was undertaken to identify the characteristics common to these instruments, examine their psychometric properties, and identify the concepts these instruments are designed to measure. Method. There were eleven instruments identified that measure cultural competence in nursing. Of these eleven instruments, four had been thoroughly tested in either initial development or in subsequent testing, with developers providing extensive details of the testing. Results. The current literature identifies that the instruments to assess cultural competence in nurses and nursing students are self-administered and based on individuals' perceptions. The instruments are commonly utilized to test the effectiveness of educational programs designed to increase cultural competence. Conclusions. The reviewed instruments measure nurses' self-perceptions or self-reported level of cultural competence but offer no objective measure of culturally competent care from a patient's perspective which can be problematic. Comparison of instruments reveals that they are based on a variety of conceptual frameworks and that multiple factors should be considered when deciding which instrument to use.
Highlights
The United States (USA) is rapidly becoming one of the most racially and ethnically diverse nations in the world
While some progress has been made in reducing health disparities, ongoing problems exist and challenge the USA health care system
Examples of these disparities include higher infant mortality rates for babies born to black women, higher incidence of coronary heart disease and stroke, diabetes, asthma and cancer among minority populations, and increased rates of new human immunodeficiency virus diagnoses among racial and ethnic minorities [3]
Summary
The United States (USA) is rapidly becoming one of the most racially and ethnically diverse nations in the world Should this trend continue, minorities are projected to comprise 57 percent of the USA population by 2060. The current literature identifies that the instruments to assess cultural competence in nurses and nursing students are self-administered and based on individuals’ perceptions. While some progress has been made in reducing health disparities, ongoing problems exist and challenge the USA health care system Examples of these disparities include higher infant mortality rates for babies born to black women, higher incidence of coronary heart disease and stroke, diabetes, asthma and cancer among minority populations, and increased rates of new human immunodeficiency virus diagnoses among racial and ethnic minorities [3]. Though the causes of these disparities are multifaceted, improvements in cultural competence education for nurses and other healthcare providers are considered to be among the most critical and potentially effective interventions needed to reverse these circumstances [4]
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