Abstract
ObjectiveObservational instruments are preferred for assessment of cultural competence. The aim of the current study is to identify observational instruments to assess cultural competence in healthcare providers and dieticians specifically and assess their psychometric properties. MethodsA systematic review was conducted in Cinahl, Cochrane, EMBASE, PsycInfo, Pubmed, and Web of Science using search terms related to cultural competency and measurement properties. Methodological quality of the selected studies of observational cultural competence instruments in dieticians, other healthcare professionals and psychological counsellors and the measurement properties of instruments were assessed using the COSMIN checklist. ResultsFrom 11,913 articles, six articles on five instruments were selected. Instruments were targeted at health professionals and counsellors only, and designed for face-to-face communication (n = 4) or verbal responses to videotaped simulated interactions (n = 1). The instruments’ content varied largely, with main focus on attitude, and little on knowledge and skills. The measurement properties were suboptimal. ConclusionNo observational instrument are available to evaluate cultural competence of dieticians. Studies on psychometric properties of instruments targeted at other health professionals lack methodological rigour. Practice implicationsFuture work should focus on developing an instrument that encompasses both ‘general’ cultural competences necessary for all healthcare professionals and dietetic specific competences.
Highlights
With growing rates of migration all over the world, healthcare providers are facing an increasing ethnically and culturally diverse patient population
The COSMIN methodology focusses on Patient Reported Outcome Measures (PROMs) used as outcome measurement instruments, it may be used for other types of instruments, including performance-based outcome measures [31]
Studies on psychometric properties of instruments targeted at other health professionals lack methodological rigour
Summary
With growing rates of migration all over the world, healthcare providers are facing an increasing ethnically and culturally diverse patient population. Health in general is worse compared to the ethnic majority population [3]. In Europe, type 2 diabetes mellitus is two to four times more prevalent in ethnic minority populations compared to native inhabitants [4]. Dementia, coronary heart diseases, anxiety disorders and stroke are more prevalent in ethnic minorities compared to ethnically Dutch populations [5,6]. Both quality and outcomes of healthcare are worse. For example, is of lower quality and less effective in ethnic minorities, leading to higher rates of complications and higher health care costs [7]. Ethnic minority patients visit their family physician more often [8], they are less satisfied with the contact with their physician than ethnic majority patients [9,10]
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