Development and Psychometrics of Nurses’ Cultural Sensitivity Measurement Tool in Pediatric Care

Abstract

Abstract: Introduction: Cultural sensitivity care is one of Family-Centered Care (FCC) components to lead the care satisfactory and treatment adherence. Dispit the importance of cultural sensitivity care, this concept is not clarify in the pediatric setting and there is any instument to measure it. The aim of this study was to design and psychometrics of instument for measuring nurses' cultural sensitivity in pediatric car of Iran. Methods and Materials: This study employed in two qualitative and quantitative phase, using mixed method. Qualitative phase conducted using content analysis for item generation, semi-structured interviews with 25 nurses and 9 parents was guided, and fieldnotes were used in data gathering as complementary of interviews. Then, literature review was done. In the quantitave phase, face validity was performed by 10 nurses, 5 parents, and 15 experts (investigating the impact scores and experts opions). Then, content validity ratio, and content validity index were studied with 15 experts. In the next step, after providing parents-form (by changing I to he/she and verbs in items), internal consistency reliability by Coronbach's alpha coefficient, constract validity (factor analysis and convergence validity), as well as the internal consistency reliability and test–re-test of entire instroment were assessed. Finding: In the qualitative phase, 3 dimentions of "cultural exposure", "intercultural communication", and "adaptation of care with child/family’s culture" were extracted and 73 items were generated. After face and content validity, number of items reduced to 34 item and instrument entered construct validity. Based on factor analysis results with factor loading more than 0.3, five factors including: “common understanding”, “awareness of the child/family’s cultural manifestations”, “considering and valuing the culture of the child/family”, “adaptation care with child/family’s culture”, and “intercultural communication” were determineded as the cultural sensitivity care dimentions, that could explained 54.29% in nurses version and 58.01% in parents version of the variance. Corrolation scores between FCC scale and two versions of instument were significant and 0.44 and 0.74 respectively for nurses parents in convergence validity. Additionally, Corrolation scores between Cultural intelligence scale and nurse version of instument were moderate significant. According to reliability measure by Coronbach's alpha coefficient were 0.9 and 0.93 respectively for nurses parents. For the entire instument and between 0.73 to 0.84 for subscales, and test-re-test were reliability 0.71 and 0.9, ICC were 0.89 and 0.9 respectively for nurses parents with 2-week time interval. Conclusion: Nurses' cultural sensitivity in pediatric car instument can measure different dimentions of cultural sensitivity pediatric care among nurses and parents. It has good validity and reliability. Evaluation of cultural sensitivity in pediatric care has potentionally to clarify the exisist situation in the healthcare systems, and the results can utilize to improve health care planning and child/family satisfaction.