由原住民主导的文化能力测量工具的开发：一项针对助产专业学生的试点研究。
Development of a First Peoples-led cultural capability measurement tool: A pilot study with midwifery students.
作者信息
West Roianne, Wrigley Somer, Mills Kyly, Taylor Kate, Rowland Dale, Creedy Debra K
机构信息
Griffith University, Parklands Dr, Southport, QLD 4215, Australia; First Peoples Health Unit, Griffith University, G40 Griffith Health Centre, Level 8, Gold Coast Campus, Griffith University, QLD 4222, Australia; Menzies Health Institute, G40 Griffith Health Centre, Level 8, Gold Coast Campus, Griffith University, QLD 4222, Australia.
Griffith University, Parklands Dr, Southport, QLD 4215, Australia; First Peoples Health Unit, Griffith University, G40 Griffith Health Centre, Level 8, Gold Coast Campus, Griffith University, QLD 4222, Australia; Menzies Health Institute, G40 Griffith Health Centre, Level 8, Gold Coast Campus, Griffith University, QLD 4222, Australia.
出版信息
Women Birth. 2017 Jun;30(3):236-244. doi: 10.1016/j.wombi.2017.01.004. Epub 2017 Feb 7.
BACKGROUND
Midwives have a central role in closing the gap in health inequalities between Australias' First Peoples and other childbearing women. The Aboriginal and Torres Strait Islander Health Curriculum Framework (The Framework) identifies five core cultural capabilities (respect, communication, safety and quality, reflection and advocacy) to foster culturally safe health care.
AIM
To use a decolonising, First Peoples-led approach to develop and validate a tool to measure the development students' cultural capabilities.
METHOD
A pre- post intervention design was used. Development of the Cultural Capability Measurement Tool followed a staged process which centred on First Peoples' knowledges. This process included: item generation, expert review; a pilot, test-retest; and psychometric testing (reliability, factor analysis and construct validity). All third year midwifery students (n=49) enrolled in a discrete First Peoples health course were invited to complete the survey pre and post course.
FINDINGS
A response rate of 77.5% (n=38/49) pre-course and 30.6% (15/49) at post-course was achieved. The tool demonstrated good internal reliability (Cronbach alpha=.89-.91). Principal component analysis with varimax rotation produced a five-factor solution. A paired samples t-test revealed a significant increase from pre-course (mean 93.13, SD 11.84) to post-course scores (mean=100.53, SD 7.54) (t (14)=-2.79, p=.014).
CONCLUSION
A First Peoples approach was critical to tool development and conceptual validity. The 22 item Cultural Capability measurement Tool reflected the core cultural capabilities of The Framework. The draft tool appears suitable for use with midwifery students.
背景
助产士在缩小澳大利亚原住民与其他育龄妇女之间的健康不平等差距方面发挥着核心作用。《原住民和托雷斯海峡岛民健康课程框架》（以下简称《框架》）确定了五项核心文化能力（尊重、沟通、安全与质量、反思与倡导），以促进文化安全的医疗保健。
目的
采用去殖民化的、由原住民主导的方法来开发和验证一种工具，以衡量学生文化能力的发展情况。
方法
采用干预前后设计。文化能力测量工具的开发遵循一个分阶段的过程，该过程以原住民知识为核心。这个过程包括：项目生成、专家评审；试点、重测；以及心理测量测试（信度、因子分析和结构效度）。邀请所有参加一门独立的原住民健康课程的三年级助产专业学生（n = 49）在课程前后完成该调查。
结果
课程前的回复率为77.5%（n = 38/49），课程后的回复率为30.6%（15/49）。该工具显示出良好的内部信度（克朗巴哈系数 = 0.89 - 0.91）。采用方差最大化旋转的主成分分析产生了一个五因素解决方案。配对样本t检验显示，从课程前（均值93.13，标准差11.84）到课程后分数（均值 = 100.53，标准差7.54）有显著增加（t(14) = -2.79，p = 0.014）。
结论
原住民方法对于工具开发和概念效度至关重要。这个包含22个条目的文化能力测量工具反映了《框架》的核心文化能力。该工具草案似乎适用于助产专业学生。
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