Noji Ariko, Mochizuki Yuki, Nosaki Akiko, Glaser Dale, Gonzales Lucia, Mizobe Akiko, Kanda Katsuya
Graduate School of Nursing, Chiba University, Chiba, Japan.
Hahn School of Nursing and Health Science, San Diego, CA, USA.
Int J Nurs Pract. 2017 Jun;23 Suppl 1. doi: 10.1111/ijn.12551.
This paper describes the factor analysis testing and construct validation of the Japanese version of the Caffrey Cultural Competence Health Services (J-CCCHS). The inventory, composed of 28 items, was translated using language and subject matter experts. Psychometric testing (exploratory factor, alpha reliability, and confirmatory factor analyses) was undertaken with nurses (N = 7494, 92% female, mean age 32.6 years) from 19 hospitals across Japan. Principal components extraction with varimax rotation yielded a 5-factor solution (62.31% variance explained) that was labeled: knowledge, comfort-proximal, comfort-distal, awareness, and awareness of national policy. Cronbach α for the subscales ranged from 0.756 to 0.892. In confirmatory factor analysis using the robust maximum likelihood estimator, the chi-square test was as follows: χ (340) = 14604.44, P < .001. After correlated errors were introduced, there was evidence of improved model fit (χ (335) = 8681.61, P < .05) but the other indices showed improvement (RMSEA = .058 [90% CI, 0.057-0.059], TLI = .891, CFI = .903, and SRMR = .059). The discriminating power of the J-CCCHS was indicated by statistically mean differences in J-CCCHS subscale scores between predefined groups. Taking into consideration that this is the first foray into construct validation for this instrument, and that fit was improved when a subsequent data driven model was tested, and it has the ability to distinguish between known groups that are expected to differ in cultural competence, the instrument can be of value to clinicians and educators alike.
本文描述了日文版卡弗里文化能力健康服务量表（J - CCCHS）的因素分析测试和结构效度验证。该量表由28个项目组成，通过语言和主题专家进行翻译。对来自日本各地19家医院的护士（N = 7494，92%为女性，平均年龄32.6岁）进行了心理测量测试（探索性因素分析、α信度分析和验证性因素分析）。采用主成分提取法和方差最大化旋转得到了一个五因素模型（解释方差为62.31%），分别命名为：知识、近端舒适感、远端舒适感、意识以及国家政策意识。各分量表的Cronbach α系数在0.756至0.892之间。在使用稳健最大似然估计器进行的验证性因素分析中，卡方检验结果如下：χ(340) = 14604.44，P <.001。引入相关误差后，有证据表明模型拟合得到改善（χ(335) = 8681.61，P <.05），但其他指标也有所改善（RMSEA =.058 [90% CI，0.057 - 0.059]，TLI =.891，CFI =.903，SRMR =.059）。J - CCCHS的区分能力通过预定义组之间J - CCCHS分量表得分的统计学平均差异来体现。考虑到这是对该工具进行结构效度验证的首次尝试，并且在测试后续数据驱动模型时拟合得到了改善，同时它有能力区分预期在文化能力方面存在差异的已知组，该工具对临床医生和教育工作者都具有价值。
