Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihira-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan.
Nakagami Hospital, 610 Noborikawa, Nakagami-Gun, Okinawa, 904-2142, Japan.
BMC Health Serv Res. 2024 Mar 23;24(1):369. doi: 10.1186/s12913-024-10814-6.
To provide better quality healthcare services to patients with different linguistic and cultural backgrounds, the cross-cultural competence of medical professionals is important. However, assessing and improving the cross-cultural competence of healthcare professionals is difficult in Japan, as there is no standardized scale to measure the competence. This study's purpose was to translate the Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP), which was developed and used in Europe, and to examine its reliability and validity among Japanese nurses.
During June and July 2021, nursing staff were invited to take web- and paper-based surveys in Okinawa Japan. The CCCHP (five-factor model with 27 items across motivation, attitude, skills, emotion, and knowledge) was translated using a combination translation method, and a five-point Likert scale was used for responses. Exploratory and confirmatory factor analyses and known-group method were used to examine structural validity, while Cronbach's alpha coefficient was used to test reliability.
A total of 294 responses were analyzed; 77.2% had more than five years of experience. Since the fit index indicated that the five-factor model was not a good fit, it was modified to a four-factor model (J-CCCHP24) by moving three variables, removing the knowledge factor, and using the error covariance of the variables. The fit index after the modification was improved to comparative fit index (CFI) = 0.92, Tucker-Lewis index (TLI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, and standardized root mean square residual (SRMR) = 0.06, and Cronbach's alpha was 0.85. The mean scores of J-CCCHP24 were significantly higher in the group with a history of overseas travel, higher foreign language skill, training in intercultural care, experience of foreign patient care, and intercultural interactions outside the workplace than in the group without these characteristics.
This study confirmed the validity and reliability of the modified Japanese version of the CCCHP (four-factor model with 24 items). The results suggest that the exposure to different cultures on a personal level may help improve nurses' cross-cultural competence. Further refinement of this scale for practical use would encourage the implementation of necessary countermeasures to improve the cross-cultural competence of Japanese healthcare professionals.
为了向具有不同语言和文化背景的患者提供更好的医疗服务，医学专业人员的跨文化能力很重要。然而，在日本，评估和提高医疗保健专业人员的跨文化能力具有挑战性，因为没有标准化的衡量能力的量表。本研究的目的是翻译在欧洲开发和使用的《医疗保健专业人员跨文化能力量表》（CCCHP），并检验其在日本护士中的信度和效度。
2021 年 6 月至 7 月，邀请冲绳的护理人员参加网络和纸质调查。使用组合翻译方法翻译 CCCHP（五因素模型，包含动机、态度、技能、情感和知识 27 个项目），并采用 5 点李克特量表进行作答。采用探索性和验证性因子分析以及已知群体法检验结构效度，同时采用克朗巴赫 α系数检验信度。
共分析了 294 份答卷；77.2%的答卷者有 5 年以上的工作经验。由于拟合指数表明五因素模型拟合不佳，因此通过移动三个变量、删除知识因素以及使用变量的误差协方差，将其修改为四因素模型（J-CCCHP24）。修改后的拟合指数得到改善，比较拟合指数（CFI）=0.92，塔克-刘易斯指数（TLI）=0.91，近似均方根误差（RMSEA）=0.05，标准化均方根残差（SRMR）=0.06，克朗巴赫 α系数为 0.85。在有海外旅行经历、外语技能较高、接受跨文化护理培训、有照顾外国患者经验以及有工作场所之外的跨文化互动经历的组中，J-CCCHP24 的平均得分显著高于没有这些特征的组。
本研究证实了经过修改的 CCCHP（四因素模型，包含 24 个项目）的日本版本的有效性和可靠性。结果表明，个人层面上接触不同文化可能有助于提高护士的跨文化能力。进一步细化该量表以便实际应用，将鼓励实施必要的对策，以提高日本医疗保健专业人员的跨文化能力。
