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Background and Purpose: Growing diversity in health care requires culturally competent care. Assessing nurses' cultural competence is the first step in designing cultural competency education. The Clinical Cultural Competency Questionnaire (CCCQ) is one instrument to assess nurses' cultural competence. Methods: The psychometric properties and factor structure of the revised CCCQ-PRE (CCCQ-PRE-R) for nurses was examined. Results: A 1-factor solution was noted for the knowledge and skills subscales. A 2-factor solution was discovered for the comfort and awareness subscales: differentiating between comfort in dealing with positive and negative cross-cultural encounters/situations, and differentiating between importance awareness and self-awareness. Cronbach's alpha coefficients were high for all subscales. Conclusions: The findings support the use of the revised CCCQ-PRE-R with nurses. Further testing in larger, more diverse nursing populations is warranted.
Keywords: factor analysis; nurses; cultural competence; psychometric testing
The United States is continuing to experience rapid growth with a constantly evolving demographic profile. The U.S. Census Bureau (2011) reports a 9.7% increase in the total number of U.S. residents between 2000 and 2010, with notable percentage increases in the numbers of Hispanic or Latino (58.1%), Black or African American (36.9%), Asian (86.9%), and American Indian/Alaska Natives (32.3%) residents. Growing racial and ethnic diversity in the health care arena requires that nurses provide culturally competent care.
Luquis and Perez (2003) define cultural competence as the ability of a nurse to acknowledge, understand, respect, and individualize nursing care to a patient/family's cultural values, attitudes, beliefs, and mores. Cultural competence requires knowledge and skills, along with an appreciation for the context in which the nursing encounter takes place (St. Clair & McKenry, 1999). Culturally competent care is more than an ethical requirement for patient and family care; it is a directive of major health care accrediting organizations, including the Joint Commission. The Joint Commission (2010) mandates that clinicians assess for and adapt care to unique cultural values and beliefs to provide safe, effective, and equitable patient and familycentered care.
Understanding nurses' levels of cultural competence is an important first step in designing educational programs to improve cultural competence awareness, knowledge, skills, and comfort during patient/family encounters. The Clinical Cultural Competency Questionnaire (CCCQ) developed by Like (2004) and revised by Krajic, Strabmayr, Karl-Trummer, NovakZezula, and Pelikan (2005) is one instrument that organizations...