The level of cultural self-efficacy among a sample of Spanish nurses in southeastern Spain.

A collaborative study between faculty from the United States and Spain was undertaken to investigate levels of cultural self-efficacy among a sample of Spanish nursing students and nurses. Bandura's self-efficacy theory provided the conceptual framework for this descriptive study. The Spanish version of the Cultural Self-Efficacy Scale (CSES-S) was translated from the original developed by Bernal and Froman using the back-translation technique recommended by Brislin. The CSES-S was administered to 113 Spanish nurses and students. Alpha coefficient results for the CSES-S ranged from .90 to .95. Low to neutral levels of confidence in caring for four ethnic groups were found. Regression analyses showed significant relationships between cultural exposure and cultural self-efficacy for the practicing nurses. Results will assist this collaborative transcultural nursing research effort between the United States and Spain to develop and implement programs and experiences to increase cultural self-efficacy among Spanish nurses and improve care provided to Spain's diverse population.

Acculturation level and postpartum depression in Hispanic mothers.

PURPOSE: Perinatal health outcomes for Hispanic women are associated with acculturation. The purpose of this study was to explore the relationship between acculturation levels and postpartum depressive symptomatology and diagnosed postpartum depression among Hispanic subgroups. STUDY DESIGN AND METHODS: The Postpartum Depression Screening Scale and the Short Acculturation Scale were used in the two phases of data collection. Phase 1 and 2 samples consisted of 377 and 150 Hispanic mothers, respectively. Puerto Rican mothers showed higher levels of acculturation than Mexican and other Hispanic women. A DSM-IV diagnostic interview (SCID) was used to establish a diagnosis of depression. Hierarchical regression analyses were used to study the unique relationships between ethnicity, depressive symptomatology, diagnosed depression, and acculturation. RESULTS: There was no consistent relationship between acculturation and postpartum depression. Significant predictors of elevated postpartum depressive symptoms in Hispanic mothers were Puerto Rican ethnicity and cesarean delivery. Single marital status was a significant risk factor for postpartum depression. A limitation of the study was use of language as the sole criterion measure for acculturation. Acculturation is a complex construct with problematic measurement that needs greater refinement to facilitate research in which it is used as a variable. CLINICAL IMPLICATIONS: Hispanic mothers are a heterogeneous group and should not be treated as a homogeneous group. Subgroups of Hispanic mothers may not have the same level of acculturation or the same level of postpartum depressive symptomatology.

An integrative review of American nurses' perceived cultural self-efficacy.

PURPOSE: To review use of the Cultural Self-Efficacy Scale (CSES) and to summarize the cumulative findings. METHODS: A combination of literature searches and questionnaires to those who have requested the scale indicated 26 known uses. Fifteen reported sufficient data for statistical analysis. FINDINGS: Of the 26 known uses of the CSES, 8 were published in peer-reviewed journals, 5 in dissertations, 8 in theses, and 3 as data sets only. Two additional theses were not retrievable for the study. On a 5-point Likert-type scale, nurses reported the highest degree of self-efficacy with African American (3.1) and Hispanic (3.1) patients and the lowest with Asian American patients (2.4). Six of the reports include Cronbach's alpha coefficients, ranging from .86 to .98. In the final sample of 15 studies, nurses did not report feeling confident caring for patients from other cultures. CONCLUSIONS: Although the CSES has been used in many settings with over 3,000 nurses, inconsistencies in the data preclude specific conclusions. Further research is needed using consistent reporting practices and sufficient predictor variables to draw further conclusions regarding the scale's psychometric properties.

Essential concepts in developing community-university partnerships. CareLink: the Partners in Caring Model.

University and community partnerships are being created to increase community-based educational experiences for nursing students and to assist agencies in facing ever-decreasing resources to pay for health services for clients. Many challenges often burden these partnerships, leading to a less than satisfying experience for all those involved. The Partners in Caring Model described in this article is one approach to forming a successful partnership, proven effective in meeting the educational needs of the University of Connecticut, School of Nursing students, while providing additional resources to the Visiting Nurse Association of Central Connecticut, Inc. Using Anderson and McFarlane's Community as Partner Model as the framework, the essential principles behind the development of this successful partnership are discussed. The Partners in Caring Model demonstrates that community-university partnerships can sustain themselves when the partners have a commitment to care for the population being served, and it is a shared responsibility between education and practice.

Methods to document semantic equivalence of a translated scale.

To ensure the semantic equivalence of the Postpartum Depression Screening Scale (PDSS)-Spanish Version, multiple methods were used, including back-translation, the committee approach, pretest techniques, and alternate forms equivalence. The back-translation process involved eight translators who represented the four predominant Hispanic groups in the United States. In the committee approach the Hispanic translators convened together to discuss the results of the back-translations and to come to group consensus on problematic items. In pretesting the PDSS-Spanish Version was field-tested with five Hispanic mothers, and it was determined that it accurately captured the connotative meanings of the screening scale. Alternate forms equivalence of the two language versions of the PDSS was assessed with a sample of 30 bilingual Hispanic mothers. Alpha reliability estimates ranged from 0.94 to 0.99. Though lengthy, this systematic procedure was needed to guarantee the production of a fully equivalent linguistic version of the PDSS.

The role of social support in the self-management of diabetes mellitus among a Hispanic population.

The rising incidence of diabetes mellitus continues to be a major health concern among Hispanic Americans. Social support has been found to be a relevant factor in diabetes self-management, however, it has not been explored within a Hispanic community. This cross-sectional study was therefore conducted with 95 insulin-requiring Hispanic adults to explore the composition of the support network, the type of assistance needed, the degree of satisfaction with support received, and the relationship between social support and diabetes self-management. Overall, the participants had fairly large networks, composed primarily of family members. The greatest need for assistance was associated with transportation or interactions that involved speaking English, and the assistance offered in these areas was viewed as highly satisfactory. Participants were least satisfied with the help they received for diabetes-related self-care, personal care, and financial assistance. Social support was not strongly related to diabetes self-management. Community health nurses must be aware that this population may have needs that are unsatisfactorily met. They should provide education and resources for support persons and carefully evaluate the support network, not only for availability, but also for satisfaction. Effort should also be directed toward developing alternative support for those without available family.