A multilevel investigation of cultural competence among South Korean clinical nurses.

BACKGROUND: There is lack of empirical evidence on whether organisational variables affect the cultural competence of nurses. AIM: This study aimed to investigate individual and organisational characteristics associated with South Korean clinical nurses' cultural competence. METHODS: A descriptive cross-sectional research design was used. A convenient sample of 401 clinical nurses from 21 hospitals in South Korea was recruited between November 2015 and February 2016. Multilevel modelling was used to estimate the effects of individual- and organisation-level predictors. Data were analysed using the nlme package in R. RESULTS: Multilevel modelling indicated that professionalism (ß = 0.02, p < 0.001) and foreign language fluency (ß = 0.25, p = 0.012) were significant individual-level predictors. Education on foreign patient care was marginally significant at p = 0.069. At the organisational level, nurse-to-patient ratio (ß = 0.37, p = 0.038) and organisational cultural competence (ß = 0.02, p < 0.001) were significant predictors. In addition, hospital ownership and work environment were marginally significant at p = 0.054 and p = 0.050, respectively. Furthermore, there was a significant cross-level interaction between professionalism and hospital ownership (ß = 0.03, p = 0.003). CONCLUSION: To provide culturally competent care, nurse leaders should recognise the importance of organisational-level factors, such as nurse staffing and organisational cultural competence, and create an environment that is inclusive of diverse patients, as well as promote professionalism among individual nurses.

Evaluation of the psychometric properties of the Korean version of the Cultural Competence Assessment.

AIM: The 25 item Cultural Competence Assessment assesses the cultural competence of multiple types of healthcare providers. This study aimed to examine the validity and reliability of the Korean version of the questionnaire (KCCA) and to determine the need for changes to improve its validity and reliability. METHODS: Data from 161 hospital nurses were used for the item analysis and to assess the reliability and construct validity of the KCCA before and after the deletion of nine items. RESULTS: The KCCA did not demonstrate acceptable construct validity and subscale internal reliability. Nine items with high interitem correlations, high modification indices, and relatively lower factor loadings were deleted. The 16 item Modified KCCA showed improved construct validity, convergent and discriminant validity, and reliability. CONCLUSION: While further psychometric evaluation of the Modified KCCA should be undertaken with larger samples and diverse professionals, the study's data provide evidence that the Modified KCCA might be a more suitable measure for use among Korean healthcare providers.

[Development of performance measure indicators in hospital nursing units].

PURPOSE: The purpose of this study was to develop performance measure indicators for hospital nursing units based on a Balanced Scorecard (BSC). METHOD: This study was a methodological study. The development process consisted of 3 stages. The first stage was setting up strategies for nursing units from a nursing department's mission and vision. The second stage was developing performance measure indicators after a validity check. The third stage was modifying developed performance measure indicators and classifying them. RESULTS: 7 strategies were set up according to 4 perspectives of a BSC. 15 performance measure indicators for hospital nursing units were developed, and the indicators were divided into 8 independent indicators and 7 shared indicators according to the degree of performance responsibility. In addition, they were classified into two groups, 7 leading indicators and lagging indicators. CONCLUSIONS: The result of this study suggests that performance measure indicators for hospital nursing units provide a framework and method for nursing organizations' performance management. Also, the developed indicators are expected to provide valuable information for successful organization management.

[Health status, health perception, and health promotion behaviors of low-income community dwelling elderly].

PURPOSE: The purpose of the study was to investigate the health status(present illness, ADL and IADL), health perception, and health promotion behaviors of low-income elderly who are receiving the visiting nurse service in the community. METHOD: The sample of the study was 735 elderly over 65 years old with basic livelihood security, who were conveniently selected from 245 public health centers nation-wide. Data collection was done using a structured questionnaire through interviews by visiting nurses. RESULT: The average number of present illnesses in the study subjects was 4.18. The average scores of ADL and IADL were 15.903.39 and 9.772.97 respectively, which indicates a relatively independent everyday life. However, 64.2% of the subjects perceived their health status as 'not healthy'. In terms of health promotion behaviors, 77.8% of the subjects had ceased smoking, 83.9% stopped drinking, 56.4% had a regular diet, 45.8% received regular physical check-ups during the past two years, and 66% received flu shots. Approximately 50% of the subjects were practicing 3-4 health promotion behaviors. Significant factors associated with health promotion behaviors were ADL, IADL and self-efficacy. CONCLUSION: Health promotion programs which focus on regular diet, exercise, and regular physical check-ups should be developed to improve independence of everyday life and quality of life among low-income elderly.