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Validity and utility of the Swedish version of the Cultural Competence Assessment Instrument
Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0002-9455-9491
Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-2980-2835
Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
2019 (English)In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 82, no 7, p. 422-432Article in journal (Refereed) Published
Abstract [en]

Introduction: Global migration as well as migration to Sweden has increased during the last few decades. A self-rating instrument that measures cultural competence could support occupational therapists' professional knowledge when they encounterclients from different cultural backgrounds. The purpose of this study was to evaluate the content validity and utility of the Swedish version of the Cultural Competence Assessment Instrument among occupational therapists. Nineteen occupational therapists participated in four focus groups.

Method: Qualitative analysis was used to evaluate content validity and utility.

Results: The results revealed that all 24 items of the Cultural Competence Assessment Instrument were valid, even though six of the items were in need of reformulations and exemplifications. The category Interactions with clients showed that the Cultural Competence Assessment Instrument – Swedish version could be utilised individually to raise awareness on cultural issues inpractice. The category Workplace and its organisational support showed that the Cultural Competence Assessment Instrument – Swedish version had potential for use in different workplaces, and indicated the importance of organisational support in the development of communications and cultural competence.

Conclusion: The evaluation indicated positive content validity for the Cultural Competence Assessment Instrument – Swedish version, and that it had the potential to be utilised in the Swedish context.

Place, publisher, year, edition, pages
2019. Vol. 82, no 7, p. 422-432
Keywords [en]
Instrument development, occupational therapy, qualitative research, ethnicity, cultural competence
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:liu:diva-156137DOI: 10.1177/0308022619825813ISI: 000473502900005OAI: oai:DiVA.org:liu-156137DiVA, id: diva2:1302603
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-07-19
In thesis
1. Cultural Competence for Health Professionals: Instrument Development
Open this publication in new window or tab >>Cultural Competence for Health Professionals: Instrument Development
2019 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

In recent decades, both global migration in general and specifically migration to Sweden have increased. This development compels the need for delivering healthcare to the increasingly diverse populations in Sweden. To support health professionals, for instance occupational therapists, in developing their professional knowledge in encounters with foreign-born clients a self-rating instrument measuring cultural competence is developed. This may contribute to the development of suitable services for foreignborn clients and improve person-centered interventions for these clients.

The general aim of this thesis was to develop an instrument for health professionals by examining psychometric properties and utility of the Swedish version of the Cultural Competence Assessment Instrument (CCAI-S) among occupational therapists. The specific aim of study I was to evaluate the content validity and utility of the Swedish version of the Cultural Competence Assessment Instrument (CCAI-S) among occupational therapists. The study had a descriptive and explorative design. Nineteen occupational therapists participated, divided into four focus groups. Qualitative content analysis was used to examine the content validity and utility of the CCAI-S. The specific aim of study II was to examine the clinical relevance, construct validity and reliability of the Swedish version of the Cultural Competence Assessment Instrument (CCAI-S) among Swedish occupational therapists. The study had a cross-sectional design. A web-based questionnaire was e-mailed to a randomised sample of 428 occupational therapists to investigate the construct validity, reliability and utility of the CCAI-S. Factor analysis was performed as well as descriptive statistics.

The findings from study I revealed high content validity for all 24 items. However, six items needed reformulations and exemplifications. Regarding utility, the results showed strong support for CCAI-S. The category ‘Interactions with clients’ showed that the CCAI-S could be utilised individually for the health professional and create a higher awareness of cultural questions in practice. The category ‘Workplace and its organisational support’ displayed potential for use in different workplaces regarding CCAI-S and indicated the importance of organisational support for health professionals in the development of cultural competence. The findings from study II regarding construct validity generated a three-factor model with the labels ‘Openness and awareness’, ‘Workplace support’ and ‘Interaction skills’. All three factors showed high factor loadings and contained 12 of the 24 original items. The Cronbach’s Alpha showed high support for the three-factor model. Concerning utility, the participants reported that all 24 items had high clinical relevance.

In conclusion, the findings from the two studies indicated good measurement properties and high clinical relevance for the CCAI-S. This may sup-port the utilisation of CCAI-S in the Swedish context for health professionals, for instance occupational therapists. The results of the instrument development show that the upcoming published version of the CCAI-S can be a valuable self-assessment tool for health professionals who strive to improve in person-centred communication in encounters with foreign-born clients. CCAI-S can also be of support for the organisation to serve as a guide for what to focus on to develop cultural competence within the staff. Altogether this presumably influence the effectiveness of the healthcare and enhance the evidence of interventions for foreign-born clients. To develop an instrument is an iterative process requiring several evaluations and tests in various settings and populations. Therefore further psychometric testing and utility studies on the CCAI-S is crucial.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2019. p. 82
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 137
Keywords
self-assessment, occupational therapy, ethnic groups, cultural competency, health personnel, qualitative research, psychometrics
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-156147 (URN)10.3384/lic.diva-156147 (DOI)9789176851265 (ISBN)
Presentation
2019-04-29, K3, Kåkenhus, Campus Norrköping, Norrköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2019-04-05 Created: 2019-04-05 Last updated: 2019-04-05Bibliographically approved

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Holstein, JaneLiedberg, Gunilla M.Öhman, AnnikaKjellberg, Anette

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