Identification of nursing assessment models/tools validated in clinical practice for use with diverse ethno-cultural groups: an integrative review of the literature

Abstract

BackgroundHigh income nations are currently exhibiting increasing ethno-cultural diversity which may present challenges for nursing practice. We performed an integrative review of literature published in North America and Europe between 1990 and 2007, to map the state of knowledge and to identify nursing assessment tools/models which are have an associated research or empirical perspective in relation to ethno-cultural dimensions of nursing care.MethodsData was retrieved from a wide variety of sources, including key electronic bibliographic databases covering research in biomedical fields, nursing and allied health, and culture, e.g. CINAHL, MEDline, PUBmed, Cochrane library, PsycINFO, Web of Science, and HAPI. We used the Critical Appraisal Skills Programme tools for quality assessment. We applied Torraco's definition and method of an integrative review that aims to create new knowledge and perspectives on a given phenomena. To add methodological rigor with respect to the search strategy and other key review components we also used the principles established by the Centre for Reviews and Dissemination.ResultsThirteen thousand and thirteen articles were retrieved, from which 53 full papers were assessed for inclusion. Eight papers met the inclusion criteria, describing research on a total of eight ethno-cultural assessment tools/models. The tools/models are described and synthesized.ConclusionsWhile many ethno-cultural assessment tools exist to guide nursing practice, few are informed by research perspectives. An increased focus on the efficiency and effectiveness of health services, patient safety, and risk management, means that provision of culturally responsive and competent health services will inevitably become paramount.

Sociocultural and linguistic boundaries influencing intercultural communication between nurses and Moroccan patients in southern Spain: a focused ethnography

“…Unfortunately, to date there is a paucity of primary research that specifically investigates the use of a model or tool in improving nursing care delivery and patient satisfaction/outcomes [35]. In general, most of the evidence related to models and tools developed to enhance cultural competency in nursing practice has focused primarily on education and training of nurses and health professionals.…”

“…To improve social harmony, cultural respect and quality of care, nurses must master intercultural communication and their ability to appropriately adapt their nursing care to various ethnocultural groups. Part of this process will depend on their becoming knowledgeable about other cultures and alternative ways of experiencing the health-disease process, but more importantly about nursing theories and models exploring cultural care and cultural nursing competence [13,14,35,37]. …”

Evaluating the utility of the FamCHAT ethnocultural nursing assessment tool at a Canadian tertiary care hospital: A pilot study with recommendations for hospital management

“…After full article review, eight papers were selected that described eight models/tools for use in ethnocultural nursing practice (see Figure 1). Many of these assessment tools and models are based on clinical experience but have never been tested in any manner for use within nursing practice [22] . One of the tools, an open-ended questionnaire entitled the Family Cultural Heritage Assessment Tool (FamCHAT), was developed to add cultural dimensions to an existing validated family health assessment tool (FAMTOOL) and evaluated for reliability with 131 Kansas clients ages 8-80 in a rural family practice [24,25] .…”

“…In nursing, models of cultural competency have tended to be seminally informed by the transcultural nursing theory of Leininger [22,23] . The research team performed a critical review of the literature to identify an empirical perspective on the use of a model or tool within clinical nursing practice specifically devised for use with diverse ethnocultural groups, and which might thus be transferable to the care context at this particular hospital [22] .…”

“…In nursing, models of cultural competency have tended to be seminally informed by the transcultural nursing theory of Leininger [22,23] . The research team performed a critical review of the literature to identify an empirical perspective on the use of a model or tool within clinical nursing practice specifically devised for use with diverse ethnocultural groups, and which might thus be transferable to the care context at this particular hospital [22] . Using a systematic approach with a comprehensive search strategy, many of the abstract citations described the development/validation of tools such as questionnaires for use with specific disease states or procedures, and not related to cultural aspects of care, and for evaluating various training programs in the topic.…”