A preliminary multicultural nursing competence instrument for assessing undergraduate student nurses

Purpose:To develop a multicultural nursing competence instrument for use in assessing undergraduate student nurses(SNs).Methods:This study enrolled 322 student nurses(SNs)employed at five hospitals in Hunan Province.The nurses were identified by the cluster sampling method.The items on the competence instrument were retained or deleted after analyzing their coefficient of variation,coefficient of correlation with the total score,t-test results.Reliability tests and correlation analysis were used to examine internal consistency,while exploratory factor analysis was used to determine construct validity.Results:After analyzing items,the final multicultural nursing competence instrument comprised a total of 49 items that evaluated five dimensions.The instrument showed good overall reliability(0.958),and the internal consistency of the five dimensions ranged from 0.884 to 0.952.Furthermore,the correlations among the five dimensions were statistically significant(P<0.01).An exploratory factor analysis of the five dimensions showed that five items incorporated aspects of cultural cognition(factor loading range,0.824-0.888),five items incorporated aspects of cultural attitude(factor loading range,0.629-0.815),twentytwo items involved cultural knowledge(factor loading range,0.587-0.792),seven items incorporated aspects of cultural skills(factor loading range,0.743-0.860),and 10 items involved cultural encounters(factor loading range,0.522-0.909).Conclusion:The multicultural nursing competence instrument for SNs demonstrated good reliability and validity,and can be utilized in nursing education programs and research.

Controversies on the Values for Health Instruments of Chinese Medicine

Currently, there are increasing debates on the necessity of health instruments in Chinese medicine（CM） emerging in China. This study aims to reevaluate its status and values. Analyzing the causes, limits, advantages, and properties characters of health instruments in CM, it is found that weak fundamental research, incomplete self-awareness, and complicated social factors are the primary causes of debates. A comprehensive analysis showed health instruments in CM have health evaluation benefits to people from a dominant Chinese culture, meet the requirements of cultural background, and bring long-term value to Chinese instrument researches. However, its values and status should be treated differently depending on various subtypes. Although little theoretical and practical evidences proved that patients-reported health instruments in CM should be proposed independently, the doctors- and nurses-reported questionnaires are necessary. With this in mind, the study group proposes the ＇Chinese cultural instruments（CCIs）＇ and ＇health-related CCIs＇. The latter one aims to evaluate the health status of people in a dominant Chinese culture. The CCIs theory represents Chinese instrument researches on a larger regional and higher level, and resolves the debates on instruments between CM and Western medicine in China. Health instruments in CM bring more scientific and social benefits for Chinese instrument researches. However, it does not include cultural demands, and lacks scientific significance. CCIs have all its virtues, and add solutions to the latter＇s theory bottleneck and scientific debates, thus bringing increased benefits to clinical assessment in complementary and alternative medicine researches.

Assessing the Quality of the First Batch of Evidence-Based Clinical Practice Guidelines in Traditional Chinese Medicine

Objective: To assess the quality of the first batch of Chinese evidence-based clinical practice guidelines (CPGs) in Traditional Chinese Medicine (TCM) using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Methods: Evidence-based CPGs in TCM supported by the World Health Organization Western Pacific Regional Office (WHO/WPRO) and whose development was organized by the China Academy of Chinese Medical Sciences were identified and manually retrieved. CPGs were assessed using the AGREE instrument, and the data in each CPG were analyzed in terms of the six domains in the AGREE instrument: scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, and editorial independence. Results: Twenty-eight CPGs were identified, of which 26 were included in the study. The AGREE instrument rated the 26 CPGs in terms of the six domains. The assessment results showed the following average scores: for editorial independence, 84.16%; for rigor of development, 80.95%; for scope and purpose, 79.96%; for clarity and presentation, 70.88%; for stakeholder involvement, 61.28%; for applicability, the average score was only 27.09%. In summary, nine CPGs were rated as "strongly recommended", six as "recommended with provision or alternation", and 11 as "unsure". Conclusion: Most of the first batch of Chinese evidence-based CPGs in TCM had significant shortcomings in applicability. It is suggested that special attention be paid to enhancing the quality of applicability when developing evidence-based CPGs in TCM.