Cultural self-efficacy of licensed registered nurses in New Mexico.

Abstract: This study determined the level of cultural self-efficacy of licensed Registered Nurses caring for multiethnic patients (White non-Hispanic, Hispanic, African American Native American and Asian American) in New Mexico, and the level of influence of various background and demographic variables. The sample consisted of 1000 randomly selected New Mexico licensed RNs. The Cultural Self-Efficacy Scale, developed by Bernal and Froman (1987), was modified and used to measure the confidence level of the licensed Registered Nurses. It is a 25-item Likert-type scale that groups cultural self-efficacy ratings into three categories: (a) knowledge of cultural concepts; (b) self-efficacy in performing cultural nursing skills; and (c) knowledge of cultural life patterns for specific ethnic groups. The data show that RNs in New Mexico are moderately efficacious in caring for patients/clients of cultures other than their own. Few demographic variables (age, number of years an RN) correlated with higher cultural self-efficacy levels. This study provided information on practicing nurses in New Mexico which, to date, was non-existent. Licensed Registered Nurses in New Mexico are moderately efficacious in caring for patients of five cultural/ethnic groups. Key Words: Cultural Diversity, Cultural Self-Efficacy, Registered Nurses, New Mexico Today's health care systems serve an increasing number of persons from traditions based on non-Western, non-European medical traditions, religious philosophies, values, and worldviews (Salimbene, 1999). By 2056, the majority of Americans will trace their roots to somewhere in the world other than Europe (Takaki, 1993). This trend will influence society at every level, and nowhere more importantly than in health care. New Mexico has a richly diverse population that consists of primarily five major ethnic/racial groups: non-Hispanic White (44.7%), Hispanic (42.1%), Native American (8.9%), African American (1.7%), and Asian American (1%) (U.S. Bureau of Census, 2000). Minority populations in New Mexico experience poorer health overall than non-minority populations (State of Health in New Mexico: 2000 Report, 2000). Although Hispanic, Native American and African Americans in New Mexico have lower death rates due. to heart disease and malignant neoplasms, they have higher death rates due to accidents, diabetes, cirrhosis and homicide (State of Health in New Mexico: 2000 Report, 2000). Health care professionals in New Mexico, including registered nurses, must be able to care for clients from different cultural backgrounds than their own. Thus, what we do today to identify strengths and overcome weaknesses in our health care providers will mean better care and outcomes for our increasingly diverse population of the future. This study measured the cultural self-efficacy of a randomly selected sample of licensed Registered Nurses in New Mexico and the level of influence of various demographic variables using the Cultural Self-Efficacy Scale (CSES) developed by Bernal and Froman (1987). A culture is a collection of symbols that is shared, learned, and passed on through generations of a group (Lipson, Dibble & Minarik, 1997). When nursing care fails to accurately reflect the patient's beliefs, values, and ways of caring, there may be conflict, noncompliance with medical regimes, stress, and ethical and moral concerns (Leininger, 1991). These potential negative outcomes can be avoided when there is mutual respect and sensitivity to our differences (Pachter, 1994). Providing culturally appropriate health care requires knowledge of theories that guide that care. One such theory is Leininger's Theory of Culture Care Diversity and Universality (1991). The purpose of the theory is to discover, document, interpret, and explain the multiple factors influencing and explaining care from a holistic cultural perspective (Leininger, 1991). Factors that influence how a person relates to health care systems and health care providers include the person's worldview, social structure, religion, economics, education, technology, political, social, ethnohistory, environmental context, language, and generic and professional care factors. …