New Mexico nurses' cultural self-efficacy: a pilot study.

Abstract: Health care providers must develop a level of comfort in caring for patients/clients from cultures other than their own. A pilot study of 15 registered nurses caring for multiethnic patients in New Mexico was conducted to determine their level of self-efficacy, to test the Cultural Self-Efficacy Scale, and to determine the feasibility of a larger study. The participants were moderately confident with their knowledge of cultural concepts, cultural nursing skills, and three of the five ethnic groups' cultural life patterns. Although no conclusions can be drawn due to the small convenience sample, this study should lead to larger, more rigorous studies. Key Words: Cultural Self Efficacy; New Mexico; Nurses Our society is becoming more and more diverse. Lipson, Dibble, and Minarik (1997) describe a tapestry of culturally diverse societies made up of various threads. Some are thick and fluffy, some thin and strong, while others are sleek and shiny, each adding to the beauty of the whole. Diversity influences society at all levels and nowhere more importantly than in health care. New Mexico is listed as second in the list of the ten fastest-growing states (New Mexico Department of Health, 1999). The U.S. Census Bureau (2000) projects that by 2025, African Americans in New Mexico will increase 36.2%; Native Americans, 83.2%; Hispanics, 88.5%; and Asian Americans, 116.6%. Health care professionals in New Mexico must be able to care for clients from cultural backgrounds different from their own. The efficaciousness of all health care providers in caring for multiethnic patients is especially important since we tend to avoid uncomfortable situations, which can lead to a decrease in health care services (O'Leary, 1985). Health care that is not congruent with a patient's beliefs, values, and expectations can cause conflict, leading to noncompliance with prescribed plans of care, resulting in stress and ethical and moral concerns (Leininger, 1991). Potential negative outcomes can be avoided when there is sensitivity to and respect for our differences (Pachter, 1994). A pilot study was performed to determine the level of self-efficacy of licensed registered nurses (RNs) in caring for multicultural patients/clients in New Mexico, as well as to test the Cultural SelfEfficacy Scale (CSES; Bernai & Froman, 1987) and to determine the feasibility of a larger study. The concepts of culture and self-efficacy were important to this study. Leininger (1991) defined culture as "the learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group that guides their thinking, decisions, and actions in patterned ways" (p. 46). It is a dynamic concept and therefore in constant flux, always combining the lived experiences of the person or group. Bandura (1977) defined self-efficacy as the belief that one can successfully complete a task or behaviors to accomplish an outcome. METHOD Sample A convenience sample of 15 licensed RNs in New Mexico participated in the study. The size of the sample was based on acceptable pilot study protocol (personal communication, P. Duryea, July 15, 1999). There were no exclusion criteria, and consent to participate was implied by participants completing and returning the survey. This study followed all guidelines for and was approved by The Institutional Review Board of the University or New Mexico. Instrument The CSES, developed by Bernai and Froman (1987) and modified by Kulwicki and Bolonik (1996), was used to measure the confidence level of the licensed RNs in providing cultural care for five ethnic groups (Middle Eastern/Arab American, Hispanic, African American, Native American, and Asian Pacific Islander). The participants were given or mailed the questionnaire with a self-addressed stamped return envelope. Permission to use the tool was obtained from Drs. Bernal and Froman prior to its administration. …